Perceptions and Experiences of Patients Across All Skin Tones Living with Psoriasis in Canada

Psoriasis is a chronic inflammatory skin disease that significantly impacts patients' quality of life. Patients with skin of colour (SoC) often face unique barriers related to gaining access to care, diagnosis and treatment, which can contribute to health disparities. The aim of this study was to assess patient-reported experiences across the psoriasis care continuum in Canada, comparing white and non-white populations.

A 15-min online survey was administered between 9 December and 19 December 2022 to patients ≥ 18 years with a confirmed psoriasis diagnosis. The survey included 33 questions covering demographics, medical history, psoriasis experience and access to information. Responses were analysed using t-tests at a 90% confidence level to identify significant differences based on ethnicity, treatment users, gender, psoriasis severity and region.

Of approximately 2500 invited participants, 103 met the eligibility criteria: 62 self-identified as white and 41 as non-white. A higher proportion of non-white patients reported severe psoriasis, delays in diagnosis and greater emotional and social burden during the pre-diagnosis stage. Non-white patients were more frequently diagnosed and treated by dermatologists and more commonly used non-topical therapies. Misdiagnosis, often as eczema or dermatitis, was more prevalent among non-white patients. Treatment initiation was more commonly delayed in non-white patients, with 71% reporting difficulty accessing effective therapy, compared to 31% of white patients. A greater proportion of non-white respondents sought additional support and education, especially for mental wellness and advocacy resources.

Disparities in psoriasis care are evident across the experience of patients with psoriasis. Among those who participated in the survey, a greater proportion of the non-white patients faced delayed diagnosis, misdiagnosis, and greater barriers to treatment access, often reflecting more severe disease and unmet informational needs. These findings highlight the importance of culturally competent care and inclusive research to ensure equitable outcomes for all patients with psoriasis. Enhanced representation in clinical trials and targeted health interventions are essential to address these disparities.