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So… You Think You Have Psoriasis?

Don’t worry, you’re not alone. Psoriasis is a common but uncomfortable skin condition affecting around 2 percent of the earth’s population – that’s 125 million people for those with a calculator in hand.1 However, there are other conditions – some of them common and benign, and some of them rare and more serious – that have similar symptoms to psoriasis. We’ll call them psoriasis mimics.

The right first step

 

So you’ve noticed something: a rash, an itch, a hive, whatever. Although it’s tempting to hop online and start anxiously researching forums and threads (we’ve all been there), your first step should be to see a doctor so it can be properly diagnosed. Make sure you tell your doctor everything that is going on, and we mean everything. Starting the wrong treatment, even for a disease with very similar symptoms, can lead to serious physical problems –not to mention frustration for you when things don’t get better. So, the golden rule here is (repeat after us) to always check with your doctor first. After all, they are the experts.

But, while you’re still in research mode, waiting for that doctor’s appointment, here are the details on a few sneaky conditions that may try to pull one over on you. Although they are similar to psoriasis in a lot of ways, it is important to highlight the many differences.

 

  • Eczema – Eczema, or atopic dermatitis, is even more common than psoriasis. Like psoriasis, the exact cause of the condition is unknown, and like psoriasis, you can’t give it to anyone else through contact.


  • Atopic dermatitis is most common in babies and children, although anyone can get it. People who live in cities and dry climates may be more susceptible to the condition.2 Doctors will generally take a biopsy to determine whether you have psoriasis or eczema. “But how do I know the difference,” you ask? Well, it turns out that under a microscope, skin with psoriasis looks thicker and more inflamed when compared to skin with eczema.3


  • Seborrheic dermatitis – In infants, this condition is often called “cradle cap”. But in adults, it can become a more long-term problem, coming and going in flare ups through a person’s life4. The skin tends to have a reddish color, with a swollen and greasy appearance. Things like cold and dry weather, as well as stress, can trigger flare ups.


  • Dandruff – Dandruff is a common chronic condition identified by an itchy scalp and white, oily looking flakes of dead skin that appear on a person’s hair and shoulders.5 The good news is that this condition is rarely serious and often doesn’t require a visit to the doctor’s office, although if the dandruff worsens or lingers for an extended period of time, a prescription shampoo may be needed to fight the flakes. Keep in mind, however, that you should check with your doctor first to make sure dandruff is not something serious, like psoriasis.


  • Scabies – Scabies is caused by the mite Sarcoptes scabiei, and can be mistaken for psoriasis due to the same scaly, crusty plaques.6 Unlike psoriasis, however, the condition is contagious and can be transmitted by direct contact. Be sure to consult a doctor if you are experiencing the symptoms above.


  • Pityriasis rubra pilaris – Known as PRP, this is a rare skin disorder often initially misdiagnosed as psoriasis – although it’s far more resistant to treatment.7 It’s a chronic condition with no known cause, and no known cure, and it usually presents as red scaly patches. These can cover the entire body, although they sometimes are limited to the elbow and knee areas. It’s more common in adults over 40 but can also affect children.

 

Although many of these diseases are non-life threatening, they certainly provide discomfort in their own way. On the other hand, a far more serious disease can also occasionally present similar symptoms to psoriasis. For example, cutaneous T-cell lymphoma, or mycosis fungoides, can mimic psoriasis or any of the conditions above.8

 

It’s important to have the correct diagnosis because while these conditions have similar symptoms, sub-optimal treatments can sometimes make the problems even worse. For example, the treatment for psoriasis can make a patient with crusted scabies worse.9

 

Although psoriasis is a condition that may be painful, it can be managed. Now that you know some of the psoriasis mimics, or their ‘friends’, shall we say, you should feel even more prepared when you head into your doctor’s office. Whether it’s through biopsies, tests, or other methods, getting the proper diagnosis will ultimately help you better understand the condition that you’re living with. And if you are diagnosed with psoriasis, be sure to join with our online communities on Facebook and Twitter. We’re here for you!

  1. World Health Organization. (2013, April 5). Psoriasis: Report by the Secretariat. http://apps.who.int/gb/ebwha/pdf_files/EB133/B133_5-en.pdf
  2. National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2014, November). What Is Atopic Dermatitis? Retrieved February 12, 2016, from http://www.niams.nih.gov/Health_Info/Atopic_Dermatitis/atopic_dermatitis_ff.asp
  3. National Psoriasis Foundation. About Psoriasis. Retrieved February 16, 2016, fromhttps://www.psoriasis.org/about-psoriasis
  4. American Academy of Dermatology. Seborrheic dermatitis. Retrieved February 16, 2016, from https://www.aad.org/public/diseases/scaly-skin/seborrheic-dermatitis
  5. The Mayo Clinic. (2014, January 23). Diseases and Conditions: Dandruff. Retrieved February 12, 2016, from http://www.mayoclinic.org/diseases-conditions/dandruff/basics/symptoms/con-20023690
  6. Lehmberg, J., Roper, B., Omouryi, E. A., & Evangelista, M. (2015, October). Skin Plaques Mimicking Psoriasis. The Journal of Pediatrics, 167(4), 937-937.e1. Retrieved February 16, 2016, from http://www.jpeds.com/article/S0022-3476(15)00714-3/fulltext 
  7. The American Osteopathic College of Dermatology. Pityriasis Rubra Pilaris. Retrieved February 16, 2016, fromhttp://www.aocd.org/?page=PityriasisRubraPil
  8. Elmer, K. B., & George, R. M. (1999, May 15). Cutaneous T-Cell Lymphoma Presenting as Benign Dermatoses. American Family Physician, 59(10), 2809-2813. Retrieved February 16, 2016, from http://www.aafp.org/afp/1999/0515/p2809.html 
  9. Meffert, J. (2015, December 17). Psoriasis: Manifestations, Management Options, and Mimics. Retrieved February 16, 2016, from http://reference.medscape.com/features/slideshow/psoriasis-subtypes#page=23

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