Disease Profiles

Explanation

Visible flare-ups are what people remember and picture when they think of psoriasis, so the disease gets judged by its most visually dramatic moments rather than its typical day-to-day reality.

Evidence

The same 31-country survey found approximately 45% of patients had been asked whether they were contagious. (Novartis “Clear About Psoriasis” Worldwide Survey, 2018)

Economic Consequence

This reinforces avoidance behaviour among colleagues and customers, increasing workplace exclusion and reducing career advancement opportunities — compounding the same employment penalty.

Sources

• Novartis “Clear About Psoriasis” Worldwide Survey (2018)
• Germain N, et al. (2021), “Stigma in visible skin diseases,” J Eur Acad Dermatol Venereol
• Akerlof, G. A. (1970), Quarterly Journal of Economics, 84(3), 488–500
• Tversky, A., & Kahneman, D. (1973), Cognitive Psychology, 5(2), 207–232

Explanation

Patients repeatedly choosing between immediate treatment costs (financial, time, side effects) and uncertain long-term symptom control disproportionately weight the certain near-term loss over the uncertain future gain — a textbook loss-aversion pattern.

Evidence

A four-country study (France, Germany, UK, USA) found weekly work-productivity loss rising from 2.4 hours (mild disease) to 19.0 hours (severe disease). (Br J Dermatol, 2020;182(4):1007–1016, PMID: 31260080)

Economic Consequence

Under-treatment driven by loss-averse decision-making prolongs flare-ups, increasing absenteeism, presenteeism, and healthcare cost burden.

Sources

• Br J Dermatol 2020;182(4):1007–1016, PMID: 31260080
• Germain N, et al. (2021), J Eur Acad Dermatol Venereol
• Kahneman, D., & Tversky, A. (1979), Econometrica, 47(2), 263–291
• Simon, H. A. (1955), Quarterly Journal of Economics, 69(1), 99–118

Explanation

Because vitiligo’s depigmentation is constant rather than intermittent, the “signal” employers and peers react to persists across a person’s entire working life, unlike conditions with visible flare-and-remission cycles.

Evidence

A comparative stigma study found psoriasis patients report more job discrimination than vitiligo patients — showing the signalling effect is read differently depending on visible texture and presumed contagiousness, not visibility alone. (Germain et al., 2021)

Economic Consequence

This uneven signalling effect produces inconsistent employment penalties across visible skin conditions, with the sharpest exclusion concentrated in public-facing and customer-facing roles.

Sources

• Da Costa AF, Ashkanani H, Ferreira C, Torres T. (2026), J Int Med Res, 54(5), PMID: 42082425
• Germain N, et al. (2021), J Eur Acad Dermatol Venereol
• Spence, M. (1973), Quarterly Journal of Economics, 87(3), 355–374
• Tversky, A., & Kahneman, D. (1973), Cognitive Psychology, 5(2), 207–232

Explanation

Visible difference triggers immediate categorisation into a stereotyped “other” group, followed by broad, evidence-free assumptions — Tversky & Kahneman’s representativeness bias, where people judge category membership by resemblance to a stereotype rather than actual evidence.

Evidence

Academic research across South Africa and Zimbabwe documents myths linking albinism to curses, contagion, and claims that body parts hold magical properties — assumptions based entirely on visible difference, not evidence. (Baker, Lund, Nyathi & Taylor, 2010)

Economic Consequence

These evidence-free categorisations drive exclusion from education, employment, and marriage markets, and in the most severe cases create direct safety risk that suppresses economic participation entirely.

Sources

• Under the Same Sun, “Frequency of Albinism / Rates of Occurrence”
• Baker, C., Lund, P., Nyathi, R., & Taylor, J. (2010), “The myths surrounding people with albinism in South Africa and Zimbabwe,” Journal of African Cultural Studies
• Spence, M. (1973), Quarterly Journal of Economics, 87(3), 355–374
• Tversky, A., & Kahneman, D. (1974), Science, 185(4157), 1124–1131