Racial minorities less likely to see a doctor for psoriasis

December 13, 2017

PHILADELPHIA - Despite the fact that their disease may be more severe, a new study shows minorities are less likely than white Americans to see a doctor for psoriasis treatment. Researchers from the Perelman School of Medicine at the University of Pennsylvania found that black, Asian, and other non-Hispanic minorities are about 40 percent less likely to see a dermatologist for psoriasis than whites. Additionally, whites averaged about double the number of doctor's appointments for psoriasis overall compared with non-Hispanic minorities. Rates were similar between white and Hispanic individuals. Researchers published their findings this week in the Journal of the American Academy of Dermatology.

Psoriasis is a chronic inflammatory disease that causes skin cells to multiply faster than normal resulting in raised, red patches covered by silvery scales. It occurs most commonly in a symmetrical manner on the scalp, knees, and elbows but can appear anywhere on the body including the face, genitals, nails, and other places. It also has profound effects on health-related quality of life, and in moderate to severe cases, it carries an increased risk of heart attack, stroke, and premature death. The National Psoriasis Foundation estimates psoriasis affects about 7.5 million Americans.

"While psoriasis is less common among minorities, previous research has shown their disease can be more severe. Despite that, this study shows minorities are less likely to see a dermatologist for treatment," said the study's senior author Junko Takeshita, MD, PhD, MSCE, an assistant professor of Dermatology and Epidemiology at Penn.

The study's lead author was Alexander H. Fischer, MD, MPH, who was a medical student at Johns Hopkins University at the time of the research.

The researchers gathered data from the Medical Expenditure Panel Survey, the most complete source of data currently available on healthcare utilization, cost, and insurance coverage in the United States. All of the information is self- or caregiver-reported over a series of interviews, and is designed to be representative of the general population. The team used information from 2001 through 2013 and identified 842 psoriasis individuals representing over 1.6 million Americans.

An average of 50.8 percent of whites saw a dermatologist for their psoriasis, compared to just 38.3 percent for non-Hispanic minorities, which include blacks, Asians, native Hawaiians and Pacific Islanders, and others. Among Hispanics, 46.7 percent saw a dermatologist for their psoriasis.

In addition to the rates for dermatological visits, whites also averaged approximately twice as many visits to a doctor overall. Researchers found whites averaged 2.69 visits per year, compared to 1.87 for Hispanics and 1.30 for non-Hispanic minorities. In total, this amounts to over 3 million fewer visits per year for psoriasis among non-Hispanic racial minorities compared with whites.

"When you combine the results of our study with the knowledge that psoriasis severity and quality of life impact suggest a larger burden of psoriasis among minorities, it brings into focus the racial gaps that exist in psoriasis care," Takeshita said.

The researchers say more research is needed to understand what may be contributing to these disparities, and if the gap in medical care is directly contributing to the increased severity of disease among minorities.

"Ultimately, increasing awareness of these disparities is the first step in trying to provide equitable care and improve outcomes for all individuals with psoriasis," Takeshita said.
-end-
This study was supported by grants from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (K23-AR068433, K24-AR064310).

Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $6.7 billion enterprise.

The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $392 million awarded in the 2016 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center -- which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report -- Chester County Hospital; Lancaster General Health; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2016, Penn Medicine provided $393 million to benefit our community.

University of Pennsylvania School of Medicine

Related Psoriasis Articles from Brightsurf:

Most psoriasis patients taking immunosuppressants survive COVID-19
Patients with psoriasis who are taking drugs that affect their immune system have high rates of survival from COVID-19.

Getting under the skin of psoriasis
Psoriasis afflicts millions of people worldwide, but treatments are limited to small molecules like steroids, which can cause skin thinning and lose their effectiveness over time.

Psoriasis patients' mental health is more than skin-deep
A new study from Umeå University, Sweden, shows that other somatic diseases have even more impact on patients' mental health than their skin symptoms, highlighting the importance of holistic patient care.

Psoriasis: Towards a novel therapeutic approach
Researchers at the Université libre de Bruxelles (ULB) and the Department of Dermatology of the Erasme hospital uncover the importance of VEGFA signaling in the epidermis to mediate psoriasis development.

Insights into psoriasis suggest a new treatment target
Investigators from Brigham and Women's Hospital and the Harvard Stem Cell Institute have uncovered a novel pathway that may explain why skin thickens in psoriasis and suggests new strategies for developing therapies for the condition.

Psoriasis onset determines if psoriatic arthritis patients develop arthritis or psoriasis first
In a new study presented at the 2019 ACR/ARP Annual Meeting, researchers found the age of psoriasis onset determines whether arthritis or psoriasis starts first in people with psoriatic arthritis.

Study: Some biologic treatments for psoriasis may be safer for patients
In the largest study of its kind, Erica D. Dommasch, M.D., M.P.H., a dermatologist in the Department of Dermatology at BIDMC, and colleagues found a decreased risk of infection in patients with psoriasis using some of the newer, more targeted medications compared to those taking methotrexate, a drug widely used since the 1960s as a first line treatment for moderate-to-severe psoriasis.

Higher weight increases risk of psoriasis
The higher a person's BMI, the greater the chance of getting psoriasis.

Lipid that aids normal skin turnover may help psoriasis
Topical application of the lipid phosphatidylglycerol, or PG, on a mouse model of psoriasis reduced inflammation as well as characteristic, raised skin lesions, they report in the Journal of Investigative Dermatology.

New insight into the mechanism of the drug against sclerosis and psoriasis
A multidisciplinary research team at Aarhus University has provided fundamental new insight into the mechanism of the medical drug dimethyl fumarate, which is the active component of important treatments for multiple sclerosis and psoriasis.

Read More: Psoriasis News and Psoriasis Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.