Psoriasis: What is it, symptoms and treatment

A man scratching his itchy arm in a park. Picture: supplied

A man scratching his itchy arm in a park. Picture: supplied

Published Feb 29, 2024


If you ever feel like you are the only person dealing with psoriasis, fear not. You're not alone. More than 7.5 million adults in the US are right there with you.

Psoriasis, a chronic skin condition affecting millions worldwide, has long been a topic of concern in the medical community due to the absence of a cure, although there are various options available to alleviate its symptoms.

Man with purulent arthritis scar on right knee. Picture: Supplied

Psoriasis can manifest differently on black or brown skin compared to white skin, yet the common symptom of itchiness remains consistent.

Despite the lack of representation in medical literature, treatment is available to help manage the symptoms of psoriasis on darker skin tones.

While media representations often focus on how psoriasis affects individuals with lighter skin tones, psoriasis affects people of all races, including people of colour. The symptoms may vary from person to person.

Psoriasis is characterised by hardened skin and itchy, scaly patches, resulting from the immune system mistakenly attacking healthy skin cells.

The exact cause remains elusive, but researchers are exploring the complex interplay between genetics, environment and ethnicity. Studies have also investigated disparities in the prevalence and severity of psoriasis among different racial and ethnic groups.

The appearance of psoriasis can vary based on the type and location of the body. For individuals with non-white skin tones, pink or red skin discolouration may not be a typical symptom of psoriasis.

Ahmed El Hofy, general manager in South Africa for the Janssen Pharmaceutical Companies of Johnson & Johnson, emphasised that psoriasis can affect anyone, regardless of race or ethnicity.

Studies have shown that psoriasis cases tend to increase in colder, less sunny regions, possibly due to reduced exposure to sunlight, a natural source of vitamin D that plays a role in skin health.

Lifestyle factors such as smoking, excessive alcohol consumption and stress have been linked to the onset and severity of psoriasis, often associated with one’s cultural environment, according to El Hofy.

While research suggests that certain ethnic groups may be more susceptible to the condition, psoriasis has historically been considered less common in people of African, Hispanic and Native American descent compared to Caucasians.

The prevalence of psoriasis appears to be highest in northern European countries, with Norway topping the list, while East Asia appears to have the lowest incidence.

More recent studies are suggesting that psoriasis might be under-diagnosed in African populations because of differences in healthcare access, under-reporting or even misdiagnosis in lower-income districts.

Additionally, the genetic diversity within Africa is vast, so the umbrella term of “African” is not a precise one, when it comes to the accurate reporting of genetic differences. Healthcare professionals and researchers continue to investigate in a more focused fashion, in the quest to provide better insights into the condition’s prevalence among different populations.

The reasons behind the ethnic disparities among psoriasis patients are intricate and multifaceted, involving genetic predisposition and environmental factors.

Specific genetic markers associated with psoriasis have been identified in different population groups, indicating the significant role of genetics in the condition.

For example, variations in the HLA-C gene have been linked to a higher risk of psoriasis in Caucasians, while genetic factors such as the PSORS1 locus are more prevalent among individuals of South Asian descent, explained El Hofy.

In addition to genetic predispositions, environmental factors have been reported to exacerbate the risk of psoriasis. Climate, lifestyle and socio-economic status all contribute to the complex web of psoriasis susceptibility.

Furthermore, limited access to healthcare, education, and resources, particularly among marginalised communities, can lead to delayed or mistaken diagnoses and inadequate management of symptoms.

Raising awareness about psoriasis is a crucial first step, and culturally sensitive educational initiatives can debunk myths and misconceptions, encouraging affected individuals to seek medical help without fear of social stigma.

By addressing the genetic and environmental factors, as well as the social and cultural aspects, it is possible to provide more effective support and care for individuals from diverse ethnic backgrounds affected by psoriasis.

There are several treatments available to alleviate the symptoms of psoriasis. These treatments can include:

Topical treatments: These are applied directly to the skin and can include corticosteroids, vitamin D analogues, retinoids and coal tar preparations.

Phototherapy: This involves exposing the skin to ultraviolet light under medical supervision. Both natural sunlight and artificial light can be used in this treatment.

Systemic medications: These are prescription medications that work throughout the body and are often used for moderate to severe cases of psoriasis. They can include oral or injected medications such as methotrexate, cyclosporine and biologics.

Moisturisers: Keeping the skin well-moisturised can help alleviate the dryness and itching associated with psoriasis.

Lifestyle changes: Avoiding triggers such as excessive alcohol consumption, smoking and stress can help manage the symptoms of psoriasis.