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Psoriasis:
The erythema of psoriasis can be striking within the spectrum of skin tones as it ranges from a salmon and deep reddish hue to a conspicuous violaceous color with areas of hypo- and hyperpigmentation. While you view the psoriasis collections, note the perilesional hyperpigmentation in some psoriatic plaques on darker tones.
The Woronoff Ring can be appreciated on lighter skin tones, but it is not as common as skin tones deepen. Also note that plaques can be so hyperkeratotic, doing justice to the term ostracious, that it is hard to unmask the color of the plaque, especially as skin tones darken in color.
Chronic or treated psoriasis can present without the silvery scales typical of psoriasis in all skin tones. In darker skin tones we can appreciate more of the post-inflammatory hyperpigmentation from healed psoriatic lesions.
For patients with darker skin tones, it is important to consider other conditions like hypertrophic lichen planus, chronic eczematous plaques, and discoid lupus plaques. When cutaneous lesions become more violaceous a lichenoid
eruption can be considered.
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