The National Psoriasis Foundation has released a Psoriasis Health Indicator Report detailing the health impacts of psoriasis. The report includes information and data on psoriasis, its health outcomes, prevention of comorbidities, health disparities, and disease treatment and management.
The report makes note that no national goals exist to guide improvements in psoriatic disease care and the alleviation of disease burden. The majority of the data included in the report thus makes use of data that has been published in peer-reviewed studies from scientific journals, patient registries, patient and provider surveys, systematic literature reviews and meta-analyses, as well as insurance claims databases.
Psoriasis Incidence and Prevalence
The report sets out the following data on disease incidence and prevalence:
- An estimated 3% (7.5 million) of the U.S. adult population (20 years and above) is affected by psoriasis.
- Around 600,000 U.S. adults live with undiagnosed psoriasis.
- The prevalence of psoriasis is similar between males (2.8%) and females (3.2%).
- Although it appears psoriasis prevalence differs by race and ethnicity, this may also be due to health disparities experienced by individuals with psoriasis. This includes the disproporionate underdiagnosis and lower rates of utilizing dermatologic care among racial and/or ethnic minorities.
- Whites have the highest prevalence of psoriasis at 3.6%, followed by Asians at 2.5%, and Blacks at 1.5%.
- It is estimated that approximately 1.9% of Hispanics have psoriasis.
- The prevalence of psoriasis increases with age. People between 50-59 have the highest prevalence at 4.3% followed by those 70 and above at 3.9%.
- Those adults aged 20-29 had the lowest prevalence of psoriais at 1.6%.
Psoriatic Arthritis
The report states that no diagnostic test for psoriatic arthritis exists, yet there are validated screening tools which can be used. It goes on to state that a total of 9 – 33% of individuals with psoriasis go on to develop psoriatic arthritis, and 10-15% of individuals living with psoriasis have undiagnosed psoriatic arthritis.
Race and Ethnicity
In analyzing the racial and ethnic health disparities among people with psoriasis, the report indicates that these racial and/or ethnic minority groups are 112% times more likely than White people to live with undiagnosed psoriasis. Furthermore, people with skin of color are said to wait up to three times longer to recieve a diagnosis and also three times more likely to have to undergo a skin biopsy to confer a diagnosis. Asians, Hispanics and Blacks are also more likely to experience higher rates of severe psoriasis than Whites, yet the use of biologic therapy is lower in Blacks than in Whites.
Pediatric Psoriasis
The prevalence of psoriasis is higher among children aged 15-17 years and lowest among those 0-9 years.
Risk Factors
Although it is noted that anyone can develop psoriasis, the lifetime risk of developing the disease is strongly associated with family history. If both parents have psoriasis, the risk for development is 40-65% compared to only 4% if no parent has the condition.
Burden of Disease
According to the report, psoriasis is associated with significant burden of disease, including increased rates of mortality, a lower quality of life, stigmatization, and loss of work productivity.
The report goes on to state that psoriasis is independently associated with an increased risk of mortality. Individuals with severe psoriasis—defined as having more than 10% of their body surface area (BSA) affected—face an 80% higher mortality risk independent of risk factors (e.g., history of smoking, age, comorbidities).
In addition, psoriasis significantly affects patients’ quality of life, with 40.6% to 43.3% of indiviudals saying the condition has a moderate to very large impact on their quality of life. The impact worsens with the severity and location of the disease, particularly when it affects areas like the scalp, face, hands, feet, or genitals.
The report also indicates that social stigmatizing beliefs about individuals with psoriasis are widespread with many in the general population wanting to avoid people with psoriasis in social situations. Those without psoriasis are more likely to feel uneasy—avoiding actions like dating, shaking hands, or inviting someone with psoriasis into their home.
As it concerns work productivity, a total of 64.9% of patients with psoriasis report some work impairment, while 81% with psoriatic arthritis report the same. Compared to individuals without these conditions, “individuals with psoriasis and/or psoriatic arthritis experience more non-recreational work absences, more sick leave, and a higher utilization of short-term disability.”
Comorbidities
Psoriasis is associated with various comorbidities, including psoriatic arthritis, cardiovascular disease, obesity, and diabetes/metabolic disorder. Due to a lack of diagnostic testing for psoriatic arthritis, many individuals may go undiagnosed for extended periods.
- Compared to the general population, individuals with psoriasis experience a 46% increased risk of CVD mortality and a 19% increased risk of stroke.
- Individuals with psoriasis have a 41 – 66% higher likelihood of having obesity compared to the general population.
- The severity of psoriasis is associated with an increased risk of type-2 diabetes, showing that for each 10% increase in BSA affected by psoriasis, the risk of type-2 diabetes increases by 20%.
- The estimates of rate of depression among individuals with psoriasis range from 20 – 28%.
Addressing Future Areas of Improvement
This is the first comprehensive report on the health of individuals with psoriasis, and although there are limitations in the availability of data, the report highlights several significant gaps and challenges. Moving forward, there is a pressing need to address these issues, including the health disparities for patients, improving awareness, assessing the mental health impact, and further research into more effective treatment strategies and support for those living with this condition.
For more information and resources on psoriasis, please visit our Psoriasis Digital Education Hub.
