Moderate to Severe Plaque Psoriasis: A Closer Look at its Impact on People of Color
Although moderate to severe plaque psoriasis is a well-documented condition among individuals with light skin tones, there is a lack of representation and understanding in people of color. We had the opportunity to speak with Dr. Andrew Alexis about this chronic disease, its effects on people of color, and the ongoing efforts in dermatology to address research gaps and improve care.
Understanding Moderate to Severe Plaque Psoriasis
Moderate to severe plaque psoriasis is an immune-mediated disease that can affect various parts of the skin, including the scalp, torso, hands, and feet. It can also involve the nails. This condition leads to the accumulation of skin cells, causing red to darker brown or purple raised areas with scales. It can be accompanied by itching, pain, and a burning sensation, significantly impacting the individual’s quality of life.
Presentation of Plaque Psoriasis on Skin of Color
In individuals with lighter skin tones, plaque psoriasis typically manifests as red, scaly, elevated lesions. However, in people with darker skin tones, the plaques may appear as different shades, including purple, grayish, or darker brown. This variation in appearance can make it challenging for people of color to recognize the symptoms, resulting in delayed or incorrect diagnosis and limited access to appropriate treatments. It is essential for individuals suspecting plaque psoriasis to consult a board-certified dermatologist for accurate diagnosis and timely treatment.
Challenges Faced by People of Color with Plaque Psoriasis
Living with plaque psoriasis poses several challenges for people of color, including delays in diagnosis, misdiagnosis, treatment barriers, and difficulties in navigating the healthcare system. The visible presence of scaly plaques can lead to embarrassment and inquiries, creating social and professional discomfort. A survey revealed that people of color with plaque psoriasis often experience additional burdens related to pigmentary changes, exacerbating feelings of shame and embarrassment. In some cases, individuals may feel uncomfortable seeking healthcare or believe their concerns are not adequately addressed by their physicians.
Building an Effective Relationship with Your Dermatologist
Patients can establish an effective relationship with their dermatologist by embracing shared decision-making. It is crucial for individuals to express how the condition affects their daily lives and any specific concerns or preferences they may have regarding treatment options. Open communication allows both the patient and the healthcare provider to develop a personalized treatment plan that considers the patient’s unique needs, lifestyle, and routine.
The Role of Race and Skin Color in Plaque Psoriasis Treatment
While clinical studies for approved plaque psoriasis treatments have included patients of color, their representation remains limited. This lack of data hinders the understanding of how the disease and its medications impact diverse populations. Moreover, certain nuances necessitate customized treatment approaches, such as avoiding daily medicated shampoo treatments for individuals with African descent or afro-textured hair. Effective communication with healthcare providers is vital to address these specific needs and ensure appropriate treatment plans.
The Gap in Biologic Therapy Prescriptions for Black Patients
Biologic therapies, which target specific proteins involved in plaque psoriasiss inflammation, have proven effective in treating severe forms of the condition. However, a study revealed that Black patients were significantly less likely to receive biologic treatment. Factors contributing to this gap include underdiagnosis, limited access to specialty care, and insufficient awareness of available therapies. Addressing these complex issues requires improved diversity in clinical research and healthcare providers’ efforts to understand the unique challenges faced by people of color.
The VISIBLE Study: Bridging the Gaps in Care
The VISIBLE study, conducted in collaboration with Janssen, aims to address the gaps in care for people of color with moderate to severe plaque psoriasis. This large-scale study focuses on understanding and characterizing the disease among Black, Hispanic, Asian, Indigenous, and other people of color. It evaluates the efficacy and safety of a targeted treatment and generates valuable insights into disease burden and patient experiences. With a strong emphasis on diversity, community engagement, and inclusive research practices, the VISIBLE study seeks to promote equitable care and expand our knowledge of plaque psoriasis across diverse populations.
Ensuring Equitable Care for People of Color with Plaque Psoriasis
The medical and industry communities must prioritize diversity in clinical research to achieve health equity for people of color living with plaque psoriasis. Efforts like the VISIBLE study enhance our understanding of the condition and improve treatment outcomes. Additionally, increasing diversity in the physician workforce has been shown to reduce healthcare disparities and better serve underserved populations. Encouraging younger generations to pursue careers in dermatology is essential for a stronger, more inclusive specialty that can effectively support our communities.
To learn more about plaque psoriasis and find a doctor near you, visit the Skin of Color Society.