Psoriasis on black skin: What to know

Psoriasis is a skin disease that causes lesions to develop in certain skin areas. The presence of psoriasis differs across various skin tones, and on black skin, diagnosis can be more difficult.

Psoriasis lesions tend to be thick and crusty, and on the scalp, elbows , knees, and back, they also develop.

Learn more about black skin psoriasis in this post, including its appearance and symptoms, as well as how to treat it.

Prevalence

Psoriasis is a common disease in the United States that affects more than 8 million people and 125 million people globally.

According to the National Psoriasis Foundation, compared with 2.5 percent of white people, it affects about 1.3 percent of African Americans.

Approximately one-third of psoriasis individuals have a parent with the same disorder, which means that genetics is a risk factor.

Psoriasis typically occurs between 15 and 25 years of age, but at any age it can occur. It is a disease that is long-term. While there is no cure, there are several options available for treatment to help relieve the symptoms.

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  • Psoriasis on black skin
  • Psoriasis on black skin

Symptoms

Psoriasis, sometimes with an overlying scaly crust that may look shiny or silver, occurs as thickened areas of the skin. Normally, these lesions are itchy. They can bleed and scab over if a person scratches them.

Psoriasis can look violet or purple in black individuals. Areas of darker, thicker skin can also be found by the individual. The lesions will look scaly in both cases. Lesions, including the scalp, can grow anywhere in the body.

It can leave areas of discoloration as psoriasis heals, which can take between 3 and 12 months to disappear.

A relapsing-remitting trend appears to be accompanied by psoriasis, meaning that people will experience a period of little or no symptoms and then a flare-up of more serious symptoms.

There are many forms of psoriasis that can vary in their appearance. They are:

Chronic plaque psoriasis

The most common type of the disorder is chronic plaque psoriasis. On the elbows , knees, and scalp, it causes clearly defined lesions to develop.

These red or violet lesions are 1 to 10 centimeters (cm ) in diameter and have silvery scales overlying them.

Guttate psoriasis

In children or young people recovering from an infection, such as pharyngitis, guttate psoriasis is more common.

On the back , arms, and thighs, it causes tiny bumps smaller than 1 cm wide to appear.

Nail psoriasis

Some people with psoriasis only have nail signs. Nail psoriasis on the fingernails or toenails appears like small pinpricks.

Also, the nails may turn brown or become thick and crumbly.

Inverse psoriasis

On less visible areas of the skin, such as the armpits, the buttocks, the groin, and the folds under the breasts, inverse psoriasis occurs. Purple or darker than the surrounding skin may be the lesions.

Diagnosis

A doctor with her patient
A doctor may ask about family history to help diagnose psoriasis.

A dermatologist may carry out a physical examination and ask questions about the lesions in order to diagnose psoriasis. They are also likely to inquire about any psoriasis family history or associated disorders, such as arthritis.

It may be hard to diagnose psoriasis on black skin because it can mimic other skin conditions that are more common in black people.

The doctor will also take a skin biopsy in certain cases so that they can rule out other conditions.

Treatment

The treatment options for psoriasis, regardless of skin color, are generally the same, although some have particular considerations for people with darker skin.

Standard therapies for psoriasis include:

Creams and ointments

For most individuals with psoriasis, creams and ointments are the first treatment choice.

Steroids are the most widely used creams. It can also help treat psoriasis flare-ups with anthralin, synthetic vitamin D-3, and vitamin A products. These tend only to be accessible with a prescription.

Over-the-counter psoriasis creams include products containing aloe vera, jojoba, capsaicin or salicylic acid, zinc pyrithione and coal tar.

Prescription medications

A doctor may prescribe psoriasis medications if creams and ointments do not work. These medications are referred to as systemic drugs and can be in the form of pills, liquids, or injections.

Systemic medications include:

  • acitretin
  • cyclosporine
  • methotrexate

Biologic drugs for moderate-to – severe psoriasis can be recommended by a doctor. These drugs, which target specific parts of the immune system, are typically given as an injection or infusion to people.

Examples of biologic drugs include:

  • TNF inhibitors, such as Enbrel (etanercept) and Humira (adalimumab)
  • interleukin-12/23 inhibitors, such as Stelara (ustekinumab)
  • the interleukin-17A inhibitor Cosentyx (secukinumab)
  • T cell inhibitors, such as Orencia (abatacept)

Phototherapy

Management

Protecting the skin from sunburn can help prevent psoriasis flares.
Protecting the skin from sunburn can help prevent psoriasis flares.

Phototherapy is also called light therapy. This procedure includes exposing the skin regularly, under medical supervision, to ultraviolet light.

Two or three days a week, standing in a light box will cause the skin to tan or darken. This can make dark spots more visible on black skin, the American Academy of Dermatology (AAD) warns.

In this post, read more about psoriasis phototherapy.

No cure is available for psoriasis. Anything that irritates the skin will cause a flare-up of the disease. The AAD gives the following guidance, whenever possible, to prevent flare-ups:

  • avoid skin injuries, such as nicks, cuts, and bug bites
  • protect the skin from sunburn
  • use a cold compress and moisturize regularly to alleviate the itching
  • avoid scratching itchy skin

People should also learn to recognize the causes that contribute to their flare-ups. These vary between individuals, but may include:

  • stress
  • bug bites
  • summer heat and cold winter weather

Some people with psoriasis develop scalp lesions, so doctors can also prescribe shampooing with medicated shampoo regularly.

Summary

Psoriasis is a common skin disease that affects fewer African Americans in the United States than white people.

Psoriasis can look darker than the surrounding skin in black individuals or may appear purple. In both cases, it tends to have a scaly overlay. Psoriasis lesions, including the scalp, may occur anywhere in the body.

Anyone with symptoms of psoriasis should discuss diagnosis and appropriate treatment options with a doctor.

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