Addressing Diagnostic Gaps in Psoriasis for Skin of Color

Announcer:
You’re listening to DermConsult on ReachMD. On this episode, we’ll hear from Dr. Megan Hauptman, who’s a Clinical Research Fellow in the Program for Clinical Research in Dermatology at the University of Michigan Medical School in Ann Arbor. She’ll be discussing the challenges of diagnosing psoriasis in patients with skin of color.

Here’s Dr. Hauptman now.

Dr. Hauptman:
Some of the diagnostic challenges that clinicians face when evaluating psoriasis patients with darker skin types is that, due to the altered color presentation and reduced clinical recognition, there are often diagnostic delays and increased need for biopsy confirmation. There's also variation in plaque appearance across skin tones and, with patients with Fitzpatrick skin types four tosix, psoriasis plaques typically appear dark brown, gray, or blue rather than the classic red erythematous or salmon pink presentation seen in lighter skin. Misdiagnosis is common, and this probably has a lot to do with that. It looks different. It has a different clinical presentation than lighter skin types.

And so the differential becomes more complex as conditions like lichen planus, tinea corporis, and subacute cutaneous lupus erythematosus must be distinguished from psoriasis. And post-inflammatory dyspigmentation is more common after psoriasis plaques resolve in skin of color, which leads to another layer of diagnostic and management complexity.

So these diagnostic challenges contribute to underdiagnosis and undertreatment of psoriasis in individuals with skin of color, which highlights the need for increased clinical awareness and education regarding psoriasis presentation across the full spectrum of skin tones.

Announcer:
That was Dr. Megan Hauptman talking about the complexities of psoriasis diagnosis in patients with skin of color. To access this and other episodes in our series, visit DermConsult on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!