As our cultural environment becomes more defined by visual social media and instant knowledge, the human body is examined like never before. But some physical conditions remain misunderstood, hiding in the shadows of popular knowledge. Plaque psoriasis is such a condition – highly visible to those who experience it, yet poorly understood by the general public. Plaque psoriasis is a chronic autoimmune skin disease that leads to physical and often emotional distress. But what does plaque psoriasis look like? And why does it matter how we understand its appearance?
The Physical Manifestation
Psoriasis is a condition that affects millions of people all over the world with plaque psoriasis being the most common. A common telltale symptom of plaque psoriasis is raised red patches topped with a silvery-white buildup of dead skin cells, also referred to as plaques. These plaques can occur anywhere in the body but most commonly appear on the elbows and knees, scalp or lower back.
These patches have a characteristic feel: thick and scaly, rough and dehiscent, in stark contrast to the skin surrounding them. The redness of the plaques stems from inflammation, as the immune system wrongly attacks healthy skin cells, causing them to proliferate at an accelerated rate. This increased turnover of skin cells produces the characteristic buildup and scale, which can lead to itch, pain and even bleeding.
However, the visual manifestation of plaque psoriasis can range from small and isolated to large and widespread, depending on the affected person. Sometimes, the plaques appear as small discrete lesions, seemingly isolated, one by one, that can be easily concealed; other times, the plaques appear large and coalescent, merging into large areas that cover broad fields of the body. At times, the manifestations can be severe, presenting with widespread disease and covering body parts up to around 70-80 per cent of the body surface; at other times, the manifestations are mild and present with minimal disease. These manifestations vary in their timing and intensity, with flares of symptoms followed by periods of remission or lessened symptoms.
Beyond the Surface
Although we talk about plaque psoriasis in clinical terms – it’s most often described as red, scaly and inflamed – for many plaque psoriasis patients, the visual nature of the disease can be extremely isolating. The plaques are there all the time and they are visible evidence of the disease. They draw attention, they get stares and comments and questions from people who are unfamiliar with the illness.
Because plaque psoriasis is highly visible, it can have a powerful psychological effect. People with psoriasis are more likely to experience depression, anxiety and other psychiatric illnesses. The perceived ugliness of the plaques makes some sufferers self-conscious and socially withdrawn; overall, the disease can diminish patients’ quality of life. ‘It’s just skin’: where does this reaction come from, and what does it mean?
Why Understanding Matters
But why should it matter what plaque psoriasis looks like? The answer to this question is that recognising the appearance can help persons experiencing symptoms to get medical advice early, which in turn could lead to better management of the disease. Early treatment of psoriasis can slow the progression of the condition and prevent the development of complications.
Another is the practicality of raising public awareness about what plaque psoriasis looks like, which can lead to an increased capacity for empathy and compassion, and reduce stigma. Once we realise that the plaques and scales are not a product of bad hygiene or contagion, treated as a normal part of life, they become easier to engage with. There might even be an increased capacity for empathy and compassion – for the person and their condition. As Antonio points out, being free of the stigma often associated with visible skin conditions
Plaque psoriasis is as complex as it is common. When it shows itself on a person’s skin, it can also be an outward manifestation of an internal struggle, affecting a patient’s physical, emotional and social life. So knowing what plaque psoriasis looks like is a small step towards greater understanding and increased empathy, demonstrating that the person experiencing it is not beyond the realm of human. More than ever, in a world that often seems to judge by appearances, a greater understanding can make all the difference.
