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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

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An Author Correction to this article was published on 16 February 2018

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Abstract

Psoriasis is a chronic inflammatory skin condition affecting diverse racial/ethnic groups throughout the world. Large population-based studies suggest that psoriasis occurs most often in individuals of European ancestry, followed by black and Hispanic individuals, although the true prevalence of psoriasis in non-white individuals is likely underestimated. Despite similarities in psoriasis between ethnic groups, there are notable differences in the presentation, quality-of-life impact, and treatment of psoriasis with important implications for the management of non-white individuals. Overall, heterogeneity in psoriasis susceptibility alleles, in combination with cultural and socioeconomic factors, may explain these differences. In this article, we review the epidemiology, clinical presentation, genetic polymorphisms, quality-of-life impact, and treatment nuances of psoriasis in patients with skin of color.

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Change history

  • 16 February 2018

    In the original publication, section 5, paragraph 1 was incorrectly published.

References

  1. Parisi R, Symmons DP, Griffiths CE, Ashcroft DM. Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Invest Dermatol. 2013;133(2):377–85.

    Article  CAS  PubMed  Google Scholar 

  2. Farber E, Nall M. Epidemiology: natural history and genetics. In: Roenigk H, Maibach H, editors. Psoriasis. New York: Marcel Dekker; 1998. p. 107–58.

    Google Scholar 

  3. Lomholt G. Prevalence of skin disease in a population; a census study from the Faroe Islands. Dan Med Bull. 1964;11:1–7.

    CAS  PubMed  Google Scholar 

  4. Chandran V, Raychaudhuri SP. Geoepidemiology and environmental factors of psoriasis and psoriatic arthritis. J Autoimmun. 2010;34(3):J314–21.

    Article  CAS  PubMed  Google Scholar 

  5. Gelfand JM, Stern RS, Nijsten T, Feldman SR, Thomas J, Kist J, et al. The prevalence of psoriasis in African Americans: results from a population-based study. J Am Acad Dermatol. 2005;52(1):23–6.

    Article  PubMed  Google Scholar 

  6. Raychaudhuri SP, Farber EM. The prevalence of psoriasis in the world. J Eur Acad Dermatol Venereol. 2001;15(1):16–7.

    Article  CAS  PubMed  Google Scholar 

  7. Rachakonda TD, Schupp CW, Armstrong AW. Psoriasis prevalence among adults in the United States. J Am Acad Dermatol. 2014;70(3):512–6.

    Article  PubMed  Google Scholar 

  8. Helmick CG, Lee-Han H, Hirsch SC, Baird TL, Bartlett CL. Prevalence of psoriasis among adults in the U.S.: 2003–2006 and 2009–2010 National Health and Nutrition Examination Surveys. Am J Prev Med. 2014;47(1):37–45.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Leder R, Farber E. The variable incidence of psoriasis in sub-Saharan Africa. Int J Dermatol. 1997;36(12):911–9.

  10. Yip SY. The prevalence of psoriasis in the Mongoloid race. J Am Acad Dermatol. 1984;10(6):965–8.

    Article  CAS  PubMed  Google Scholar 

  11. Kawada A, Tezuka T, Nakamizo Y, Kimura H, Nakagawa H, Ohkido M, et al. A survey of psoriasis patients in Japan from 1982 to 2001. J Dermatol Sci. 2003;31(1):59–64.

    Article  PubMed  Google Scholar 

  12. Fatani MI, Abdulghani MH, Al-Afif KA. Psoriasis in the eastern Saudi Arabia. Saudi Med J. 2002;23(2):213–7.

    PubMed  Google Scholar 

  13. Ogawa E, Okuyama R, Seki T, Kobayashi A, Oiso N, Muto M, et al. Epidemiological survey of patients with psoriasis in Matsumoto city, Nagano Prefecture, Japan. J Dermatol. 2017. https://doi.org/10.1111/1346-8138.14101 (epub ahead of print).

  14. Takahashi H, Nakamura K, Kaneko F, Nakagawa H, Iizuka H. Analysis of psoriasis patients registered with the Japanese Society for Psoriasis Research from 2002–2008. J Dermatol. 2011;38(12):1125–9.

    Article  PubMed  Google Scholar 

  15. Wu JJ, Black MH, Smith N, Porter AH, Jacobsen SJ, Koebnick C. Low prevalence of psoriasis among children and adolescents in a large multiethnic cohort in southern California. J Am Acad Dermatol. 2011;65(5):957–64.

    Article  PubMed  Google Scholar 

  16. Alexis AF, Blackcloud P. Psoriasis in skin of color: epidemiology, genetics, clinical presentation, and treatment nuances. J Clin Aesthet Dermatol. 2014;7(11):16–24.

    PubMed  PubMed Central  Google Scholar 

  17. McMichael AJ, Jackson S. Issues in dermatologic health care delivery in minority populations. Dermatol Clin. 2000;18(2):229–33, viii.

