OVERVIEW OF PSORIASIS IN PEOPLE WITH DIVERSE SKIN TONES
Psoriasis affects people worldwide, regardless of race or ethnicity, and can present differently in appearance and severity depending on skin tone. Yet, psoriasis research and education have primarily focused on how it presents in people with lighter skin tones. For example, descriptions of psoriasis in textbooks often focus on lighter skin, and psoriasis clinical trials have been mostly conducted with White participants. This lack of representation of people with diverse skin tones continues to hinder earlier diagnosis and access to medicines in certain patient populations.
Furthermore, there is no universal definition of “skin of color,” which adds a layer of complexity in which social constructs (e.g., race) cannot be clearly linked to biological characteristics (e.g., ancestry). There must be a clear separation of these social and biological constructs from skin color. Evaluating data in alignment with these aspects could help address these disparities and improve care.
Understanding the challenges and unmet needs that affect psoriasis patients with diverse skin tones, including access to care, diagnosis, and treatment, is vital. IPC is committed to helping bridge the gap and increase awareness and education about treating psoriasis patients with diverse skin tones.
The International Psoriasis Council (IPC) conducted a comprehensive literature review to provide an evidence-based update on the characteristics of psoriasis in individuals with diverse skin tones—a population for which data has historically been limited. The review included a systematic search of PubMed, MEDLINE, and the Cochrane Library from January 2018 to August 2023.
International Expert Consensus on Defining Skin of Color and Delivering Equitable Dermatologic Care. Lim HW, Zhang C, Taylor M, et al. Int J Dermatol. 2026 Jan;65(1):28-40. doi: 10.1111/ijd.70100. Epub 2025 Nov 6. PMID: 41195697; PMCID: PMC12712775.
This consensus defines “skin of color” and provides practical recommendations for equitable dermatologic care, emphasizing standardized terminology, inclusive research, and culturally competent clinical practices.
This comprehensive review identifies gaps in dermatological care for individuals with skin of color in the United States and surveys existing and emerging initiatives aimed at closing those gaps to advance equity in dermatology practice and research.
Guselkumab for Moderate to Severe Psoriasis Across All Skin Tones: Cohort A of the VISIBLE Randomized Clinical Trial. Alexis A, McMichael A, Soung J, et al. JAMA Dermatol. Published online June 25, 2025. doi:10.1001/jamadermatol.2025.1836|
The study demonstrates that guselkumab is safe and effective in treating moderate to severe psoriasis across diverse racial and ethnic groups, supporting its broad clinical applicability.
Response to Biologic Therapy in Skin of Colour Participants With Moderate-to-Severe Psoriasis and Atopic Dermatitis: A Systematic Review. Rijal H, Bouadi N, Abduelmula A, et al. Journal of Cutaneous Medicine and Surgery. 2024;28(5):468–472.
This systematic review evaluates treatment responses to biologic therapies among patients with skin of color, highlighting gaps and consistencies in outcomes across inflammatory skin diseases.
Optimizing the Management of Psoriasis in Patients with Skin of Color: A Canadian Delphi Consensus. Yadav G, Miller-Monthrope Y, Rao J, et al. JAAD International. 2024;19:12–20.
This consensus statement provides expert-driven recommendations to address diagnostic, therapeutic, and equity-related considerations in the management of psoriasis in patients with skin of color.
Inclusive and Equitable Language for Skin Colour in the British Journal of Dermatology: Acknowledging Our Past and Laying the Foundations to Move Forward. Oyesiku L, Dlova N, Ahmed S, et al. British Journal of Dermatology. 2024;190(5):605–607.
This editorial outlines principles for inclusive and equitable terminology in dermatologic publishing to better reflect diversity in skin color and lived experience.
Colorimetric Scale for Skin of Color: A Practical Classification Scale for the Clinical Assessment, Dermatology Management, and Forensic Evaluation of Individuals With Skin of Color. Cohen PR, DiMarco MA, Geller RL, et al. Cureus. 2023;15(11):e48132. Published 2023 Nov 1. doi:10.7759/cureus.48132.
Authors introduce a colorimetric scale to classify skin tones for clinical and forensic use, improving diagnostic accuracy, treatment planning, and research inclusivity.
Diagnosing Psoriasis in Skin of Color Patients. Khanna R, Khanna R, Desai SR. Dermatologic Clinics. 2023;41(3):431–434.
This review discusses diagnostic challenges and clinical features of psoriasis in skin of color, emphasizing strategies to improve recognition and reduce diagnostic delay.
Unmet Need in People with Psoriasis and Skin of Color in Canada and the United States. Yadav G, Yeung J, Miller-Monthrope Y, et al. Dermatol Ther (Heidelb). 2022;12(11):2401-13.
This paper highlights disparities in awareness, diagnosis, and treatment of psoriasis among individuals with skin of color in North America and calls for targeted interventions to address these gaps.
Psoriasis in Skin of Color: Insights into the Epidemiology, Clinical Presentation, Genetics, Quality-of-Life Impact, and Treatment of Psoriasis in Non-White Racial/Ethnic Groups Kaufman BP, Alexis AF. [published correction appears in Am J Clin Dermatol. 2018 Feb 16;:]. Am J Clin Dermatol. 2018;19(3):405-423. doi:10.1007/s40257-017-0332-7.
The review surveys epidemiologic patterns, genetic factors, clinical features, and the psychosocial impact of psoriasis in non-White populations, guiding culturally sensitive management.
