title: Psoriasis and psoriatic arthritis in African-American patients--the need to measure disease burden.
abstract: Gaps in knowledge exist regarding the clinical characteristics of psoriatic disease in ethnic minority patients. We evaluated validated clinical disease measures of psoriasis and psoriatic arthritis in African-American and Caucasian patients. Adult outpatients with confirmed diagnoses of psoriasis and psoriatic arthritis and seen at four urban academic institutions were eligible for evaluation. Validated patient and physician-reported disease outcome parameters, quality of life measures of psoriasis and psoriatic arthritis, and frequencies of systemic immunosuppressive therapies and patient comorbidities were documented. Psoriatic arthritis was less frequent in African-Americans compared to Caucasians (30 vs. 64.5 %, respectively, p < 0.001); however, African-Americans had more severe skin involvement [Psoriasis Area and Severity Index 8.4 (10.0) vs. Caucasians 5.5 (6.4), p = 0.06], with greater psychological impact and impaired quality of life. Use of biologic therapies was greater in Caucasian patients (46.2 vs. 13.3 % in African-Americans, p < 0.0001); yet, only one in four patients of the study cohort achieved minimal disease activity. Comorbidity was not associated with frequency of immunosuppressive drug use. In order to achieve a target of low disease activity and to reduce ethnic disparities in the care of psoriatic disease, the routine application of measures of disease status is needed.
authors.affiliation: Rheumatology Section, Veterans Affairs Medical Center, 50 Irving Street NW, Washington, DC, 20422, USA. Gail.Kerr@va.gov.|Division of Rheumatology, Georgetown University, 3800 Reservoir Rd, Washington, DC, 20007, USA. Gail.Kerr@va.gov.|Division of Rheumatology, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060, USA. Gail.Kerr@va.gov.
authors.forename: Gail S
authors.initials: GS
authors.lastname: Kerr
authors.affiliation: Division of Rheumatology, Georgetown University, 3800 Reservoir Rd, Washington, DC, 20007, USA.
authors.forename: Seema
authors.initials: S
authors.lastname: Qaiyumi
authors.affiliation: Rheumatology Section, Veterans Affairs Medical Center, 50 Irving Street NW, Washington, DC, 20422, USA.|Division of Rheumatology, Georgetown University, 3800 Reservoir Rd, Washington, DC, 20007, USA.
authors.forename: John
authors.initials: J
authors.lastname: Richards
authors.affiliation: Division of Rheumatology, Georgetown University, 3800 Reservoir Rd, Washington, DC, 20007, USA.
authors.forename: Hashem
authors.initials: H
authors.lastname: Vahabzadeh-Monshie
authors.affiliation: Division of Dermatology, Howard University Hospital, 2041 Georgia Avenue NW, Washington, DC, 20060, USA.
authors.forename: Chesahna
authors.initials: C
authors.lastname: Kindred
authors.affiliation: Division of Rheumatology, Georgetown University, 3800 Reservoir Rd, Washington, DC, 20007, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Whelton
authors.affiliation: Division of Rheumatology, Washington Hospital Center, 110 Irving Street NW, Washington, DC, 20010, USA.
authors.forename: Florina
authors.initials: F
authors.lastname: Constantinescu
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D001741:Black or African American; D000368:Aged; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology* / Q000503:physiopathology; D001688:Biological Products / Q000627:therapeutic use; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006304:Health Status; D006787:Hospitals, Veterans; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology*; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D044465:White People
chemical_list: D001688:Biological Products; D007166:Immunosuppressive Agents
keywords: Disease activity measures; Ethnic minorities; Psoriasis; Psoriatic arthritis