  18. Kurd SK, Gelfand JM. The prevalence of previously diagnosed and undiagnosed psoriasis in US adults: results from NHANES 2003–2004. J Am Acad Dermatol. 2009;60(2):218–24.

    Article  PubMed  Google Scholar 

  19. Verhagen AR, Koten JW. Psoriasis in Kenya. Arch Dermatol. 1967;96(1):39–41.

    Article  CAS  PubMed  Google Scholar 

  20. Leder RO, Farber EM. The variable incidence of psoriasis in sub-Saharan Africa. Int J Dermatol. 1997;36(12):911–9.

    Article  CAS  PubMed  Google Scholar 

  21. Doe PT, Asiedu A, Acheampong JW, Rowland Payne CM. Skin diseases in Ghana and the UK. Int J Dermatol. 2001;40(5):323–6.

    Article  CAS  PubMed  Google Scholar 

  22. Ogunbiyi AO, Daramola OO, Alese OO. Prevalence of skin diseases in Ibadan, Nigeria. Int J Dermatol. 2004;43(1):31–6.

    Article  PubMed  Google Scholar 

  23. Lomholt G. Psoriasis in Uganda: a comparative study with other parts of Africa. In: Farber EM, Cox AJ, editors. Psoriasis: proceedings of the International Symposium, Stanford University. Stanford (CA): Stanford University Press, p. 41–8.

  24. Aej M. Psoriasis in Tanzania. Int Psor Bull. 1973;1:1.

    Google Scholar 

  25. Jacyk WK. Psoriasis in Nigerians. Trop Geogr Med. 1981;33(2):139–42.

    CAS  PubMed  Google Scholar 

  26. Shrank AB, Harman RR. The incidence of skin diseases in a Nigerian teaching hospital dermatological clinic. Br J Dermatol. 1966;78(4):235–41.

    Article  CAS  PubMed  Google Scholar 

  27. Shrank AB. A field survey in Nigeria. Trans St Johns Hosp Dermatol Soc. 1965;51(1):85–94.

    CAS  PubMed  Google Scholar 

  28. Obasi OE. Psoriasis vulgaris in the Guinea Savanah region of Nigeria. Int J Dermatol. 1986;25(3):181–3.

    Article  CAS  PubMed  Google Scholar 

  29. Vollum DI. An impression of dermatology in Uganda. Trans St Johns Hosp Dermatol Soc. 1973;59(1):120–8.

    CAS  PubMed  Google Scholar 

  30. Strobel M, Ndiaye B, Diop M, Marchand JP. Psoriasis in Senegal. Dakar Med. 1981;26(1):18–25.

    CAS  PubMed  Google Scholar 

  31. Saint-Andre P, Louvet M. Psoriasis in blacks of Bamako: therapeutic notes. Ann Dermatol Syphiligr (Paris). 1976;103(5–6):666.

    CAS  PubMed  Google Scholar 

  32. Ding X, Wang T, Shen Y, Wang X, Zhou C, Tian S, et al. Prevalence of psoriasis in China: a population-based study in six cities. Eur J Dermatol. 2012;22(5):663–7.

  33. Chang YT, Chen TJ, Liu PC, Chen YC, Chen YJ, Huang YL, et al. Epidemiological study of psoriasis in the national health insurance database in Taiwan. Acta Derm Venereol. 2009;89(3):262–6.

    Article  PubMed  Google Scholar 

  34. Kubota K, Kamijima Y, Sato T, Ooba N, Koide D, Iizuka H, et al. Epidemiology of psoriasis and palmoplantar pustulosis: a nationwide study using the Japanese national claims database. BMJ Open. 2015;5(1):e006450.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Tsai TF, Wang TS, Hung ST, Tsai PI, Schenkel B, Zhang M, et al. Epidemiology and comorbidities of psoriasis patients in a national database in Taiwan. J Dermatol Sci. 2011;63(1):40–6.

    Article  PubMed  Google Scholar 

  36. Sinniah B, Saraswathy Devi S, Prashant BS. Epidemiology of psoriasis in Malaysia: a hospital based study. Med J Malays. 2010;65(2):112–4.

    CAS  Google Scholar 

  37. Choon SE, Ngim CF, Premaa S, Tey KW, Nalini MN. Clinico-epidemiological profile, including body mass index of Malaysian children with psoriasis. Med J Malays. 2016;71(4):171–6.

    CAS  Google Scholar 

  38. Hernandez-Vasquez A, Molinari L, Larrea N, Ciapponi A. Psoriasis in Latin America and the Caribbean: a systematic review. J Eur Acad Dermatol Venereol. 2017. https://doi.org/10.1111/jdv.14393 (epub ahead of print).

  39. Suite M. The epidemiology of psoriasis in a dermatology clinic in a general hospital in Port-of-Spain, Trinidad and Tobago, West Indies. West Indian Med J. 2006;55(6):399–402.

