Psoriasis diagnoses in primary care settings may be delayed by up to five years, according to a study by the University of Manchester.

In primary care settings, researchers have found psoriasis is often misdiagnosed as other skin conditions such as eczema or fungal infections, and opportunities for early diagnosis are often missed.

Patients later diagnosed with psoriasis are more than twice as likely as other patients to be prescribed steroid or antifungal creams when they go to a GP. This treatment can often mask the signs and symptoms of psoriasis and contribute to a delay in diagnosis.

The findings are published in The British Journal of General Practice.

Psoriasis affects around 3% of people in the UK and is linked with other serious medical conditions such as arthritis, heart disease and depression. The debilitating skin disease can lead to the deterioration of a patient’s quality of life and general practice is often the first point of contact for people with the condition.

Using electronic health records from more than 700 general practices in the UK, the researchers analysed data from over 100,000 patients between 2010 and 2017.

By comparing the clinical diagnoses and treatments for people with and without psoriasis, the researchers identified delays in diagnosis and treatment. The analysis was repeated with a second database, the Clinical Practice Datalink Aurum, looking at data from over 77,000 patients.

Patients with psoriasis were up to eight times more likely than those without psoriasis to be diagnosed with the minor skin condition, pityriasis rosea, six months before the diagnosis of psoriasis. One year before diagnosis, patients were twice as likely to be diagnosed with eczema or the fungal infection, tinea corporis.

Lead author Maha Abo-Tabik, from the University of Manchester, said: ‘We already know that early diagnosis of psoriasis can improve the effectiveness of treatment for psoriasis, so these findings are pertinent.’

Patients were also more likely to report symptoms of psoriasis such as dry skin, rash, skin texture changes and itching than controls up to five years before diagnosis.

Professor Chris Griffiths from the University of Manchester and head of the GPA said: ‘The findings from this study suggest the diagnosis of psoriasis may be missed or delayed by up to five years for some individuals hence leading to a potentially detrimental delay in establishing an appropriate treatment regimen. It is crucial that diagnosis and treatment start as soon as possible if patients are to reduce the risk of life-long impairment.’

This comes after the National Institute of Health and Care Excellence (NICE) recommended secukinumab for children aged 6 to 17 with severe plaque psoriasis last September.