What Is Cdc Doing About Psoriasis
In 2010, CDC worked with experts in psoriasis, psoriatic arthritis, and public health to develop a public health perspective that considers how these conditions affect the entire population. The resulting report is Developing and Addressing the Public Health Agenda for Psoriasis and Psoriatic Arthritis pdf icon. You can read a short article about the agendaexternal icon in The American Journal of Preventive Medicine.
CDCs National Health and Nutrition Examination Survey , an intermittent source of national psoriasis data, has included questions about psoriasis as late as the 2013-2014 cycle. A recent analysis of NHANES data estimates that 7.4 million adults had psoriasis in 2013external icon.
- Psoriasis causes patches of thick red skin and silvery scales. Patches are typically found on the elbows, knees, scalp, lower back, face, palms, and soles of feet, but can affect other places . The most common type of psoriasis is called plaque psoriasis.
- Psoriatic arthritis is an inflammatory type of arthritis that eventually occurs in 10% to 20% of people with psoriasis. It is different from more common types of arthritis and is thought to be related to the underlying problem of psoriasis.
- Psoriasis and psoriatic arthritis are sometimes considered together as psoriatic disease.
Who is at risk for psoriasis?
Anyone can get psoriasis. It occurs mostly in adults, but children can also get it. Men and women seem to have equal risk.
Can I get psoriasis from someone who has it?
What Is Koebners Phenomenon
Koebners phenomenon is a psoriatic rash that appears around an injury, such as a cut or a burn. The rash can show up anywhere on the body where trauma to the skin has occurred.
Koebner’s phenomenon looks like raised skin lesions. The lesions tend to have the same features as a persons existing dermatologic condition. The lesions usually follow the injury lines, and they may cover the entire skin injury or develop on only one part.
Although Koebners phenomenon occurs after skin trauma, it is not an acute condition. Rather, it activates an underlying disease.
People with preexisting skin conditions are most susceptible to Koebners phenomenon. For example, Koebnerization occurs 11% to 75% of the time in people with psoriasis and 21% to 62% of the time in people with vitiligo.
Home Remedies For Psoriasis
Psoriasis is a recurring autoimmune disorder, characterized by itchy or sore patches of thick, red skin with silvery scales often occurring on your elbows, knees, scalp, back, face, palms and feet. Oddly enough, while it affects your skin, psoriasis actually begins deep on the inside in your immune system. Per the International Federation of Psoriasis Associations, 125 million people worldwide about 2 to 3 percent of the total population suffer from psoriasis.
Though it can be hard to diagnose because it can look like other skin diseases, heres what we know. A problem within your immune system causes psoriasis. In a process called cell turnover, skin cells grow deep in your dermis before rising to the surface. This typically takes about one month. With psoriasis, the process is complete in a matter of days. Because your cells are rising entirely too fast, youre left with the unsightly skin woe.
Even more, theres no cure. In fact, psoriasis symptoms tend to come and go as they please. In saying that, many factors can worsen or soothe the ailment.
Factors that worsen psoriasis:
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What Are The Different Types Of Psoriasis
According to a 2014 studyTrusted Source, psoriasis affects almost 6.7 million adults in the United States. There are multiple types of psoriasis, including:
- Plaque psoriasis. This is the most common type of psoriasis, accounting for over 80 percent of psoriasis cases. This type of psoriasis causes red or purplish patches with silvery-white or gray scales. It commonly affects the exposed areas of the skin, such as the knees and elbows, as well as the scalp.
- Inverse psoriasis. As opposed to plaque psoriasis, inverse psoriasis commonly appears in the folds of skin, such as the armpits, groin, or under the breasts. These patches can also appear as red or purple, but do not contain any scales.
- Guttate psoriasis. This type of psoriasis affects roughly 8 percent of people with the condition and commonly appears during childhood. This type appears as small, circular spots on the limbs and torso.
- Pustular psoriasis. This type of psoriasis affects the hands, feet, or other surfaces of the skin and appears as red skin with white pustules. These pustules appear in cycles after the skin has reddened and can sometimes form scales, like in plaque psoriasis.
- Erythrodermic psoriasis. This is a rare and serious form of psoriasis thats widespread and resembles plaque psoriasis, with red or purple skin and silvery scales. This type of psoriasis flare-up requires immediate medical attention.
