Population differences in psoriasis

Psoriasis affects an estimated 125 million individuals worldwide and is a major contributor to skin-related disability. The clinical manifestation of psoriasis may vary within people with different skin types and may affect the outcome of the management of this chronic immune-mediated inflammatory disease. Special consideration should be given to variances not only in morphology and presentation, but also in treatment and in cultural and psychosocial factors. Globally, more light-skin-coloured people tend to get diagnosed with psoriasis than people of darker skin types. Chances of developing this long-term skin condition may be different based on age, gender, race and ethnicity. Education on the clinical variation of psoriasis among different skin colors and treatment options may help doctors to better diagnose and treat this skin disease. This will also promote the awareness of this visible skin disease, reducing the stigmata that many patients frequently face.

Psoriatic arthritis with more affected swollen joint counts is more prevalent in patients with darker-coloured skin types. They are also more likely to have radiographic axial involvement. These findings may reflect racial and ethnic differences in skin and joint manifestation of psoriasis. Associations between sociodemographic factors and the activity of the adaptive and innate immune system are set by genes and several epigenetic factors. The gut and skin microbiota will also play an important mediating role in defining the severity and course of psoriasis in individuals of racially and ethnically diverse backgrounds. Finally, the effects of environmental factors (climate change, heat and pollution) in various racial and ethnic groups need to be taken into serious consideration in future psoriasis clinical care and research design.