    Article  CAS  PubMed  Google Scholar 

  40. Alfonso Trujillo I, Díaz García MA, Torres Gemeil O, Torres Barbosa F, Falcón Lincheta L, Pérez Hernández M. Psoriasis vulgar: estudio descriptivo de 200 pacientes. Rev Cubana Med. 2002;41:12–5.

    Google Scholar 

  41. Davis SA, Narahari S, Feldman SR, Huang W, Pichardo-Geisinger RO, McMichael AJ. Top dermatologic conditions in patients of color: an analysis of nationally representative data. J Drugs Dermatol. 2012;11(4):466–73.

    PubMed  Google Scholar 

  42. Child FJ, Fuller LC, Higgins EM, Du Vivier AW. A study of the spectrum of skin disease occurring in a black population in south-east London. Br J Dermatol. 1999;141(3):512–7.

    Article  CAS  PubMed  Google Scholar 

  43. Alexis AF, Sergay AB, Taylor SC. Common dermatologic disorders in skin of color: a comparative practice survey. Cutis. 2007;80(5):387–94.

    PubMed  Google Scholar 

  44. Kim J, Oh CH, Jeon J, Baek Y, Ahn J, Kim DJ, et al. Molecular phenotyping small (Asian) versus large (Western) plaque psoriasis shows common activation of IL-17 pathway genes but different regulatory gene sets. J Invest Dermatol. 2016;136(1):161–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Abrouk M, Lee K, Brodsky M, Nakamura M, Singh R, Zhu TH, et al. Ethnicity affects the presenting severity of psoriasis. J Am Acad Dermatol. 2017;77(1):180–2.

    Article  PubMed  Google Scholar 

  46. Nnoruka EN, Obiagboso I, Maduechesi C. Hair loss in children in South-East Nigeria: common and uncommon cases. Int J Dermatol. 2007;46(Suppl. 1):18–22.

    Article  PubMed  Google Scholar 

  47. Chiam LY, de Jager ME, Giam YC, de Jong EM, van de Kerkhof PC, Seyger MM. Juvenile psoriasis in European and Asian children: similarities and differences. Br J Dermatol. 2011;164(5):1101–3.

    Article  CAS  PubMed  Google Scholar 

  48. Frez ML, Asawanonda P, Gunasekara C, Koh C, Loo S, Oon HH, et al. Recommendations for a patient-centered approach to the assessment and treatment of scalp psoriasis: a consensus statement from the Asia Scalp Psoriasis Study Group. J Dermatolog Treat. 2014;25(1):38–45.

    Article  PubMed  Google Scholar 

  49. Chandran NS, Gao F, Goon AT, Chong WS, Giam YC, Theng CT. Clinical characteristics of childhood psoriasis in a multi-ethnic Asian population. J Dermatol. 2012;39(3):278–9.

    Article  PubMed  Google Scholar 

  50. Kerr GS, Qaiyumi S, Richards J, Vahabzadeh-Monshie H, Kindred C, Whelton S, et al. Psoriasis and psoriatic arthritis in African-American patients: the need to measure disease burden. Clin Rheumatol. 2015;34(10):1753–9.

    Article  PubMed  Google Scholar 

  51. Thumboo J, Tham SN, Tay YK, Chee T, Mow B, Chia HP, et al. Patterns of psoriatic arthritis in Orientals. J Rheumatol. 1997;24(10):1949–53.

    CAS  PubMed  Google Scholar 

  52. Harden JL, Krueger JG, Bowcock AM. The immunogenetics of psoriasis: a comprehensive review. J Autoimmun. 2015;64:66–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Andressen C, Henseler T. Inheritance of psoriasis: analysis of 2035 family histories. Hautarzt. 1982;33(4):214–7.

    CAS  PubMed  Google Scholar 

  54. Farber EM, Nall ML. The natural history of psoriasis in 5,600 patients. Dermatologica. 1974;148(1):1–18.

    Article  CAS  PubMed  Google Scholar 

  55. Chularojanamontri L, Kulthanan K, Suthipinittharm P, Jiamton S, Wongpraparut C, Silpa-Archa N, et al. Clinical differences between early- and late-onset psoriasis in Thai patients. Int J Dermatol. 2015;54(3):290–4.

    Article  PubMed  Google Scholar 

  56. Namazi MR. Why is psoriasis uncommon in Africans? The influence of dietary factors on the expression of psoriasis. Int J Dermatol. 2004;43(5):391–2.

    Article  CAS  PubMed  Google Scholar 

  57. Gudjonsson JE, Thorarinsson AM, Sigurgeirsson B, Kristinsson KG, Valdimarsson H. Streptococcal throat infections and exacerbation of chronic plaque psoriasis: a prospective study. Br J Dermatol. 2003;149(3):530–4.

    Article  CAS  PubMed  Google Scholar 

  58. Patel RV, Weinberg JM. Psoriasis in the patient with human immunodeficiency virus, part 1: review of pathogenesis. Cutis. 2008;82(2):117–22.

