A guest stated on the August 25 episode of WebMD’s “Health Discovered” podcast that she had had psoriasis since she was 7 years old.
Alisha Bridges claimed she was in her twenties when she saw a doctor for treatment and was informed she likely did not have the disease because it did not present in the typical manner on pale skin. Bridges stated that the lack of visual representation of Black people in instructional materials offered to physicians makes it more difficult to diagnose the disease in patients with dark skin. Bridges is now on a mission to raise awareness about psoriasis and other chronic illnesses following her own misdiagnosis.
A 2015 analysis of about 799,00 Medicare psoriasis claims revealed that Black recipients were less likely than White recipients to receive biologics, the recommended treatment for moderate to severe psoriasis. Biologic treatments are typically injected medications that target immune system components and block proteins and cells that can cause psoriasis. Dr. Junko Takeshita, an assistant professor of dermatology at the University of Pennsylvania and the study’s principal investigator, stated on the podcast that incorrect diagnoses could prevent Black psoriasis patients from receiving effective treatment.
Takeshita stated that a higher presence of darker-skinned people with psoriasis in the media and in education may help people detect the disease and receive treatment more quickly.
In her 20s, Bridges’ psoriasis was misdiagnosed, delaying appropriate treatment.
Psoriasis is a chronic autoimmune skin disease in which the body’s immune system assaults healthy skin cells, leading the rapid development of new skin cells. According to the Mayo Clinic, the most prevalent form of psoriasis is plaque psoriasis, in which dead skin cells develop elevated, itchy skin patches called plaques. These patches might vary in color, depending on the person’s skin color. A panel of specialists in a podcast edition of the National Psoriasis Foundation for World Psoriasis Day in 2019 estimated that 2% to 3% of the global population had psoriasis.
Since the age of seven, Bridges has had itchy, dry patches on her body, but when she contracted chicken pox as a child, the patches spread to 90% of her body, she said. While she was diagnosed with psoriasis shortly thereafter, she said her insurance limited her to treatments like phototherapy and occlusion – a treatment when the patient is wrapped with a topical steroid and plastic suit for a prolonged period. She stated that the dry skin remained unabated.
In her mid-20s, Bridges visited a Black physician in search of cultural sensitivity and to try alternative treatments for her psoriasis.
“I was like, ‘OK, she’s Black. She’ll get it,'” Bridges said on the podcast. “But she looked at my skin and said, ‘Eh, I don’t think it’s psoriasis because it doesn’t look the way we’ve been taught to think it’s supposed to look.'”
Given the ineffectiveness of her past treatments, the doctor diagnosed Bridges with lichen planus, an autoimmune disorder that can manifest as purple skin lesions, according to Healthline.
Bridges said psoriasis on darker skin could show up as purple, dark red, and pink patches, not red, which is how the disease may present on people with lighter skin. She reported that she finally met Dr. Jamie Weisman at a National Psoriasis Foundation event. Dr. Weisman has dealt with a variety of psoriasis patients. Bridges stated that Weisman was able to prescribe her biologics, which have helped nearly completely clear her skin.
According to a study, dermatologists are less likely to diagnose and treat psoriasis among Black people.
Takeshita remarked on the podcast that her team’s research based on Medicare patients with psoriasis found that Black patients were 70% less likely to obtain biologic treatments than their White counterparts.
She stated that bias in treatment could be the result of a number of factors, such as lower rates of diagnosis among Black patients, racial inequities in insurance coverage, and a lack of representation of people of color with psoriasis. She stated that black people may not even be aware that plaque psoriasis exists because advertisements for medicine predominantly depict white people.
In addition to education, she stated that media representation of people of color with psoriasis must be improved.
Signs of plaque psoriasis
Psoriasis typically manifests as thick, scaly, and raised skin on the body. Takeshita stated that these patches typically form on the outside of the elbows, knees, scalp, as well as the belly button and buttocks. They are also often symmetrical, she said, so they sometimes appear in the same place on both sides of your body.
Bridges and Takeshita both recommend to go to the National Psoriasis Foundation’s website for information if you’re worried that you have plaque psoriasis or have been diagnosed with it.