Addressing Underrepresentation in Psoriasis and the Broader Field of Dermatology

Psoriasis affects more than 3% of adults in the U.S., including 1.9% of Black and 1.6% of Latinx individuals.[1] However, research has shown that Black, Asian, and other minorities, excluding Hispanic, are less likely to see a dermatologist than White people. [2] This is even though they may have more severe disease and poorer quality of life. It is important to note that prevalence estimates may be impacted by the lack of understanding of presentation on skin of color as well as lack of care.

Even when minority patients are seen, there remain barriers to accessing treatment. Data show that in the U.S., Black patients are less likely to receive biologic treatment for their psoriasis, compared to White patients. Research has shown that there are definitive differences between the perceptions and understanding of psoriasis therapies by race and treatment history, such as Black patients who were biologic naïve were unfamiliar with self-injectable biologics. This differed from White patients who were also biologic naïve. Further analyses showed that neither income nor education levels were predictive of familiarity with self-injectable biologics. According to a research paper authored by Junko Takeshita, M.D., Ph.D., et al, these findings show that Black patients with psoriasis may be less aware of biologic treatment options, even though biologic treatment options are highly efficacious for the treatment of psoriasis. [3]

It is not only that minorities are less likely to be seen, they are less also less likely to be dermatologists. African American and Hispanics represent only 3% and 4.2% of all dermatologists, respectively. In fact, dermatology is the second least diverse specialty in medicine, even though data have shown that race concordant visits result in greater patient satisfaction [4]. There are efforts underway to increase diversity in dermatology, focusing on encouraging underrepresented minorities to pursue higher education careers in dermatology. However, this is not without barriers. A survey of underrepresented minority students showed that those students see multiple perceived barriers to applying for a dermatology residency. Those barriers includes potential risk of not matching, lack of diversity in the specialties, lack of mentorship, as well as GPA and USMLE board examination scores impacts. [4]