    PubMed  Google Scholar 

  59. Jin Y, Yang S, Zhang F, Kong Y, Xiao F, Hou Y, et al. Combined effects of HLA-Cw6 and cigarette smoking in psoriasis vulgaris: a hospital-based case-control study in China. J Eur Acad Dermatol Venereol. 2009;23(2):132–7.

    Article  PubMed  CAS  Google Scholar 

  60. Raychaudhuri SP, Gross J. Psoriasis risk factors: role of lifestyle practices. Cutis. 2000;66(5):348–52.

    CAS  PubMed  Google Scholar 

  61. Mabuchi T, Ota T, Manabe Y, Ikoma N, Ozawa A, Terui T, et al. HLA-C*12:02 is a susceptibility factor in late-onset type of psoriasis in Japanese. J Dermatol. 2014;41(8):697–704.

    Article  CAS  PubMed  Google Scholar 

  62. Chularojanamontri L, Wongpraparut C, Silpa-Archa N, Chaweekulrat P. Metabolic syndrome and psoriasis severity in South-East Asian patients: an investigation of potential association using current and chronological assessments. J Dermatol. 2016;43(12):1424–8.

    Article  PubMed  Google Scholar 

  63. Huang YH, Yang LC, Hui RY, Chang YC, Yang YW, Yang CH, et al. Relationships between obesity and the clinical severity of psoriasis in Taiwan. J Eur Acad Dermatol Venereol. 2010;24(9):1035–9.

    PubMed  Google Scholar 

  64. Yin X, Low HQ, Wang L, Li Y, Ellinghaus E, Han J, et al. Genome-wide meta-analysis identifies multiple novel associations and ethnic heterogeneity of psoriasis susceptibility. Nat Commun. 2015;23(6):6916.

    Article  CAS  Google Scholar 

  65. Sun LD, Cheng H, Wang ZX, Zhang AP, Wang PG, Xu JH, et al. Association analyses identify six new psoriasis susceptibility loci in the Chinese population. Nat Genet. 2010;42(11):1005–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Tiilikainen A, Lassus A, Karvonen J, Vartiainen P, Julin M. Psoriasis and HLA-Cw6. Br J Dermatol. 1980;102(2):179–84.

    Article  CAS  PubMed  Google Scholar 

  67. Elder JT. PSORS1: linking genetics and immunology. J Invest Dermatol. 2006;126(6):1205–6.

    Article  CAS  PubMed  Google Scholar 

  68. Chang YT, Liu HN, Shiao YM, Lin MW, Lee DD, Liu MT, et al. A study of PSORS1C1 gene polymorphisms in Chinese patients with psoriasis. Br J Dermatol. 2005;153(1):90–6.

    Article  CAS  PubMed  Google Scholar 

  69. Chiu HY, Huang PY, Jee SH, Hu CY, Chou CT, Chang YT, et al. HLA polymorphism among Chinese patients with chronic plaque psoriasis: subgroup analysis. Br J Dermatol. 2012;166(2):288–97.

    Article  CAS  PubMed  Google Scholar 

  70. Fan X, Yang S, Sun LD, Liang YH, Gao M, Zhang KY, et al. Comparison of clinical features of HLA-Cw*0602-positive and -negative psoriasis patients in a Han Chinese population. Acta Derm Venereol. 2007;87(4):335–40.

    Article  PubMed  Google Scholar 

  71. Choonhakarn C, Romphruk A, Puapairoj C, Jirarattanapochai K, Leelayuwat C. Haplotype associations of the major histocompatibility complex with psoriasis in Northeastern Thais. Int J Dermatol. 2002;41(6):330–4.

    Article  PubMed  Google Scholar 

  72. Chang YT, Chou CT, Yu CW, Lin MW, Shiao YM, Chen CC, et al. Cytokine gene polymorphisms in Chinese patients with psoriasis. Br J Dermatol. 2007;156(5):899–905.

    Article  CAS  PubMed  Google Scholar 

  73. Chang YT, Tsai SF, Lee DD, Shiao YM, Huang CY, Liu HN, et al. A study of candidate genes for psoriasis near HLA-C in Chinese patients with psoriasis. Br J Dermatol. 2003;148(3):418–23.

    Article  CAS  PubMed  Google Scholar 

  74. Cassia FF, Carneiro SC, Marques MT, Pontes LF, Filgueira AL, Porto LC. Psoriasis vulgaris and human leukocyte antigens. J Eur Acad Dermatol Venereol. 2007;21(3):303–10.

    Article  CAS  PubMed  Google Scholar 

  75. Oka A, Tamiya G, Tomizawa M, Ota M, Katsuyama Y, Makino S, et al. Association analysis using refined microsatellite markers localizes a susceptibility locus for psoriasis vulgaris within a 111 kb segment telomeric to the HLA-C gene. Hum Mol Genet. 1999;8(12):2165–70.

