“Sometimes in this area the patches may be less thick and less scaly, which can make the diagnosis of eyelid psoriasis harder to make,” says Faranak Kamangar, MD, a dermatologist at Palo Alto Foundation Medical Group in Palo Alto, California.
Diagnosing psoriasis in the eye area can be challenging, especially if someone doesn’t already have an established psoriasis diagnosis based on symptoms in other areas of the body.
“When we think of rashes on the eyelids, allergic contact dermatitis is more common, so it certainly could be misdiagnosed,” says Jordan Praytor, an instructor in the department of dermatology at Oregon Health & Science University in Portland.
When someone shows symptoms of what may be psoriasis around the eyes, it’s important to do a thorough skin exam of other areas of the body, says Praytor. Often, she says, doing so will reveal signs of psoriasis in more typical areas — such as around the ears, on the scalp, or within skin folds — that patients were not aware of, or did not find bothersome enough to call attention to. This “gives the provider additional clues that can help differentiate psoriasis from other diagnoses,” she says, such as eczema around the eyes.
If it’s unclear what’s causing skin symptoms around the eyes based on a physical exam, your doctor may take a small tissue sample (biopsy) for examination under a microscope.
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