Psoriasis in Skin of Color

Abstract

Psoriasis is a chronic inflammatory disease that affects approximately 3.2% of the adult population of the USA. Amongst this population, Caucasians have the highest prevalence rate at 3.6%, while in non-Caucasians or individuals with skin of color the prevalence is lower, 1.9%, 1.6%, and 1.4% in African Americans, Hispanics, and other non-Caucasians, respectively [1]. Based on these statistics, one might gather that psoriasis is less likely in skin of color [2]. One of the earliest review articles detailing psoriasis prevalence by ethnic origin highlights several groups including the specific categories: Caucasian, African American, black-skinned South African, Fiji Islands, American Indian, Latin American Indian, Japanese, and Indonesians [3]. The 1965 text perpetuates the idea that psoriasis is relatively common in Caucasians and much less frequent in skin of color while acknowledging that psoriasis may not be as rare in those of African descent as previously believed. It was proposed that in evaluating the incidence of psoriasis among different ethnic groups, the potential influence of variables such as genetics, climate, diet, degree of skin pigmentation, exercise, stress level, economic factors, social factors, and hygiene factors must be considered [3]. This study was subject to selection bias as the text concluded that psoriasis was uncommon in black-skinned individuals during a time period when black-skinned individuals with psoriasis were much less likely to visit the dermatologist than white Caucasians.