    Article  CAS  PubMed  Google Scholar 

  76. Kastelan M, Gruber F, Cecuk E, Kerhin-Brkljacic V, Brkljacic-Surkalovic L, Kastelan A. Analysis of HLA antigens in Croatian patients with psoriasis. Acta Derm Venereol Suppl (Stockh). 2000;211:12–3.

    Article  Google Scholar 

  77. Tsai TF, Hu CY, Tsai WL, Chu CY, Lin SJ, Liaw SH, et al. HLA-Cw6 specificity and polymorphic residues are associated with susceptibility among Chinese psoriatics in Taiwan. Arch Dermatol Res. 2002;294(5):214–20.

    Article  CAS  PubMed  Google Scholar 

  78. Chandra A, Lahiri A, Senapati S, Basu B, Ghosh S, Mukhopadhyay I, et al. Increased risk of psoriasis due to combined effect of HLA-Cw6 and LCE3 risk alleles in Indian population. Sci Rep. 2016;6(6):24059.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  79. Marsh S, Parham P, Barber L. Cw*06-Cw6. The HLA facts book. London: Academic; 2000. p. 255–6.

  80. Gourraud PA, Khankhanian P, Cereb N, Yang SY, Feolo M, Maiers M, et al. HLA diversity in the 1000 genomes dataset. PLoS One. 2014;9(7):e97282.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  81. Nakagawa H, Asahina A, Akazaki S, Tokunaga K, Matsuki K, Ishibashi Y, et al. Association of Cw11 in Japanese patients with psoriasis vulgaris. Tissue Antigens. 1990;36(5):241–2.

    Article  CAS  PubMed  Google Scholar 

  82. Stuart PE, Nair RP, Hiremagalore R, Kullavanijaya P, Tejasvi T, Lim HW, et al. Comparison of MHC class I risk haplotypes in Thai and Caucasian psoriatics shows locus heterogeneity at PSORS1. Tissue Antigens. 2010;76(5):387–97.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  83. Nair RP, Ruether A, Stuart PE, Jenisch S, Tejasvi T, Hiremagalore R, et al. Polymorphisms of the IL12B and IL23R genes are associated with psoriasis. J Invest Dermatol. 2008;128(7):1653–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  84. Tsoi LC, Spain SL, Knight J, Ellinghaus E, Stuart PE, Capon F, et al. Identification of 15 new psoriasis susceptibility loci highlights the role of innate immunity. Nat Genet. 2012;44(12):1341–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  85. Ellinghaus D, Baurecht H, Esparza-Gordillo J, Rodríguez E, Matanovic A, Marenholz I, et al. High-density genotyping study identifies four new susceptibility loci for atopic dermatitis. Nat Genet. 2013;45(7):808–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  86. Girolomoni G, Strohal R, Puig L, Bachelez H, Barker J, Boehncke WH, et al. The role of IL-23 and the IL-23/TH 17 immune axis in the pathogenesis and treatment of psoriasis. J Eur Acad Dermatol Venereol. 2017;31(10):1616–26.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  87. Farooq M, Nakai H, Fujimoto A, Fujikawa H, Matsuyama A, Kariya N, et al. Mutation analysis of the IL36RN gene in 14 Japanese patients with generalized pustular psoriasis. Hum Mutat. 2013;34(1):176–83.

    Article  CAS  PubMed  Google Scholar 

  88. Li M, Lu Z, Cheng R, Li H, Guo Y, Yao Z. IL36RN gene mutations are not associated with sporadic generalized pustular psoriasis in Chinese patients. Br J Dermatol. 2013;168(2):452–5.

    Article  CAS  PubMed  Google Scholar 

  89. Hayashi M, Nakayama T, Hirota T, Saeki H, Nobeyama Y, Ito T, et al. Novel IL36RN gene mutation revealed by analysis of 8 Japanese patients with generalized pustular psoriasis. J Dermatol Sci. 2014;76(3):267–9.

    Article  CAS  PubMed  Google Scholar 

  90. Mossner R, Wilsmann-Theis D, Oji V, Gkogkolou P, Lohr S, Schulz P, et al. The genetic basis for most patients with pustular skin disease remains elusive. Br J Dermatol. 2017. https://doi.org/10.1111/bjd.15867 (epub ahead of print).

  91. Lizzul PF, Aphale A, Malaviya R, Sun Y, Masud S, Dombrovskiy V, et al. Differential expression of phosphorylated NF-kappaB/RelA in normal and psoriatic epidermis and downregulation of NF-kappaB in response to treatment with etanercept. J Invest Dermatol. 2005;124(6):1275–83.

    Article  CAS  PubMed  Google Scholar 

  92. Wang W, Zhu Z, Zhu C, Zheng X, Zuo X, Chen G, et al. A genetic variant rs1020760at NFKB1 is associated with clinical features of psoriasis vulgaris in a Han Chinese population. Ann Hum Genet. 2016;80(4):197–202.

