It’s not just a rash! Dr. McKinley-Grant knows about the inequities surrounding Black women with plaque psoriasis.
Plaque Psoriasis is an autoimmune disease of the skin, “often lumped with Eczema”, says Dr. McKinley-Grant, Associate Professor of Dermatology at Howard University College of Medicine and Adjunct Professor and former Vice Chair for Diversity and Community Engagement at Duke University School of Medicine. Dr. Grant is also the former president of the Skin of Color Society.
Some people are born with it, some develop it during childhood. It sometimes starts with arthritis, then a patch of plaque that develops into a life-threatening condition. Patients don’t always have both, says Dr. Grant but a large percentage will.
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Disparities in diagnosis
She explains that because most of the information about plaque psoriasis is directed toward lighter-skinned people, “It's hard to diagnose in darker skin” therefore, people of color often go through hurdles that others do not.
Dr. Grant further explains that the common places people will see the psoriasis are in the scalp, both elbows, and knees. She speaks about a symmetrical pattern.
This condition is “debilitating” psychologically and physically. It affects a person’s self-image in addition to their physical health.
Dr. Grant encourages the public to learn about Determi-nation, Janssen Pharmaceuticals' commitment to addressing health disparities and bridging the gaps in care for people of color.
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She shares that medical professionals from all areas are working together (Nurse Practitioners, Medical Assistants, Physicians, and more) to provide more training for people of color and “address people in all areas” to help with the misdiagnosis of plaque psoriasis.
Dr. Grant describes plaque psoriasis as a “difficult disease” with “no cure”. This is one of the reasons Dr. Grant advises dermatologists to “listen to patients”.
She says it is vital for them to get training on darker skin. Dr. Grant adds that dermatologists should “hear with their eyes and see with their ears”. They need to consider that “it's not just a rash”.
And finally, she urges dermatologists dealing with plaque psoriasis to know where to get help and to “refer patients somewhere else if they can’t help them”.
Dr. Grant is calling for more people of color in the field of Dermatology. She believes this would help decrease the health inequities in communities of color.
When asked about the inequities in treatment, Dr. Grant said costs are a big factor as insurance won’t always cover certain medications. Physicians may not recommend treatment and darker-skinned people may be told to wash their hair daily as a solution.
She further adds that doctors don’t always recognize the condition as plaque psoriasis and even when they do, patients may not have access to a rheumatologist.
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How to manage your psoriasis
When asked if there was advice for patients who have or may have psoriasis, Dr. Grant advises them to be aggressive; “make the doctors see things” and “make sure the doctor is listening”.
She urges patients to do some research. See if the doctor has experience with patients of color. Find out if they have had extra training and have they taken “Skin or Color Courses”. Find out where they trained. And very importantly, ask for a biopsy.
Once diagnosed, Dr. Grant wants patients to make sure the doctor gives them a treatment plan that works with their lifestyle and when they do, stick with that plan.
If the treatment requires 3 visits per week and the patient doesn’t have transportation, request a different plan. Follow-up visits are vital and just like any condition, she says “the earlier it is treated, the better”.
For more information on the Janssen movement, click here.
