International Psoriasis Council

Advancing Knowledge. Improving Care.

Psoriasis in People with Diverse Skin

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.

Read the full publication and findings here.

Fast Facts

  • More than 80% of people in psoriasis clinical trials are White.
  • In the United States, the prevalence of psoriasis is higher in White/Caucasian individuals. Still, studies have also shown that one of the categories of undiagnosed patients was more likely to be non-Caucasian.1
  • Psoriasis presentation can differ between skin tones: lighter skin (e.g., red or pink) and darker skin (e.g., violet, dark brown).1
  • Hospitalization, access to physicians, familiarity with biologic therapies, and access to these treatments can differ between White patients compared to non-White patients.2

Latest Publications

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IPC Resources

PUBLICATIONS AND RESEARCH

Additional Resources

PUBLICATIONS AND RESEARCH
The Impact of Post-inflammatory Pigment Alteration After Psoriasis: Novel Data from the VISIBLE Study. Alexis A, McMichael A, Vashi N, et al.  Dermatol Ther (Heidelb). 2026 Apr;16(4):2031-2045. doi: 10.1007/s13555-026-01688-z. Epub 2026 Mar 2. PMID: 41770445; PMCID: PMC13047027.
This study evaluates the clinical and patient-reported impact of post-inflammatory pigment alteration in psoriasis, highlighting that pigment changes persist even after skin clearance and represent an underrecognized contributor to disease burden, particularly in patients with skin of color.

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.

Paving the Way to Healthcare Equity: A Comprehensive Review of Care Gaps and Emerging Initiatives in Dermatology. Alexis A, Chovatiya R, Taylor S, et al.  Dermatol Ther (Heidelb). 2025 Dec 10. doi: 10.1007/s13555-025-01594-w.

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 TrialAlexis 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

  • Taylor SC, Lim HW. Taylor and Kelly’s Dermatology for Skin of Color. 3rd ed. New York, NY: McGraw-Hill; 2026.
  • Conceicao K, Lora Barraza L, Galvão dos Santos de Araujo AC. Dermatology for Black Skin (Dermatologia para Pele Negra). 1st ed. São Paulo, Brazil: Manole; 2024.
  • Taylor SC, Elbuluk NM. Taylor & Elbuluk’s Atlas and Synopsis for Skin of Color. New York, NY: McGraw-Hill Medical; 2023.
  •  Eleryan M, Friedman A. The Full Spectrum of Dermatology: A Diverse and Inclusive Atlas. Digital ed. Sanovaworks; 2023.
  • Donkor C, Aryee-Boi J, Osazuwa IR, Afflu FK, Alexis AF. Atlas of Dermatological Conditions in Populations of African Ancestry. Cham, Switzerland: Springer; 2021.
  • Mukwende M, Tamonv P, Turner M. Mind the Gap: A Handbook of Clinical Signs on Black and Brown Skin. London, UK: St George’s, University of London; 2020.
  • Love PB, Kundu RV. Clinical Cases in Skin of Color: Medical, Oncological and Hair Disorders, and Cosmetic Dermatology. New York, NY: Springer; 2016.
  • Dadzie OE, Petit A, Alexis AF. Ethnic Dermatology: Principles and Practice. Hoboken, NJ: John Wiley & Sons; 2013.

Page last updated: May 2026

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