Psoriasis in Patients of Color: Differences in Morphology, Clinical Presentation, and Treatment

This is the authors' abstract. We don't add key points for this paper.

Psoriasis is a chronic inflammatory skin disease affecting 2% to 3% of individuals worldwide.However, the majority of clinical data are in white patients, with limited data in patients of color.We present 3 cases of psoriasis representative of patients presenting to an urban and racially diverse hospital-based dermatology clinic in Toronto, Ontario, Canada, to illustrate the differences in psoriasis in patients of color compared to white patients.We review the differences in the morphology, presentation, treatment, and psychosocial impact of psoriasis in this population.We also discuss the importance of early diagnosis, treatment considerations, and education in dermatology training programs regarding psoriasis in patients of color.Cutis.2020;106(suppl 2):7-10. Psoriasis is a chronic inflammatory skin disease that affects 2% to 3% of individuals worldwide.1 Despite extensive research, the majority of clinical data are in white patients with limited data in patients of color, yet a number of differences are known.The prevalence of psoriasis differs among racial and ethnic groups, with lower prevalence in racial minorities. 2 A cross-sectional American study using data from 2009 through 2010 showed the prevalence for psoriasis was 3.6% in white patients, 1.9% in black patients, 1.6% in Hispanic patients, and 1.4% in other racial groups.3 Psoriasis presents differently in patients of color, both in morphology and severity.Cultural differences and stigma may contribute to the differences seen in severity but also to the psychological impact and treatment choices in patients of color compared to white patients.4 It has even been theorized that treatment efficacy could differ because of potential genetic differences.5 Psoriasis in patients of color is an emerging clinical issue that requires further attention so that dermatologists can learn about, diagnose, and treat them.We report 3 cases of patients of color with psoriasis who presented to an urban and racially diverse dermatology clinic affiliated with Scarborough General Hospital in Toronto, Ontario, Canada.A retrospective chart review was performed on these high-yield representative cases to demonstrate differences in color and morphology, disease severity, and treatment in patients of various races seen at our clinic.After informed consent was obtained, photographs were taken of patient cutaneous findings to illustrate these differences.Discussion with these selected patients yielded supplementary qualitative data, highlighting individual perspectives of their disease. Case SeriesPatient 1-A 53-year-old black man from Grenada presented to our clinic with a history of psoriasis for a number of years that presented as violaceous plaques throughout large portions of the body (Figure 1).He previously had Psoriasis in Patients of Color: Differences in Morphology, Clinical Presentation, and Treatment