Photo Credit: Andrey Popov
Findings from the VISIBLE trial will help address gaps in psoriasis care for patients with skin of color and inform best practices to drive inclusive research.
At Maui Derm 2025, multiple sessions focused on current challenges in managing psoriasis, including a panel discussion with Joel Gelfand, MD, and April W. Armstrong, MD, MPH.
One goal of the presentation by Dr. Gelfand and Dr. Armstrong focused on the development of “patient-centered treatment plans to maximize outcomes and improve quality of life,” according to Dr. Gelfand.
In his introduction, Dr. Gelfand addressed the healthcare disparities that in psoriasis. “It’s a little less common in Black patients, but still prevalent, and these patients tend to have more severe or more extensive disease than White patients and tend to experience a greater HRQOL impact than White patients. For some of these, there are currently no great answers,” Dr. Gelfand continued.
In a separate study that was not presented at the meeting, Amy McMichael, MD, and colleagues aimed to address gaps in psoriasis care for patients with skin of color, starting at the point of clinical trial enrollment. A primary goal of the study was to generate data “to help improve clinical care and inform future best practices in diversity within dermatology research,” Dr. McMichael and colleagues wrote.
The results were published in JAMA Dermatology.
Practical Tips for Clinicians & Patients
Dr. McMichael and colleagues conducted a quality improvement assessment of participant recruitment and retention approaches in the VISIBLE trial, which randomly assigned 211 patients (mean age, 43; 64% men) with skin of color and moderate to severe plaque psoriasis. The self-identified race and ethnicity of the participants were largely Hispanic/Latino (44.5%), followed by Asian (29.9%), Black (11.4%), and Middle Eastern (6.2%), with multiple other races and ethnicities included in smaller percentages.
The researchers took steps to improve diversity in the clinical trial setting at multiple levels, including during site selection, training for study investigators, and recruitment methods.
The cultural sensitivity training for staff included multiple strategies that could be employed in clinical settings, including:
- Cultural awareness, competence, and knowledge
- Tips for exams that require an interpreter
- Best practices for asking about self-identification of race and ethnicity
Other takeaways include practical, patient-centered steps, including translating patient materials into multiple languages and using the broadest diagnostic criteria possible.
Addressing Gaps in Research & Care
The VISIBLE trial used strategies that are consistent with literature recommendations, according to Dr. McMichael and colleagues, and are applicable in clinical settings for patients with psoriasis. They include:
- Decrease healthcare barriers related to access and insurance
- Improve health literacy
- Increase awareness of clinical trials
- Foster trust in healthcare for racial and ethnic minority groups
Further, VISIBLE represents “a unique trial focused on addressing key data and knowledge gaps about participants who have moderate to severe plaque psoriasis across a diverse range of skin types and race and ethnicity groups,” the researchers wrote.
Findings from the trial “will help address important clinical care gaps and inform best practices to drive inclusive clinical research in dermatology,” Dr. McMichael and colleagues continued.
