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While psoriasis has been found more frequently among Caucasians (3.6%) than in Asians (2.5%), Latinx (1.9%), and African Americans (1.5%), these numbers may not paint the full picture. [1] Psoriasis is often misidentified in people with darker skin types. [2] Evidence also suggests that racial/ethnic minority patients may be disproportionally affected by undertreatment. [3]
People of all races and ethnicities can develop psoriasis. In research to date, psoriasis has been found more frequently among Caucasians (3.6%) than in Asians (2.5%), Latinx (1.9%), and African Americans (1.5%). [1] This difference may be because psoriasis has been more easily identified in people with lighter skin and misidentified in people with darker skin types. [2] But there may be more people with skin of color living with psoriasis than is reported.
Psoriasis may look different on different skin types. On lighter skin, psoriasis often looks red with a silvery scale on top. [2] On darker skin types, psoriasis may look salmon, dark brown, purple, or violet with grayish scale. [2,4]
Here are more ways that psoriasis may look different on darker skin types [2]:
• Plaques may be thicker and have more scaling.
• Patients may have more skin affected by psoriasis than patients with lighter skin.
• Active psoriasis flares may be misdiagnosed as post-inflammatory hyperpigmentation (dark patches on the skin).
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[1] Armstrong AW, Mehta MD, Schupp CW, Gondo GC, Bell SJ, Griffiths CEM. Psoriasis Prevalence in Adults in the United States [published online ahead of print, 2021 Jun 30]. JAMA Dermatol. 2021;e212007. doi:10.1001/jamadermatol.2021.2007
[2] Kaufman BP, Alexis AF. Psoriasis in Skin of Color: Insights into the Epidemiology, Clinical Presentation, Genetics, Quality-of-Life Impact, and Treatment of Psoriasis in Non-White Racial/Ethnic Groups [published correction appears in Am J Clin Dermatol. 2018 Feb 16;:]. Am J Clin Dermatol. 2018;19(3):405-423. doi:10.1007/s40257-017-0332-7
[3] Takeshita J, Eriksen WT, Raziano VT, et al. Racial Differences in Perceptions of Psoriasis Therapies: Implications for Racial Disparities in Psoriasis Treatment. J Invest Dermatol. 2019;139(8):1672-1679.e1. doi:10.1016/j.jid.2018.12.032
[4] Can You Get Psoriasis if You Have Skin of Color? AAD.org. https://www.aad.org/public/diseases/psoriasis/treatment/could-have/skin-color. Accessed April 26, 2021
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