Psoriasis Awareness Month: Diverse Groups More Likely to Suffer Psychological Effects From the Disease

"Salud" is a Latin Post feature series that focuses on health and wellness topics and examines Latino health trends.

Psoriasis Awareness Month is an opportunity to spread understanding about the chronic, serious long-term skin problem that affects millions in the U.S.

Psoriasis causes skin cells to grow too rapidly, producing thick, silvery, dark brown, white or red patches on the skin. Under normal circumstances, skin will grow gradually and it will flake off every four weeks, new skin replacing what was shed. However, that isn't the case when it comes to psoriasis.

When it comes to cases of psoriasis, new skin develops on the surface over the span of days, rather than weeks, then amasses and forms thick patches called plaques. The patches vary in size, and often appear on the feet, hands, scalp, elbows, knees and the lower back. It's most common in adults, but children and teens develop it also. The autoimmune disease affects as many as 7.5 million people in the U.S., and up to 30 percent of people with the incurable disease develop psoriatic arthritis, a related joint disease.

The inflammatory disease does present itself in non-Caucasian populations. In fact, diverse groups experience more severe forms of the disease, and they undergo greater emotional and social distress than their white peers. According to recently published research, Hispanics, African-Americans and Asians are more likely than non-Latino Caucasians to suffer psychological effects from the disease.

Nearly three quarters (72 percent) of patients from nonwhite groups said psoriasis interfered with their capacity to enjoy life, compared to 54 percent of Caucasian respondents. Likewise, 75 percent said psoriasis impacted overall emotional well being compared to 62 percent of Caucasian respondents. In addition to frustration and embarrassment, nonwhite patients are more likely to say that psoriasis made their appearances unsightly, often prompting them to choose clothing to conceal their psoriasis.

"The prevalence of very severe psoriasis among minority respondents to the survey may both explain and be reinforced by the negative psychological and social effects they experience," said Mark Lebwohl, M.D., professor and chairman of dermatology at the Mount Sinai School of Medicine and chair of the National Psoriasis Foundation Medical Board, in a statement. "In psoriasis, emotional and physical distress feed off each other, and emotional stress is a documented trigger for flares of both psoriasis and psoriatic arthritis."

Despite this, there's very little epidemiological, clinical or therapeutic data pertaining to psoriasis in non-Caucasian racial/ethnic groups. Psoriasis in darker skin proves to be a diagnostic challenge, due to overlapping features with other papulosquamous disorders and less conspicuous erythema, as well as lichen planus (especially the hypertrophic type), sarcoidosis and cutaneous lupus. Also, under-reporting and selection bias contribute to differences in detection and prevalence.

The National Psoriasis Foundation has conducted studies exploring differences in health-related quality of life among different ethnicities. A high percentage of nonwhite respondents reported feelings of self-consciousness, embarrassment, anger, frustration and helplessness at a greater rater than Caucasian patients with very severe psoriasis. Understanding therapeutic and clinical nuances in psoriasis patients of color is important for documenting disparities in diagnosis and quality of life. Also, it's important for recording differences in desired treatment outcomes, cultural factors and clinical presentation.

"It is disturbing to learn the extent of the emotional and social implications of the disease in minority populations," said Randy Beranek, president and CEO of the National Psoriasis Foundation. "We are committed to ensuring that everyone, regardless of their race or ethnicity, has access to treatment that will reduce both physical and emotional effects of psoriatic disease."

The National Psoriasis Foundation endorses the awareness of psoriasis and psoriatic arthritis, as well as access to treatment, education, supportive services, interactive online resources, and local support groups. They have a strategic five-year plan that's driven by a desire to accelerate the discovery of a cure, to dramatically improve the health outcomes for all with psoriatic disease, and to secure resources to achieve the mission.