Is that a rash, or is it psoriasis?

Posted on 15 October 2015

Psoriasis is an autoimmune disease that presents as red, itchy, scaly patches of abnormal skin. Unfortunately it’s often misdiagnosed by patients. We asked expert advice from a Mediclinic dermatologist.

There are few things that get under a doctor’s skin more than when a patient tries self-diagnosis. Especially now, in the internet age, many patients find it easier to take the advice of Doctor Google rather than consulting a real-life, qualified doctor – and the results can be disastrous.

Psoriasis is one of those conditions that patients often get wrong. A persistent, chronic disease, it changes the life cycle of skin cells, causing them to build up on the surface of your skin. Those extra skin cells form thick, silvery scales and itchy, dry, red patches that are sometimes painful. Usually, skin cells will grow slowly and flake off about every four weeks, with new cells growing to replace the old ones as they shed. With psoriasis, those new skin cells move quickly to the surface of your skin, taking days rather than weeks. Those lesions can be small or large, and usually appear on your knees, elbows, scalp, hands, feet or lower back.

After looking at some pictures on the internet, many patients make the mistake of misdiagnosing the condition. ‘That happens a lot,’ confirms Dr Matete Mathobela, a dermatologist at Mediclinic Cape Gate. ‘I often get patients who think they have psoriasis when it’s actually just a simple case of eczema or a fungal infection. What you’re actually looking at could be something minor like eczema, or something serious like protoporphyria. Either way, you need to know what it really is! You don’t want to self-diagnose.’ An accurate diagnosis of psoriasis is usually based on its specific signs and symptoms.

The good news about psoriasis is that it’s not contagious. The bad news is that it has no cure… but even then, Dr Mathobela says, there is still some good news: while it can’t be cured, it can be treated. ‘For localised lesions I’d usually recommend a topical treatment,’ she says. ‘If the psoriasis is extensive, or if we’re not able to control those localised lesions with the topical treatment, we’d have to look at systemic treatments – and there are plenty of those.’

Topical treatments include topical steroids and common treatments such as Dovobet. Systemic treatments include methotrexate, among others. No matter the treatment, though, the most important part is making sure you’re treating the correct disease. So if you think you may have psoriasis, don’t base your diagnosis on what you’ve read in this article. Go see a dermatologist and get an accurate diagnosis.


The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.

Published in Dermatology

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

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