How Dermatologists Can Help
While many African Americans are dealing with these skin conditions, most dont ever seek the help of a skilled dermatologist who can help heal your skin and minimize the long-term effects of skin care issues. A dermatologist is your partner in protecting, repairing, and enhancing the appearance of your skin, so dont hesitate to reach out to a local practitioner at U.S. Dermatology Partners to find out more. Use our convenient online form to request an appointment with a knowledgeable practitioner near you!
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What Are The Types Of Psoriasis
In children, common types of psoriasis include:
Plaque psoriasis. This is the most common type of psoriasis. It causes plaques and silvery scales, usually on the knees, elbows, lower back, and scalp. They can be itchy and painful and may crack and bleed.
Guttate psoriasis. This type often shows up after an illness, especially strep throat. It causes small red spots, usually on the trunk, arms, and legs. Spots also can appear on the face, scalp, and ears.
Inverse psoriasis. This causes smooth, raw-looking patches of red skin that feel sore. The patches develop in places where skin touches skin, such as the armpits, buttocks, upper eyelids, groin and genitals, or under a womans breasts.
Psoriasis On Black Skin Pictures
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How Psoriasis Is Diagnosed
A GP can often diagnose psoriasis based on the appearance of your skin.
In rare cases, a small sample of skin called a biopsy will be sent to the laboratory for examination under a microscope.
This determines the exact type of psoriasis and rules out other skin disorders, such as seborrhoeic dermatitis, lichen planus, lichen simplex and pityriasis rosea.
You may be referred to a specialist in diagnosing and treating skin conditions if your doctor is uncertain about your diagnosis, or if your condition is severe.
If your doctor suspects you have psoriatic arthritis, which is sometimes a complication of psoriasis, you may be referred to a doctor who specialises in arthritis .
You may have blood tests to rule out other conditions, such as rheumatoid arthritis, and X-rays of the affected joints may be taken.
What It Was Like Growing Up With Psoriasis As An African American Woman
I am an African-American woman in her 50s with very dark skin who in addition to battling psoriatic arthritis since my 40s, has battled plaque psoriasis the scaly skin that itches and flakes all of her life, erythrodermic psoriasis the best way to describe this is that my whole body goes on fire several times in my life, and guttate psoriasis spots that covered my entire body at one point in my life.
Whats been especially challenging in my lifelong struggle with psoriasis has been the general lack of information as well as a medical community lacking in knowledge when it comes to psoriasis in people of color.
When I was a teenager I used to go to the library and try and find pictures of someone who looked like me. I spent countless hours searching for just one photo. After months and months of searching and coming up with nothing, I believed I was alone in this world and there was no one like me with psoriasis.
I did find some photos of Caucasian people with psoriasis, but their psoriasis never looked like mine nowhere close. My psoriasis was always very dark and thick. They had red or pink patches of thickened skin that were covered with whitish scales, just like the articles that described what psoriasis looked like. This was not me.
As a child of color, this was extremely confusing because, guess what: I didnt have white silvery scales on me!
Then over the next 40 years, I went to many doctors.
But how can you find a good doctor?
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References Used In This Article
How Can I Prevent Psoriasis Flare
Psoriasis tends to flare up if a person encounters specific triggers. Triggers are different for every person. Common triggers include stress, skin trauma, dry skin, medications, alcohol, and infections.
Identifying the things that tend to trigger your psoriasis and avoiding them is important, but it might take some detective work. A symptom journal may help you figure out what causes your flare-ups.
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Psoriasis And Skin Conditions As A Black Person
It took 9 months of suffering and being misdiagnosed twice before I got an accurate diagnosis.
The more I research the issue of Black people living with psoriasis, the more Im learning about how often were misdiagnosed. Its not only psoriasis this pattern happens with many skin conditions, including those related to COVID-19 .
From what Ive learned so far, psoriasis symptoms are typically evaluated based on data used to diagnose conditions on white skin. As a result, people of color arent properly treated and often face prolonged suffering without a confirmed diagnosis.
Our healthcare system needs decolorization. By this I mean that our healthcare system must view and accept all skin colors as equally worthy of understanding, research, diagnosis, and treatment.
This must happen if healthcare researchers and doctors are interested in truly helping Black people understand our skin conditions and ailments. It must happen in order for us to live fuller and healthier lives.
