Symptoms Of Psoriasis On Darker Skin
Compared to those with lighter skin tones, darker people with psoriasis may have more dyspigmentation of the skin.
Zoe Hansen / Verywell Health
Studies show Black psoriasis patients feel they have more severe psoriasis in comparison to other groups. Meanwhile many patients with darker skin tones actually report less erythema, or redness, and are more likely to have violet or dark brown plaques.
Treating Psoriasis On Black Skin
While psoriasis medications can help control outbreaks in many people, Black people are often undertreated. Compared to white people, theyre not only less likely to be treated with biologics , according to a study published in December 2015 in The Journal of Investigative Dermatology, but they sometimes receive only topical medications or no treatment at all, according to the National Psoriasis Foundation.
Black people who have psoriasis were also less familiar with biologics as a treatment option compared to white people, according to a study published in February 2019 in the Journal of Investigative Dermatology, despite the fact these medications are highly effective at treating the skin condition, regardless of a persons pigmentation.
Dr. Hartman points out that undertreatment among Black patients is not due to a lack of concern or care for their health. Disparities such as a lack of access to quality medical care and healthcare insurance in the Black community have been well documented and contribute significantly to Black patients with psoriasis not being treated adequately.
Other research published by Dr. Takeshita has shown that dermatologists are less confident about diagnosing psoriasis in people with darker skin than those with lighter skin.
Contrary to what has been displayed in the media, psoriasis can affect people of any race. And a growing number of providers agree that we need more diverse representation and information for Black people with psoriasis.
How Is Psoriasis Diagnosed And Treated
Psoriasis often has a typical appearance that a primary care doctor can recognize, but it can be confused with other skin diseases , so a dermatologist is often the best doctor to diagnose it. The treatment of psoriasis usually depends on how much skin is affected, how bad the disease is , or the location . Treatments range from creams and ointments applied to the affected areas to ultraviolet light therapy to drugs . Many people who have psoriasis also have serious health conditions such as diabetes, heart disease, and depression. Some people with psoriasis also have an inflammatory condition which affects their joints, called psoriatic arthritis.
Psoriatic arthritis has many of the same symptoms as other types of arthritis, so a rheumatologist is often the best doctor to diagnose it. The treatment of psoriatic arthritis usually involves the use of drugs .
Psoriatic disease may be treated with drugs or a combination of drugs and creams or ointments.
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How Common Is Psoriasis In Black People
The chronic skin condition affects eight million Americans, but Black patients account for a much smaller percentage of that number. According to one study, the prevalence of psoriasis in Black patients is 1.3% compared to 2.5% in white patients. But that doesnt necessarily mean dark skin is less prone to it. Its likely not as prevalent because its not as diagnosed, says Dr. Hartman. This begs the question: Why? One theory is that training about psoriasis on Black skin isnt always taught in medical schools. I was fortunate to train in dermatology at Howard University an HBCU we are taught dermatology–not just dermatology in lighter skin tones, says Dr. Kindred. Other institutions are doing the same. However, many are playing catch-up, trying to supplement their curriculum with skin of color.
Can It Be Mistaken For Something Else
There are other skin conditions that can resemble psoriasis, which sometimes makes diagnosis difficult. These conditions may include:
- Fungal skin infections. Fungal skin infections occur when fungi multiply on the skin or find their way in through an open lesion. These infections usually appear as itchy, scaly rashes.
- Lichen planus. Lichen planus is a skin rash that often appears in conjunction with other autoimmune conditions. It can present in multiple ways, such as purplish skin bumps or white lesions on the mouth.
- Cutaneous lupus. Lupus is an autoimmune condition that causes system-wide inflammation. Cutaneous lupus affects roughly two-thirds of people with lupus and is characterized by rashes on exposed skin areas.
- Eczema.Eczema appears as red, inflamed, peeling, cracked, blistered, or pus-filled on light skin. But on darker skin, the redness may be difficult to see but will look darker brown, purple, or ashen gray. Generally, there are no scales.
In addition to the conditions above, differences in the appearance of psoriasis between skin colors can make it even more difficult to diagnose in people with darker skin.
Still, its important that doctors are trained on how to recognize psoriasis and other conditions in people of color.
As a person of color, if youre concerned that you may have psoriasis, its important to make sure that your concerns are being heard.
Advocating for yourself based on your symptoms can ensure a proper diagnosis and timely treatment.
Read Also: What Is Psoriasis Psoriatic Arthritis
Traditional Treatment Cautions Pictures Of Psoriasis On Black Skin
You make an appointment to see your doctor because your psoriasis is flaring. He takes a look and then whips out his prescription pad to order one of the following:
. A prescription strength topical treatment
. phototherapy
. oral and injection therapy
. over the counter drugs
Any of these treatments may work fine to relieve your symptoms and make you feel better for now. The trouble with conventional treatment methods is that they rarely work to cure the underlying cause of this skin condition and that can leave you suffering repeat attacks. Still it is important to know what helps are available, and how they may help or hurt your chance of treatment success.
