As dermatology continues to embrace diversity and inclusivity, increasing attention is being paid to the unique needs of patients with skin of color. A recent reanalysis of a study in patients with psoriatic arthritis (PsA) provided new insights into treatment outcomes among non-white participants, showing promising results for this patient population.
Specializing Treatment for Patients with Skin of Color
Psoriatic arthritis is a chronic inflammatory disease in which skin cells build up rapidly, leading to scaly, itchy plaques on the skin. On lighter skin tones, these plaques typically appear as raised, red patches covered with a silvery-white scale. In patients with skin of color, plaques may present as darker, thicker lesions with purple, grayish, or deep brown tones — differences that can make diagnosis and assessment more complex.
A post hoc analysis of the VISIBLE study, which included non-white patients with Fitzpatrick skin types I to IV, examined a subset of participants treated with guselkumab (Tremfya®, Janssen). Results showed that these patients achieved levels of skin clearance consistent with the overall study population, confirming that this immune-mediated disease responds similarly across diverse skin types.
“In most of our clinical trials for psoriasis, more than 90% of the patients are white,” said Joseph F. Merola, MD, MMSc, professor and chair of the Department of Dermatology, professor of internal medicine in the Division of Rheumatic Diseases, and professor in the Peter O’Donnell Jr. School of Public Health at the University of Texas Southwestern Medical Center. Speaking during a presentation at the European Academy of Dermatology and Venereology (EADV) Congress, Dr. Merola noted that the study “was an opportunity to gain a deeper understanding of patient-reported outcome measures and see how those improve over time.”
He emphasized the importance of examining both the physical and quality-of-life benefits of guselkumab treatment among patients with skin of color:
“We know there is increased burden because of dyspigmentation and other factors that are different in the population that was studied in VISIBLE.”
Key takeaways:
- After three doses of guselkumab, 60% of participants achieved clinically meaningful improvement in PsA symptoms.
- Most patients also experienced clearer skin, as assessed by IGA, PASI, and body surface area measures.
- Adults with PsA saw early improvements in symptoms and quality-of-life outcomes, with benefits sustained through four years of treatment.
Looking Ahead
The findings reinforce the importance of inclusive clinical research that reflects the diversity of real-world patient populations. As studies like VISIBLE continue to expand representation, dermatology moves closer to delivering truly equitable care, with the goal of ensuring that treatments such as guselkumab are understood, validated, and optimized for all patients, regardless of skin type.
