Psoriasis in skin of color
Nuances in diagnosis and treatment
Psoriasis is less likely among people with skin of color, but the often unsightly and quality-of-life threatening skin disease isn’t less impactful among African Americans, Hispanics/Latinos and Asians/Pacific Islanders.
Dermatologist Andrew F. Alexis, M.D., M.P.H., who directs the Skin of Color Center in New York City and is dermatology chair at Mount Sinai St. Lukes and Mount Sinai Roosevelt, New York, N.Y., presented on psoriasis in skin of color at the May 2015 Skin of Color Seminar in New York City.
Bigger burden on darker skin types?
Studies suggest that the quality-of-life effect of psoriasis on patients with darker skin types, including African Americans and Hispanics, may be greater than it is in Caucasians, according to Dr. Alexis.
“Potential reasons for this include the tendency to develop pigmentary abnormalities in association with psoriasis. So, after the psoriasis clears, there are persistent dark or light patches and vulgaris, which can last for many weeks or many months, depending on the person,” Dr. Alexis says. “Cultural perceptions of the disease that might also adversely impact quality of life.”
Ethnicity figures from a 2012 National Psoriasis Foundation study suggest that 87% of psoriasis cases are in Caucasians; 4% in the Hispanic/Latino population; 2% in African Americans; 2% Asian Americans; 1% in Native Americans; and 2% in others.
A 2011 study published in the Journal of Drugs in Dermatology by Dr. Alexis et al. found that Latinos, African-Americans and Asians are more deeply affected by psoriasis, physically and psychologically, than Caucasians.
The National Psoriasis Foundation found in 2009 that those same ethnic groups dealt with more embarrassment, anger, frustration and self-consciousness as part of their psoriasis. According to the study, nearly one-quarter of African Americans report having severe psoriasis compared to 8% of Caucasians. Seventy-two percent of minorities with psoriasis said it impacted their ability to enjoy life compared to 54% of Caucasians. More than three-quarters of minority respondents reported that psoriasis made their appearance unsightly, versus 64% of Caucasians. Minorities were also likely to report that their psoriasis was disfiguring and that they choose clothing to conceal psoriasis, according to the Foundation.