    Article  CAS  PubMed  Google Scholar 

  93. Alzolibani AA, Settin A, Ahmed AA, Ismail H, Elhefni N, Al Robaee AA. Genetic polymorphisms of NFkappaB1 -94 del/ins ATTG, NFkappaB1A 2758 A>G and SUMO rs237025 G>A in psoriasis. Int J Health Sci (Qassim). 2015;9(1):25–33.

    Article  PubMed Central  Google Scholar 

  94. Stuart PE, Nair RP, Ellinghaus E, Ding J, Tejasvi T, Gudjonsson JE, et al. Genome-wide association analysis identifies three psoriasis susceptibility loci. Nat Genet. 2010;42(11):1000–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  95. Ellinghaus E, Ellinghaus D, Stuart PE, Nair RP, Debrus S, Raelson JV, et al. Genome-wide association study identifies a psoriasis susceptibility locus at TRAF3IP2. Nat Genet. 2010;42(11):991–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  96. Goldminz AM, Au SC, Kim N, Gottlieb AB, Lizzul PF. NF-kappaB: an essential transcription factor in psoriasis. J Dermatol Sci. 2013;69(2):89–94.

    Article  CAS  PubMed  Google Scholar 

  97. Jordan CT, Cao L, Roberson ED, Duan S, Helms CA, Nair RP, et al. Rare and common variants in CARD14, encoding an epidermal regulator of NF-kappaB, in psoriasis. Am J Hum Genet. 2012;90(5):796–808.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  98. Shi G, Li SJ, Wang TT, Cheng CM, Fan YM, Zhu KJ. The common CARD14 gene missense polymorphism rs11652075 (c.C2458T/p.Arg820Trp) is associated with psoriasis: a meta-analysis. Genet Mol Res. 2016;15(3). https://doi.org/10.4238/gmr.15038357.

  99. Li Y, Cheng H, Zuo XB, Sheng YJ, Zhou FS, Tang XF, et al. Association analyses identifying two common susceptibility loci shared by psoriasis and systemic lupus erythematosus in the Chinese Han population. J Med Genet. 2013;50(12):812–8.

    Article  CAS  PubMed  Google Scholar 

  100. Han JW, Wang Y, Alateng C, Li HB, Bai YH, Lyu XX, et al. Tumor necrosis factor-alpha induced protein 3 interacting protein 1 gene polymorphisms and pustular psoriasis in Chinese Han population. Chin Med J (Engl). 2016;129(13):1519–24.

    Article  PubMed  PubMed Central  Google Scholar 

  101. Ammar M, Jordan CT, Cao L, Lim E, Bouchlaka Souissi C, Jrad A, et al. CARD14 alterations in Tunisian patients with psoriasis and further characterization in European cohorts. Br J Dermatol. 2016;174(2):330–7.

    Article  CAS  PubMed  Google Scholar 

  102. Shi G, Cheng CM, Wang TT, Li SJ, Fan YM, Zhu KJ. Association between atopic dermatitis-related single nucleotide polymorphisms rs4722404 and psoriasis vulgaris in a southern Chinese cohort. Genet Mol Res. 2016;15(2). https://doi.org/10.4238/gmr.15028356.

  103. Xu L, Li Y, Zhang X, Sun H, Sun D, Jia X, et al. Deletion of LCE3C and LCE3B genes is associated with psoriasis in a northern Chinese population. Br J Dermatol. 2011;165(4):882–7.

    Article  CAS  PubMed  Google Scholar 

  104. Li M, Wu Y, Chen G, Yang Y, Zhou D, Zhang Z, et al. Deletion of the late cornified envelope genes LCE3C and LCE3B is associated with psoriasis in a Chinese population. J Invest Dermatol. 2011;131(8):1639–43.

    Article  CAS  PubMed  Google Scholar 

  105. Ammar M, Bouchlaka-Souissi C, Soumaya K, Bouhaha R, Ines Z, Bouazizi F, et al. Failure to find evidence for deletion of LCE3C and LCE3B genes at PSORS4 contributing to psoriasis susceptibility in Tunisian families. Pathol Biol (Paris). 2014;62(1):34–7.

    Article  CAS  Google Scholar 

  106. Bassaganyas L, Riveira-Munoz E, Garcia-Aragones M, Gonzalez JR, Caceres M, Armengol L, et al. Worldwide population distribution of the common LCE3C-LCE3B deletion associated with psoriasis and other autoimmune disorders. BMC Genom. 2013;17(14):261.

    Article  CAS  Google Scholar 

  107. de Cid R, Riveira-Munoz E, Zeeuwen PL, Robarge J, Liao W, Dannhauser EN, et al. Deletion of the late cornified envelope LCE3B and LCE3C genes as a susceptibility factor for psoriasis. Nat Genet. 2009;41(2):211–5.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  108. Coto E, Santos-Juanes J, Coto-Segura P, Diaz M, Soto J, Queiro R, et al. Mutation analysis of the LCE3B/LCE3C genes in psoriasis. BMC Med Genet. 2010;23(11):45.