Topical Ointments Pictures of Psoriasis on Black Skin
Topical ointments are used at the first sign of psoriasis. If caught early enough they can sometimes stave off a full-blown attack. Unfortunately, most people report becoming immune to them when used often, which makes them useless for long term use. Still, using the occasional cream or gel can help relieve some of your symptoms. Steroids
Both topical and internal steroids can be prescribed to help ease psoriasis swelling inflammation and itching. Immunomodulators
An immune suppressing drug that was originally used to help transplant patients beat organ rejection, Cyclosporine helps to inhibit T lymphocyte production so that scaly plaque is unable to grow on the surface of the skin.
Oral Retinoid Pictures of Psoriasis on Black Skin
. stretch marks
The Link Between Psoriasis And The Immune System
No one ever really considered that the immune system had any real role in psoriasis, or its painful outbreaks. Not until a new drug Cyclosporine was offered to arthritis patients. What happened next was both surprising and unexpected. Patients who were prescribed the immune suppressing drug for their arthritis symptoms , began to report a decrease in their skin attacks. Without warning, researchers were faced with the theory that the immune system could be causing psoriasis.
It didnt take long before researchers began to figure out the mystery of psoriasis in regards to how the immune system can impact it.
The Role of the Immune System on the Skin
The immune system is responsible for standing guard and attacking any invaders which penetrate the body. Since the skins main job is to act as the bodys first defense mechanism against invasion, it is no wonder that the immune system works in close connection with each layer of the skin. Heres how it all works:
1. Immune cells patrol the entire body for dangers. Pictures of Psoriasis on Dark Skin
2. When an invader is detected, these immune send out chemical and nervous system messages to the immune system to ready itself for an attack
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Traditional Treatment Cautions Pictures Of Psoriasis On Dark Skin
You make an appointment to see your doctor because your psoriasis is flaring. He takes a look and then whips out his prescription pad to order one of the following:
. A prescription strength topical treatment
. phototherapy
. oral and injection therapy
. over the counter drugs
Any of these treatments may work fine to relieve your symptoms and make you feel better for now. The trouble with conventional treatment methods is that they rarely work to cure the underlying cause of this skin condition and that can leave you suffering repeat attacks. Still it is important to know what helps are available, and how they may help or hurt your chance of treatment success.
Topical Ointments Pictures of Psoriasis on Dark Skin
Topical ointments are used at the first sign of psoriasis. If caught early enough they can sometimes stave off a full-blown attack. Unfortunately, most people report becoming immune to them when used often, which makes them useless for long term use. Still, using the occasional cream or gel can help relieve some of your symptoms. Steroids
Both topical and internal steroids can be prescribed to help ease psoriasis swelling inflammation and itching. Immunomodulators
An immune suppressing drug that was originally used to help transplant patients beat organ rejection, Cyclosporine helps to inhibit T lymphocyte production so that scaly plaque is unable to grow on the surface of the skin.
Oral Retinoid Pictures of Psoriasis on Dark Skin
. stretch marks
What You Need To Know About Psoriasis Psoriasis On Dark Skin Images But Cheek
Is Your Stomach to Blame?
Who would have thought that a severe psoriasis outbreak could start because of something going wrong inside of your stomach and intestines? Yet, new research developed by psoriasis expert Edgard Cayce shows a distinct link between a leaky gut and a scaly psoriatic episode. According to Cayce, the primary source of psoriasis can be found in the intestinal tract, where toxins are leached into the body. This causes the immune system to react by thickening the skin. At the same time, the skin tries to purge the toxins through its layers, which can cause scabs and sores to form.
Could Arthritis Be the Cuplrit?
The intestines arent the only link to psoriasis found by researchers arthritis seems to also contribute to it. As many as one-third of all psoriasis patients eventually develop some form of psoriatic arthritis. Unlike normal forms of arthritis, those with psoriatic arthritis do not exhibit a rheumatoid factor when their blood is tested. This indicates that the arthritic condition comes solely from either the psoriasis itself or the underlying cause of the skin affliction.
Could a Virus Be the Cause?
Arthritis has been linked to certain virus and so have other auto-immune disorders. This leads some researchers to think that psoriasis too may start with a virus, which is what kicks the immune system into overdrive.
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What If Its Not Psoriasis
Psoriasis is sometimes mistaken for other skin conditions. Heres what they usually look like on dark skin:
- Eczema. This common condition is known for reddish, raised lesions. You also might have purple, dark brown, or gray patches.
