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Does Psoriasis Affect Black People Differently?

Nov 08, 2021 11:00AM ● By Boitumelo Masihleho
a Black man in white teeshirt looking into the mirror and touching above his eyebrow

Organized by the International Federation of Psoriatic Disease Associations (IFPA), World Psoriasis Day has been celebrated on October 29th for more than a decade. Although that day has passed, we want to highlight this condition as psoriasis isn’t a one-size-fits-all skin sitch. This chronic inflammatory condition comes in many scratchy shapes and scaly forms, but it can also look different depending on your skin color.

Psoriasis is an autoimmune skin condition that causes scaly, itchy, and painful patches to appear on the skin. This condition affects more than 125 million people worldwide - 2% to 3% percent of the total population. Typically, skin cells grow deep in the skin and slowly rise to the surface. Eventually, they fall off. The typical life cycle of a skin cell is one month. In people with psoriasis, this production process may occur in just a few days. Because of this, skin cells don’t have time to fall off. This rapid overproduction leads to the buildup of skin cells.

Scales typically develop on joints, such as elbows, and knees. They may develop anywhere on the body, including the:

  • Hands

  • Feet

  • Neck

  • Scalp

  • Face

It’s commonly associated with several other conditions, including:

  • Type 2 diabetes

  • Inflammatory bowel disease

  • Heart disease

  • Psoriatic arthritis

  • Anxiety

  • Depression

There are five types of psoriasis, with plaque psoriasis as the most common type of psoriasis. The American Academy of Dermatology (AAD) estimates that about 80% of people with the condition have plaque psoriasis. It causes red, inflamed patches that cover areas of the skin. Guttate psoriasis is common in childhood. This type of psoriasis causes small pink spots. The most common sites for guttate psoriasis include the torso, arms, and legs. Pustular psoriasis is more common in adults. It causes white, pus-filled blisters and broad areas of red, inflamed skin.

Erythrodermic psoriasis looks like plaque psoriasi, but it’s way more severe. This form often covers large sections of the body at once. Scales that develop often slough off in large sections or sheets. It’s not uncommon for a person with this type of psoriasis to run a fever or become very ill, making it life-threatening. Psoriasis usually appears between the ages of 15 and 25 years, but it can develop at any age. It is a long-term condition. While there is no cure, many treatment options are available to help manage the symptoms.

Psoriasis prevalence in African Americans is 1.5% compared to 3.6% of Caucasians, but psoriasis is likely to be under-diagnosed among African-Americans and other individuals with skin of color due to differences in clinical presentation. Psoriasis on Black skin tends to be purple or violet with gray scales or dark brown patches, and this might make the condition harder to diagnose. Psoriasis patches on Black skin may also be more widespread, which can make it difficult to distinguish between other conditions.

Psoriasis can show up anywhere on your body regardless of your skin color, but a 2014 study shows that scalp psoriasis is especially common in Black people. To diagnose psoriasis, a dermatologist will carry out a physical examination and ask questions about the lesions. They will probably also ask about any family history of psoriasis or related conditions, such as arthritis. 

The same 2014 study also revealed that African Americans reported that up to 10% of their body surface area was affected by psoriasis, while Caucasians reported only 1 to 2%. Another study, conducted by the National Psoriasis Foundation, found 72% of African American subjects believed their psoriasis interfered with their ability to enjoy life compared with 54% of Caucasian subjects. 

The treatment options for psoriasis are essentially the same regardless of skin tone, although some do carry special considerations for people with darker skin. Topical medications are a common treatment option for people with mild to moderate psoriasis. Phototherapy is also called light therapy, and this treatment involves regularly exposing the skin to ultraviolet light under medical supervision. The AAD warns that this may make dark spots on Black skin more noticeable.



Medical News Today

National Psoriasis Foundation

Health Grades

 Boitumelo Masihleho is a South African digital content creator. She graduated with a Bachelor of Arts from Rhodes University in Journalism and Media Studies and Politics and International Studies. She's an experienced multimedia journalist who is committed to writing balanced, informative and interesting stories on a number of topics. Boitumelo has her own YouTube channel where she shares her love for affordable beauty and lifestyle content. 

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