Psoriasis in Skin of Color: Epidemiology, Genetics, Clinical Presentation, and Treatment Nuances. Alexis AF, Blackcloud P. J. Clin Aesthet Dermatol. 2014;7(11):16-24.
The article examines unique clinical presentations, genetic considerations, and therapeutic nuances in patients with diverse skin colors, emphasizing the need for clinician awareness to optimize outcomes.
WEBSITES
AAD Skin of Color Image Atlas. Journal of the American Academy of Dermatology. Last updated 2026. Available from: https://www.jaad.org/collection-skin-of-color-images
A curated image atlas highlighting dermatologic conditions across diverse skin tones to support accurate diagnosis and clinical decision-making.
Breaking Barriers. International Federation of Psoriasis Associations (IFPA) website. Last updated 2026. Available from: https://www.ifpa-pso.com/projects/breaking-barriers
A global initiative focused on reducing stigma and improving representation and inclusion in psoriatic disease clinical research across diverse populations.
Skin Deep – Diagnoses Gallery. Skin Deep (Don’t Forget the Bubbles). Last updated July 2025. Available from: https://dftbskindeep.com/diagnoses-gallery/
An open-access dermatology image library designed to improve recognition of skin conditions in patients with darker skin tones.
Skin of Color Resource Center. National Psoriasis Foundation website. Last updated December 30, 2025. Available from: https://www.psoriasis.org/skin-of-color-resource-center/
This online resource provides educational materials, patient stories, and clinical guidance to support the management of psoriasis in individuals with diverse skin tones.
Skin of Color Society. Skin of Color Society website. Last updated 2024. Available from: https://skinofcolorsociety.org/
Resources for clinicians and patients, including educational content, advocacy initiatives, and professional guidance to improve dermatologic care for people with diverse skin tones.
Skinsight. Skinsight Dermatology Information Resource. Last updated 2026. Available from: https://skinsight.com/
A comprehensive dermatology reference with condition overviews and images across a range of skin tones for clinicians and patients.
UNC School of Medicine Dermatology Image Library. Dermatology Image Resources, University of North Carolina–Chapel Hill School of Medicine. Last Updated: April 11, 2025. Available from: https://webapps.med.unc.edu/dil/index.php
A longstanding academic image repository supporting dermatology education and clinical training.
UNM School of Medicine Inclusive Dermatology Gallery. Inclusive Dermatology Photo Gallery, University of New Mexico School of Medicine. Last Updated: 2025. Available from: https://hsc.unm.edu/medicine/departments/dermatology/inclusive-dermatology/gallery.html
An image collection focused on inclusive representation to enhance diagnostic accuracy across skin tones.
RELEVANT TEXTBOOK CHAPTERS
Page last updated: May 2026
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A patient doing well on an IL-17 inhibitor is diagnosed with cancer, and the oncologist wants the biologic stopped. It is a call most dermatologists have made without much to stand on: patients with cancer are excluded from psoriasis trials, so the entire evidence base is observational. A new IPC paper in JAAD Reviews takes a position anyway. Per the summary of product characteristics, active malignancy is not a contraindication to any biologic. IL-17 and IL-23p19 inhibitors are first-line, TNF inhibitors and deucravacitinib warrant caution, and cyclosporine is the one to avoid outright. The authors also warn that psoriasis severity is routinely underestimated once a patient is in oncology care: if they meet IPC’s criteria, they are a candidate for systemic therapy regardless of what else is on their problem list. “Too often, systemic psoriasis therapy is discontinued or never initiated in patients with cancer, even when the evidence supports safe and effective options,” says Paolo Gisondi, MD, IPC Councilor and lead author. The post includes the therapeutic options figure, designed as a reference for both specialties to work from, and a slide set for teaching and presentations.
In this article, IPC Board Member Lluís Puig, MD, PhD, gives his expert commentary on two randomized trials showing that ixekizumab plus tirzepatide outperforms ixekizumab alone for skin clearance, joint control, and weight loss in psoriasis and PsA.
IPC is accepting applications for the 2027 International Fellowship Program, a 12-month opportunity for early-career dermatologists and researchers focused on psoriasis. Fellows are matched with IPC Board Members or Councilors for hands-on clinical or research experience, along with virtual mentoring, skills-development classes, and ongoing connections to IPC’s global network throughout the fellowship year. Applications are open until September 30, 2026.
Recognizing GPP in clinical practice can be a challenge, even for experienced dermatologists. IPC’s new five-part training series walks clinicians through the practical skills needed to diagnose and assess GPP with confidence: distinguishing it from plaque psoriasis and other mimicking conditions, and scoring its severity using tools such as the GPPGA and GPPASI. Each module pairs an expert-led video with a case-based exercise, and the series is built to be completed in sequence at your own pace. All five modules are free and open to everyone; watch the videos on your own or work through the assessments as you go. Score 80% or higher on each of the five assessments to earn a Certificate of Completion.
IPC has released a set of summary slides distilling the key findings from its recent publication on psoriasis and metabolic health, published in the Journal of the American Academy of Dermatology (JAAD). The paper outlines five priorities for improving cardiometabolic risk screening and care in patients with psoriasis. Designed for sharing, the slides give clinicians and colleagues an easy way to disseminate the findings.
In this Take Ten with IPC video, IPC Junior Councilor Dr. María Julia Cura discusses paradoxical psoriasis, including its definition and pathogenesis, and reviews clinical case examples, key clinical features, histopathology, predictors of disease severity, and potential treatment options.