January 07, 2020
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US Latinos disproportionately affected by psoriatic disease severity

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Prevalence rates of psoriasis are lower among the Latino population than the white or black population in the U.S., but Latino populations are often disproportionately affected by poorer quality of life and disease severity, according to recent findings.

“Current evidence suggests that there are notable differences in the severity of psoriasis between racial and ethnic groups,” Alyssa G. Ashbaugh, an MD candidate at the Dermatology Clinical Research Center at the University of California, Irvine, and colleagues wrote. “While the U.S. Latino population is growing rapidly, there is little research on the various factors impacting disease severity in this minority population.”

The review of currently available evidence showed that, according to findings from two cross-sectional studies using National Health and Nutrition Examination Survey data, psoriasis prevalence was 1.6% among Latino patients, compared with 3.7% among white patients and 2% among black patients.

Regarding clinical presentation, recent data have shown that individuals with darker skin may be susceptible to more extensive disease involvement, thicker plaques and more scale than those with lighter skin. The researchers urged clinicians to be aware of these factors when making a diagnosis.

Elevated rates of HIV in the U.S. Latino community compared with the white community may be associated with increased incidence of psoriatic disease, as psoriasis and HIV have been linked in the data, according to the researchers.

Other findings show that Latino patients have a lower quality of life than their white counterparts with psoriasis. Possible reasons include delayed diagnosis and being less likely to seek or receive care for their disease.

Comorbidities such as depression, obesity and diabetes have been reported more frequently in U.S. Latino populations with psoriasis compared with white populations with psoriasis.

Latino patients have demonstrated comparable responses to a number of therapies in the psoriasis armamentarium, including Enbrel (etanercept, Amgen), Cosentyx (secukinumab, Novartis) or Siliq (brodalumab, Ortho Dermatologics). Despite these findings, Latino patients continue to face poorer outcomes.

The researchers noted that many of the conclusions they drew are based on insufficient or incomplete data. “We speculate that much of the paucity of information is related to cultural, socioeconomic and educational barriers to care and clinical trial participation,” they wrote. “Many confounding variables, such as independently high rates of Latino obesity, also impact the reported severity of disease and the resulting comorbidity data available.”

There may be ways of getting around some of these complications, according to the researchers. “Learning unique Latino cultural considerations and overcoming logistical challenges, such as providing Spanish translators and Spanish educational materials, and offering after-hours clinics may begin to address solutions within the scope of our field,” they wrote. – by Rob Volansky

Disclosures: The authors report no relevant financial disclosures.