title: Socioeconomic Inequalities and Severity of Plaque Psoriasis at a First Consultation in Dermatology Centers.
abstract: Psoriasis has major physical, psychological, and social impacts: its management should not be restricted by individual financial considerations in Western countries as these have well-structured health systems and social/insurance coverage. We investigated if the socioeconomic characteristics of patients were associated with severity of psoriasis and access to healthcare. In a cross-sectional study, we included 903 patients with psoriasis that were consulting for the first time. We showed that low educational level was associated with severity of disease in multivariate analyses. Moreover, patients of lower class and lower educational level, with severe psoriasis, had seen fewer physicians and had less frequently received a systemic treatment. Thus, physicians need to be vigilante of patients with a low socioeconomic status. Both low socioeconomic status and less access to dermatologists are associated with clinical severity of psoriasis at a first consultation.
authors.affiliation: Department of Dermatology, CH Victor Dupouy, FR-95100 Argenteuil, France. emmanuel.mahe@ch-argenteuil.fr.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mahé
authors.forename: Alain
authors.initials: A
authors.lastname: Beauchet
authors.forename: Ziad
authors.initials: Z
authors.lastname: Reguiai
authors.forename: François
authors.initials: F
authors.lastname: Maccari
authors.forename: Mireille
authors.initials: M
authors.lastname: Ruer-Mulard
authors.forename: Guillaume
authors.initials: G
authors.lastname: Chaby
authors.forename: Thierry
authors.initials: T
authors.lastname: Le Guyadec
authors.forename: Eric
authors.initials: E
authors.lastname: Estève
authors.forename: Catherine
authors.initials: C
authors.lastname: Goujon-Henry
authors.forename: Josiane
authors.initials: J
authors.lastname: Parier
authors.forename: Hugues
authors.initials: H
authors.lastname: Barthelemy
authors.forename: Edouard
authors.initials: E
authors.lastname: Bégon
authors.forename: Henri-Georges
authors.initials: HG
authors.lastname: Steiner
authors.forename: Nathalie
authors.initials: N
authors.lastname: Bénéton
authors.forename: Thierry
authors.initials: T
authors.lastname: Boyé
authors.forename: Laure
authors.initials: L
authors.lastname: Mery-Bossard
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Schmutz
authors.forename: Pierre
authors.initials: P
authors.lastname: Bravard
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003880:Dermatology; D004522:Educational Status; D005260:Female; D005602:France; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011565:Psoriasis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D012017:Referral and Consultation; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors