High Psoriasis Comorbidity Burden Identified in People of Color

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Researchers called for dermatologists to recognize psoriasis-associated comorbidities, which can be managed more effectively with a multidisciplinary care team.

Presenters at the 2025 AAD Annual Meeting found a high burden of comorbidities among patients with skin of color who had plaque or scalp psoriasis.

“Psoriasis is frequently associated with [psoriatic arthritis] and/or cardiovascular and metabolic comorbidities,” wrote Linda Stein Gold, MD, and colleagues. “As a first of its kind study 100% dedicated to people of color, VISIBLE provides insights into the prevalence of psoriatic comorbidities in a diverse population.”

Who Participated in the Study?

VISIBLE was a large-scale, prospective trial that tested guselkumab’s efficacy and safety in persons of diverse racial and ethnic groups. The study was funded by Janssen Pharmaceutical Companies.

Patients self-identified as Hispanic or Latino (45%), Asian (30%), Black (11%), Middle Eastern (6%), Multiracial (6%),  Pacific Islander (1%), and Other (1%). Most participants (64%) were male, and the average age across the study was 43.4 years. The researchers noted that 34.1% of participants had Fitzpatrick skin type I-III and 65.9% had type IV-VI.

Cohort A included 103 patients with moderate-to-severe plaque psoriasis, and cohort B had 108 patients with moderate-to-severe scalp psoriasis.

“VISIBLE participant baseline characteristics are reflective of a diverse population with extensive skin/scalp psoriasis across all skin tones,” the authors noted.

On average, cohort A had a psoriasis duration of 14.9 years (SD, 10.5), Psoriasis Area and Severity Index (PASI) score of 20.8 (SD, 9.1), and body surface area (BSA) affected of 26.8% (SD, 19.3). Cohort B had an average disease duration of 11.3 years (SD, 10.6), Psoriasis Scalp Severity Index (PSSI) score of 34.3 (SD, 13.2), and 59.8% (SD, 26.0) scalp surface area affected.

The study authors used medical history, laboratory test results, and vital signs to assess comorbidities.

High Comorbidity Burden Identified

“VISIBLE participants have a high burden of psoriatic comorbidities,” according to the researchers.

The prevalence of comorbidities in each cohort was as follows:

• Psoriatic arthritis: 32.0% of cohort A and 27.5% of cohort B
• Diabetes: 23.3% of cohort A and 20.4% of cohort B
• Hypertension: 67.0% of cohort A and 59.3% of cohort B
• Metabolic syndrome: 38.8% of cohort A and 25.9% of cohort B
• Dyslipidemia: 76.7% of cohort A and 66.7% of cohort B

In addition, substantial numbers of patients had preexisting psoriatic arthritis and cardiometabolic disease undiagnosed or undertreated when they entered the study.

“Moderate-to-severe plaque psoriasis in patients across all skin tones is often associated with multiple comorbidities that could be managed in collaboration with other medical specialties,” the researchers concluded, adding that their “results underscore the importance of dermatologists being aware of psoriasis-associated comorbidities and the value of a multidisciplinary team to optimize patient care.”