Psoriasis in skin of colour patients: where are we now?
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Authors
Gkini M.A.
Nakamura M.
Alexis A.
LondonoGarcia A.
P.,Van De Kerkhof
Doss N.
Griffiths C.
Kaufman B.
Kleyn E.
Lebwohl M.
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Issue Date
2024
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Conference Proceedings
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Abstract
Psoriasis is a chronic immune-mediated inflammatory disease affecting individuals across all races and ethnicities with reports of varying prevalence in different populations. Apart from similarities, there are nuances in various aspects of psoriasis in populations with skin of colour (SOC) as well as disparities in access to care and research.1 Our objective was to further understand the unique characteristics of plaque psoriasis in SOC patients. A literature search from January 2018 until August 2023 in Pubmed/MEDLINE and Cochrane Library was performed. Level of evidence for each study was assessed using the Oxford Centre for Evidence-Based Medicine recommendations and only studies with a level of evidence of I-III were included. The prevalence of plaque psoriasis is higher in White populations compared with those with SOC, although the disease is more severe, with higher body surface area affected and with a greater impact on quality of life in the latter group. The clinical picture in SOC patients may vary as lesions can appear as violaceous/grey and postinflammatory pigmentary alteration is a common associated feature. High-impact site involvement might be more common and more severe in patients with SOC. In terms of management, disparities in care have been reported. Data about the use of biologics or oral small molecules have shown similar efficacy and safety profiles across self-identified racial and ethnic groups. Psoriasis has been shown to have a greater impact on quality of life (QoL) in patients with SOC and new QoL tools that are more culturally appropriate for SOC patients may be required for use in global populations. Historically, access to clinical care and research has been more limited in people with SOC due to multiple factors. Inclusion of representative patient populations in registration trials has not changed significantly over the last years; however, postmarketing studies specifically involving SOC populations in North America have recently emerged. A limitation of our study is the lack of a universal definition and use of terms, such as ethnicity, race and SOC. In conclusion, racial and ethnic variations in epidemiology, clinical presentation, access to care, and QoL impact in psoriasis have been reported. However, data involving global populations with SOC are limited. This study raises awareness about the need to better understand psoriasis in patients with SOC so as to improve patient care globally.
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The British Journal of Dermatology