    Article  CAS  Google Scholar 

  109. Bashir S, Hassan I, Majid S, Bhat YJ, Farooq R. Feasibility of establishing deletion of the late cornified envelope genes LCE3B and LCE3C as a susceptibility factor for psoriasis. Adv Biomed Res. 2016;5:109.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  110. Shah SK, Arthur A, Yang YC, Stevens S, Alexis AF. A retrospective study to investigate racial and ethnic variations in the treatment of psoriasis with etanercept. J Drugs Dermatol. 2011;10(8):866–72.

    PubMed  Google Scholar 

  111. Kwan Z, Bong YB, Tan LL, Lim SX, Yong AS, Ch’ng CC, et al. Socioeconomic and sociocultural determinants of psychological distress and quality of life among patients with psoriasis in a selected multi-ethnic Malaysian population. Psychol Health Med. 2017;22(2):184–95.

    Article  PubMed  Google Scholar 

  112. Khawaja AR, Bokhari SM, Tariq R, Atif S, Muhammad H, Faisal Q, et al. Disease severity, quality of life, and psychiatric morbidity in patients with psoriasis with reference to sociodemographic, lifestyle, and clinical variables: a prospective, cross-sectional study from Lahore, Pakistan. Prim Care Companion CNS Disord. 2015;17(3). https://doi.org/10.4088/PCC.14m01629.

  113. Ng CY, Yang YW, Liu SH, Lu JF, Yang LC, Yang CH, et al. SF-36 health survey on psoriasis quality-of-life: a study of 414 Taiwanese patients. J Dermatol. 2015;42(2):159–65.

    Article  PubMed  Google Scholar 

  114. Nyunt WW, Low WY, Ismail R, Sockalingam S, Min AK. Determinants of health-related quality of life in psoriasis patients in Malaysia. Asia Pac J Public Health. 2015;27(2):NP662–73.

  115. Nijsten T, Meads DM, de Korte J, Sampogna F, Gelfand JM, Ongenae K, et al. Cross-cultural inequivalence of dermatology-specific health-related quality of life instruments in psoriasis patients. J Invest Dermatol. 2007;127(10):2315–22.

    Article  CAS  PubMed  Google Scholar 

  116. Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 6. Guidelines of care for the treatment of psoriasis and psoriatic arthritis: case-based presentations and evidence-based conclusions. J Am Acad Dermatol. 2011;65(1):137–74.

    Article  PubMed  Google Scholar 

  117. Feldman SR, Goffe B, Rice G, Mitchell M, Kaur M, Robertson D, et al. The challenge of managing psoriasis: unmet medical needs and stakeholder perspectives. Am Health Drug Benefits. 2016;9(9):504–13.

    PubMed  PubMed Central  Google Scholar 

  118. Charrow A, Xia FD, Joyce C, Mostaghimi A. Diversity in dermatology clinical trials. JAMA Dermatol. 2017;153(2):193.

    Article  PubMed  Google Scholar 

  119. Kailas A, Dawkins M, Taylor SC. Suggestions for increasing diversity in clinical trials. JAMA Dermatol. 2017;153(7):727.

    Article  PubMed  Google Scholar 

  120. Wu NL, Hsu CJ, Sun FJ, Tsai TF. Efficacy and safety of secukinumab in Taiwanese patients with moderate to severe plaque psoriasis: subanalysis from ERASURE phase III study. J Dermatol. 2017;44(10):1129–37.

    Article  CAS  PubMed  Google Scholar 

  121. Ohtsuki M, Morita A, Abe M, Takahashi H, Seko N, Karpov A, et al. Secukinumab efficacy and safety in Japanese patients with moderate-to-severe plaque psoriasis: subanalysis from ERASURE, a randomized, placebo-controlled, phase 3 study. J Dermatol. 2014;41(12):1039–46.

    Article  CAS  PubMed  Google Scholar 

  122. Asahina A, Nakagawa H, Etoh T, Ohtsuki M. Adalimumab in Japanese patients with moderate to severe chronic plaque psoriasis: efficacy and safety results from a phase II/III randomized controlled study. J Dermatol. 2010;37(4):299–310.

    Article  CAS  PubMed  Google Scholar 

  123. Asahina A, Torii H, Ohtsuki M, Tokimoto T, Hase H, Tsuchiya T, et al. Safety and efficacy of adalimumab treatment in Japanese patients with psoriasis: results of SALSA study. J Dermatol. 2016;43(11):1257–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  124. Cai L, Gu J, Zheng J, Zheng M, Wang G, Xi LY, et al. Efficacy and safety of adalimumab in Chinese patients with moderate-to-severe plaque psoriasis: results from a phase 3, randomized, placebo-controlled, double-blind study. J Eur Acad Dermatol Venereol. 2017;31(1):89–95.

