Pseudo Psoriasis
The Diagnosis of psoriasis is usually made on clinical examination, although a family history usually leads to suspicion of the disease. However there are other diseases that manifest itself on the skin that can mimic psoriasis symptoms. These are called pseudo psoriasis and usually medical practioner will send a biopsy of the skin for lab analysis when various treatment options fail.
Traditional Medical practioner also uses the same clinical methods to observe the ‘pattern’ of the affected skin. An additional steps in traditional medical methods is the measurement of the patient pulse or qi with three fingers. This methods will allow the chinese traditional medical practioner to ascertain the ‘internal’ reasons for the manifestation of the psoriasis on the patient skin.
Pulse Method of Diagnosis
The following are some conditions that may cause some diagnostic confusion.
Seborrhoeic dermatitis
Seborrheic Dermatitis on Edge of Scalp
Seborrhoeic dermatitits is quite common and there is no reason why it shoud not coexist with psoriasis. The lesion in seborrhoeic dermatitis are paler and less well-defined than psoriasis, with a scale that is rather dull and loose and often quite greasy.
Seborrheic Dermatitis on Top of Scalp
Eczema
In eczema, the pink color is not as deep as in psoriasis, and there is generally a less well-defined edge to lesions and scaling tends to be much finer. Nail ridges and occasionally pitting can be seen in severe eczema involving the hands, but severe nail dystrophy is unusual. Eczema can be rather “psoriasisform” on the legs where it becomes thickened and lichenified secondary to scratching. Palmar and plantar eczema can be hyperkeratotic and differentiating it from psoriasis can be quite difficult.
Candidiasis
Candidiasis
Candidiasis can also coexist in the flexures. Small satelite pustules and papules are suggestive of candidiasis.
Atopic Dermatitis
Athlete foot
Trycophyton rubrum is a fungus that commonly causes athlete’s foot. When it infects the nails it can look similar to the onycholysis seen in psoriasis. Evidence of athlete’s foot elsewhere is suggestive of the infection. This fungus may also infect the palm or sole. However, the patter tends to be assymetric, which is unusual for psoriasis on this site.
Athlete Foot
Other conditions that may mimic psoriasis include; atopic dermatitis, lichen simplex chronicus, secondary or tertiary syphilis, Reiter’s syndrome, lichen planus, pityriasis rosea and tinea corporis.
Lichen Planus
Lichen Simplex
Pityriasis
Secondary Syphilis
Tinea Corporis
You should always allow your doctor to make the initial diagnosis of psoriasis, since other conditions, including skin cancers, can mimic the appearance of psoriasis.
Superficial Skin Cancer