Psoriasis diagnoses in primary care may be delayed by up to five years, according to an observational study published online Aug. 30 in the British Journal of General Practice .

Maha Abo-Tabik, from the University of Manchester in the United Kingdom, and colleagues used electronic health records to identify potential missed opportunities for an earlier diagnosis of psoriasis. Incident cases of psoriasis were matched (1:6) with controls.

The researchers found that people with psoriasis were up to eight times more likely to be diagnosed with pityriasis rosea at six months before the index date compared with controls. Additionally, cases were twice as likely to be diagnosed with eczema or tinea corporis one year before diagnosis. Certain clinical features suggestive of psoriasis, including dry skin, rash, skin texture changes, and itching, were more likely to be reported by cases than controls up to five years before the index date. Rash was the most frequently reported clinical feature. Compared with controls, cases were prescribed topical corticosteroids or topical antifungals twice as often in the year before diagnosis.

"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," a coauthor said in a statement.

Two authors disclosed financial ties to the pharmaceutical industry.

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