What Else Affects Your Psoriasis
Here are some other things that can affect your psoriasis and your treatment:
- Psoriatic arthritis. This condition that happens along with psoriasis causes painful, stiff, and swollen joints. People with psoriatic arthritis are more likely to have severe psoriasis and need stronger treatments. Doctors can treat it with nonsteroidal anti-inflammatory drugs , disease-modifying anti-rheumatic drugs , immunosuppressants, and biologics.
- Other complications or health conditions you have. People with psoriasis are at higher risk of several other health problems, including eye conditions, type 2 diabetes, high blood pressure, and other autoimmune disorders like Crohn’s disease. Your doctor should choose psoriasis medications that don’t interfere with those you take for other conditions.
- Pustular or erythrodermic psoriasis. These rare and serious forms of psoriasis can affect your entire body and need treatment right away. Your doctor will usually prescribe a systemic drug.
- Skin color. Psoriasis is often worse in people of color. If you have darker skin, your lesions may be thicker and cover more of your body. You could also need longer-lasting treatments and a higher dose.
Racial identity also plays a role in health care for skin conditions like psoriasis. One study found that Black, Asian, and Native American people with psoriasis are 40% less likely to visit a dermatologist than white people.
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True Vs Pseudo Koebner’s Responses
A true Koebners response occurs alongside preexisting autoimmune conditions that affect the skin. A pseudo Koebner’s response is when an infection, such as viral warts or molluscum contagiosum, spread lesions across the injured skin.
If a person has an existing autoimmune disease, Koebners can be brought on by damage to the skin. Examples of trauma that may bring on Koebners phenomenon include:
- Animal or insect bites
- Tuberculosis test
- Iodine
Limited case studies have suggested that Koebners phenomenon may occur in people without preexisting autoimmune skin conditions. However, the overall body of research indicates that the condition is most closely associated with autoimmune conditions that affect the skin, such as psoriasis, vitiligo, and lichen planus.
Write Everything Down And Take Pictures
Do your research and write things down, says Wilson. Keep track, so you have an idea of whats going on with you. For example, Id notice that when I had stress, Id get more flare-ups.
When she saw the rheumatologist who eventually diagnosed her psoriasis, I had dates and times when I started to feel a certain way, so I could paint an accurate picture. This can help in getting a quicker diagnosis. Doctors might want to say, Wait and see, but youd be able to say No, here is what happened. Arm yourself with knowledge, says Wilson.
Blazer adds, Any time that you have symptoms, take a picture, because those rashes may show up and eventually resolve. For patients, by the time theyre able to get an appointment with a physician, those symptoms might not be showing up.
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Find A Doctor You Trust
Seek a doctor who understands you, says Wilson. Maybe they come from the same place you come from, or they understand melanated skin. If you can get a doctor or dermatologist of color, you may not go undiagnosed for as long.
Blazer agrees: Patients of color tend to have better outcomes when they see physicians of color, she says. Physicians of color tend to communicate in a more culturally congruent way, so it helps with patients feeling heard. Because we dont have enough rheumatologists of color, our patients tend to suffer.
A physicians race isnt the most important thing, though. It doesnt have to be a doctor of color, but find a doctor who listens, Wilson says. My doctor is not Black, but he was the first doctor to really listen to me.
When looking for a dermatologist or rheumatologist, be sure to ask about how they treat patients of color, Wilson suggests. Just like theyre asking you questions, you need to be asking them questions. Ask, Do you work with people of color? Whats the difference ? If they say theres no difference, Then get up and leave.
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Diagnosing Psoriasis In Skin Of Color
Psoriasis is found more frequently in white than in African American and Hispanic populations. However, these numbers may not paint the full picture, as psoriasis may be more readily identified in people with lighter skin and it is sometimes misidentified in people with darker skin tones. âAcross skin types, many features present similarly, such as the symmetrical distribution of psoriasis on the body and well-circumscribed nature of psoriasis plaques,â shares Junko Takeshita, M.D., Ph.D., M.S.C.E., an assistant professor of dermatology and epidemiology at the University of Pennsylvania Perelman School of Medicine. Differences do exist and are important to recognize, such as âthe red color or erythema that is typically seen with psoriasis on light skin often appears more purple or brown in darker skin types. Sometimes the scale that accompanies psoriasis is so thick that it is difficult to appreciate that underlying color of the plaque itself. Nevertheless, psoriasis remains a common condition across skin types and races/ethnicities,â continues Dr. Takeshita.