Having a condition like plaque psoriasis that is apparent to others can be challenging at times. However, you are not alone. According to a study published in JAMA Dermatology in June 2021, more than 7.5 million American people aged 20 and up suffer from the same skin disease.
According to Adam Friedman, MD, professor of dermatology at George Washington School of Medicine and Health Sciences, psoriasis is most known for its red, raised, and flaky appearance on areas like the elbows, knees, and buttocks, but it can also affect other locations, including the scalp.
According to him, the same characteristics make it simple for dermatologists to diagnose during an exam.
What does plaque psoriasis looks like?
Let's start with why it appears to be scaly. According to the National Psoriasis Foundation, people with plaque psoriasis have an overactive immune system, which causes their skin cells to develop at a rapid rate—in just three to four days. The cells, on the other hand, do not fall off as fast, causing them to accumulate on the skin's surface.
Plaques and scales form as a result of the dead skin. They come in a variety of sizes and can form solitary patches separated by healthy skin or clusters of patches that connect to cover huge amounts of skin.
"The plaques are somewhat raised. They rise above the surrounding skin to form a plateau. You could feel psoriasis if you closed your eyes and touched it "Dr. Robert T. Brodell, chair of the University of Mississippi Medical Center's department of dermatology, explains.
The scales are called "micaceous" because they resemble the mineral mica, which separates into very thin elastic plates, according to him.
"A large white flake falls off if you stick your finger underneath one of the [psoriasis] scales, unlike some other disorders where you can have a small scale, like dandruff," he says.
What do different skin tones look like when it comes to plaque psoriasis?
Psoriasis might look different depending on the color of your skin.
"When you biopsy plaque psoriasis in patients of all races, it's the same," Dr. Brodell explains. On the skin, though, it may appear otherwise," he explains. For example, he claims that persons of African descent may notice that their skin darkens in inflamed places.
"Inflammation causes brown melanin pigment to slip into the deeper dermal layer of skin behind the psoriasis," Dr. Brodell explains. "Instead of having white micaceous scale, it will be dark."
Dr. Friedman agrees, pointing out that red and flaky rashes don't represent the whole range of psoriasis symptoms on different skin tones. The scales appear pink and silvery white on lighter skin tones, he notes. The scales appear purple and yellow on deeper skin tones, and "they may look wart-like as well."
However, Dr. Friedman points out that several plaque and scale characteristics are consistent across all psoriasis kinds and skin types, including the following:
- Well-cut off or well-defined
- Raised
- Dry skin with a stuck-on appearance
Psoriasis that is irritated might resemble eczema?
Some people scrape their plaque psoriasis because it is itchy.
"Irritated psoriasis can develop inflammatory and have the appearance of chronic eczema in a patient who rubs and scratches a lot. It thickens the more you scratch it, and so on "Dr. Brodell agrees.
A dermatologist can tell the difference between the two disorders that cause your skin to be red and inflamed. Without a biopsy or blood test, the diagnosis can be determined based on subtle changes in the appearance, location, and spread of the rash, as well as other indicators (such as whether the person has joint stiffness).
What body parts does plaque psoriasis affect?
According to the American Academy of Dermatology Association, plaque psoriasis can affect any area of the body, although it most commonly affects the:
- knees
- lower back
- elbows
- scalp
According to Dr. Brodell, "one of the reasons we think psoriasis develops on the extensor elbows and knees is because of frictional stress on those sites."
It depends on whether a person's body is affected in one or more regions. Dr. Brodell examines patients with psoriasis in one part of the body and others with psoriasis in multiple places of the body. "We've even seen folks who have pitting in their nails for years before we notice psoriasis on other parts of their body," he says.
After treatment, how does plaque psoriasis look?
Dr. Friedman believes that now is the best moment to develop plaque psoriasis.
"The question isn't how you're going to cure it; it's which [therapy] you're going to choose because there are so many," he explains.
Dr. Brodell believes that once treatment begins to work after a flare-up, the plaques will be gone and the skin will be flat. However, redness may persist on lighter skin tones, and blackness may persist on deeper skin tones.
"There's no scaling, no itching," he explains, "but there's a little amount of redness or blackness that can take months and months to go away."
Even if a biopsy reveals no signs of inflammation or thickening of the skin, the pigmentation change may persist. "So, even after the inflammation is in remission, where the inflammation is gone or really well-controlled," Dr. Brodell explains, "it takes a while for the skin to appear absolutely normal."