title: Psoriasis in African-Americans: a caregivers' survey.
abstract: BACKGROUND
  Psoriasis is a common skin disease in Caucasians but less common in African-Americans.
  
  
  OBJECTIVE
  Our aim is to evaluate caregiver opinions regarding the clinical presentations and treatment of psoriasis in African-Americans compared to Caucasians.
  
  
  METHODS
  A survey was sent to 29 dermatologists who are opinion leaders in the field of psoriasis. The survey included a number of questions regarding the characteristics of the patients seen in their practice.
  
  
  RESULTS
  A total of 29 surveys were completed and returned. All of the dermatologists use the extent of disease as a criterion to determine the severity of the disease. Other criteria include scale, thickness, erythema, associated general symptoms, and dyspigmentation. About 66% of the respondents reported the different manifestations of disease, such as more dyspigmentation, thicker plaques, and less erythema in African-Americans. The most common first-line treatments for mild to moderate disease were highpotency topical steroids (68%) followed by topical vitamin D analogues (41%). For moderate to severe disease, the most commonly used first-line treatments were high-potency topical steroids (54%) and phototherapy (46%).
  
  
  CONCLUSIONS
  The clinical manifestations of psoriasis in African-Americans are not exactly the same as in Caucasians. Physicians should be aware of the difference in clinical manifestations in African-Americans. Further research and large-scale studies are necessary to elucidate the differences in the clinical presentation, natural course of the disease, and the criteria used for the evaluation of severity among ethnic groups.
authors.affiliation: Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. amcmicha@wakehealth.edu
authors.forename: Amy J
authors.initials: AJ
authors.lastname: McMichael
authors.forename: Vasanop
authors.initials: V
authors.lastname: Vachiramon
authors.forename: Daniela Araucaria
authors.initials: DA
authors.lastname: Guzmán-Sánchez
authors.forename: Fabian
authors.initials: F
authors.lastname: Camacho
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D017028:Caregivers; D003430:Cross-Sectional Studies; D003625:Data Collection; D003879:Dermatologic Agents / Q000627:therapeutic use; D003880:Dermatology / Q000706:statistics & numerical data; D006801:Humans; D010789:Phototherapy / Q000379:methods; D011565:Psoriasis / Q000453:epidemiology* / Q000208:ethnology / Q000451:nursing / Q000473:pathology; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D003879:Dermatologic Agents