- Lichen planus. This autoimmune condition can cause white lesions or purplish bumps. In some cases it can appear inside your mouth.
- Fungal skin infections. These can happen when the fungus among us infects your skin. This type of infection can make your skin itch, burn, or crack.
- Cutaneous lupus erythematosus. This chronic autoimmune condition affects about two-thirds of folks with lupus. It can cause discolored patches on your skin.
Effects Of Psoriasis On People With Darker Skin
A study by the National Psoriasis Foundation on psychosocial impacts of psoriasis found that psoriasis may have a more significant perceived impact on people with darker skin.
In the study, 72% of people with non-White skin tones reported an impact from psoriasis on their quality of life, versus 54% of White people.
Some of the concerns from people with darker skin about their psoriasis included self-consciousness, frustration, helplessness, and anger. Researchers observed that the negative impact on quality of life might be due to:
- Having more visible discoloration of the skin
- Different cultural perceptions of skin ailments
In addition, 23% of Black patients in the study stated that they had “very severe psoriasis” compared to 8% of White people.
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Psoriasis In The Black Skin: A Lack Of Representation
The Internet is flooded with images of white people who have psoriasis, but there arent nearly as many pictures of Black people who have psoriasis. This often leads people to the conclusion that psoriasis mainly develops in people with lighter skin which couldnt be further from the truth.
In fact, about 1.9 percent of Black Americans have psoriasis, according to a study published in the March 2014 issue of the Journal of the American Academy of Dermatology. The same research found that 1.6 Hispanic Americans had psoriasis, and 3.6 percent of white Americans had psoriasis.
Despite these statistics, a whopping 93 percent of all main characters who were featured in TV commercials and advertisements about psoriasis, including treatments and products, over a two-week period in 2018 were white, according to a study published in September 2020 in the journal Cutis. Black and Asian main characters only represented about 6 percent and 1 percent. The findings of this study, conducted by Junko Takeshita, MD, PhD, and other researchers, are important because advertisements are a main source of health-related information for the public.
Common Types Of Psoriasis
Plaque psoriasis is the most common form of psoriasis.
Its symptoms are dry skin lesions, known as plaques, covered in scales.
They normally appear on your elbows, knees, scalp and lower back, but can appear anywhere on your body.
The plaques can be itchy or sore, or both. In severe cases, the skin around your joints may crack and bleed.
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What You Need To Know About Psoriasis Pictures Of Psoriasis On Black Skin
Is Your Stomach to Blame?
Who would have thought that a severe psoriasis outbreak could start because of something going wrong inside of your stomach and intestines? Yet, new research developed by psoriasis expert Edgard Cayce shows a distinct link between a leaky gut and a scaly psoriatic episode. According to Cayce, the primary source of psoriasis can be found in the intestinal tract, where toxins are leached into the body. This causes the immune system to react by thickening the skin. At the same time, the skin tries to purge the toxins through its layers, which can cause scabs and sores to form.
Could Arthritis Be the Cuplrit?
The intestines arent the only link to psoriasis found by researchers arthritis seems to also contribute to it. As many as one-third of all psoriasis patients eventually develop some form of psoriatic arthritis. Unlike normal forms of arthritis, those with psoriatic arthritis do not exhibit a rheumatoid factor when their blood is tested. This indicates that the arthritic condition comes solely from either the psoriasis itself or the underlying cause of the skin affliction.
Could a Virus Be the Cause?
Arthritis has been linked to certain virus and so have other auto-immune disorders. This leads some researchers to think that psoriasis too may start with a virus, which is what kicks the immune system into overdrive.
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How Is Psoriasis Classified
Certain features of psoriasis can be categorised to help determine appropriate investigations and treatment pathways. Overlap may occur.
- Early age of onset < 35 years vs late age of onset > 50 years
- OMIM Online Mendelian Inheritance in Man
- Chularojanamontri L, Griffiths CE, Chalmers RJ. The Simplified Psoriasis Index : a practical tool for assessing psoriasis. J Invest Dermatol. 2013 133:195662. doi: 10.1038/jid.2013.138. PubMed PMID: 23807685.
- Feldman SR, Fleischer AB Jr, Reboussin DM, et al. The self-administered psoriasis area and severity index is valid and reliable. J Invest Dermatol. 1996 106:1836. doi:10.1111/1523-1747.ep12329912PubMed PMID: 8592072.
- Papp K, Gordon K, Thaçi D, et al. Phase 2 trial of selective tyrosine kinase 2 inhibition in psoriasis. N Engl J Med. 2018 379:131321. doi:10.1056/NEJMoa1806382. PubMed
- Fleming P. Tofacitinib: a new oral Janus kinase inhibitor for psoriasis. Br J Dermatol. 2019 180:1314. doi:10.1111/bjd.17323. PubMed