    Article  CAS  PubMed  Google Scholar 

  125. Menter A, Gordon KB, Leonardi CL, Gu Y, Goldblum OM. Efficacy and safety of adalimumab across subgroups of patients with moderate to severe psoriasis. J Am Acad Dermatol. 2010;63(3):448–56.

    Article  CAS  PubMed  Google Scholar 

  126. Tsai TF, Ho JC, Song M, Szapary P, Guzzo C, Shen YK, et al. Efficacy and safety of ustekinumab for the treatment of moderate-to-severe psoriasis: a phase III, randomized, placebo-controlled trial in Taiwanese and Korean patients (PEARL). J Dermatol Sci. 2011;63(3):154–63.

    Article  CAS  PubMed  Google Scholar 

  127. Igarashi A, Kato T, Kato M, Song M, Nakagawa H. Efficacy and safety of ustekinumab in Japanese patients with moderate-to-severe plaque-type psoriasis: long-term results from a phase 2/3 clinical trial. J Dermatol. 2012;39(3):242–52.

    Article  CAS  PubMed  Google Scholar 

  128. Zhu X, Zheng M, Song M, Shen YK, Chan D, Szapary PO, et al. Efficacy and safety of ustekinumab in Chinese patients with moderate to severe plaque-type psoriasis: results from a phase 3 clinical trial (LOTUS). J Drugs Dermatol. 2013;12(2):166–74.

    CAS  PubMed  Google Scholar 

  129. Imafuku S, Torisu-Itakura H, Nishikawa A, Zhao F, Cameron GS. Efficacy and safety of ixekizumab treatment in Japanese patients with moderate-to-severe plaque psoriasis: subgroup analysis of a placebo-controlled, phase 3 study (UNCOVER-1). J Dermatol. 2017;44(11):1285–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  130. Saeki H, Nakagawa H, Ishii T, Morisaki Y, Aoki T, Berclaz PY, et al. Efficacy and safety of open-label ixekizumab treatment in Japanese patients with moderate-to-severe plaque psoriasis, erythrodermic psoriasis and generalized pustular psoriasis. J Eur Acad Dermatol Venereol. 2015;29(6):1148–55.

    Article  CAS  PubMed  Google Scholar 

  131. Umezawa Y, Nakagawa H, Niiro H, Ootaki K. Long-term clinical safety and efficacy of brodalumab in the treatment of Japanese patients with moderate-to-severe plaque psoriasis. J Eur Acad Dermatol Venereol. 2016;30(11):1957–60.

    CAS  PubMed  Google Scholar 

  132. Nakagawa H, Schenkel B, Kato M, Kato T, Igarashi A. Impact of ustekinumab on health-related quality of life in Japanese patients with moderate-to-severe plaque psoriasis: results from a randomized, double-blind, placebo-controlled phase 2/3 trial. J Dermatol. 2012;39(9):761–9.

    Article  CAS  PubMed  Google Scholar 

  133. Tsai YC, Tsai TF. A review of clinical trials of biologic agents and small molecules for psoriasis in Asian subjects. G Ital Dermatol Venereol. 2016;151(4):412–31.

    PubMed  Google Scholar 

  134. Tsai T-F, Yeh T-Y. An update of the published reports on biologics use for psoriasis and the reimbursement status in Asia-Pacific region. Curr Rheumatol Rev. 2012;8(3):227–34.

    Article  Google Scholar 

  135. Tsai T-F, Yeh T-Y. The use of biologics for psoriasis in Asia-Pacific region. Curr Rheumatol Rev. 2009;5(3):149–52.

    Article  CAS  Google Scholar 

  136. Adsit S, Zaldivar ER, Sofen H, Dei-Cas I, Maldonado-Garcia C, Penaranda EO, et al. Secukinumab is efficacious and safe in Hispanic patients with moderate-to-severe plaque psoriasis: pooled analysis of four phase 3 trials. Adv Ther. 2017;34(6):1327–39.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  137. Ma L, Yang Q, Yang H, Wang G, Zheng M, Hao F, et al. Calcipotriol plus betamethasone dipropionate gel compared with calcipotriol scalp solution in the treatment of scalp psoriasis: a randomized, controlled trial investigating efficacy and safety in a Chinese population. Int J Dermatol. 2016;55(1):106–13.

    Article  CAS  PubMed  Google Scholar 

  138. Tyring S, Mendoza N, Appell M, Bibby A, Foster R, Hamilton T, et al. A calcipotriene/betamethasone dipropionate two-compound scalp formulation in the treatment of scalp psoriasis in Hispanic/Latino and Black/African American patients: results of the randomized, 8-week, double-blind phase of a clinical trial. Int J Dermatol. 2010;49(11):1328–33.

    Article  CAS  PubMed  Google Scholar 

  139. Lee MS, Yeh YC, Chang YT, Lai MS. All-cause and cause-specific mortality in patients with psoriasis in Taiwan: a nationwide population-vased study. J Invest Dermatol. 2017;137(7):1468–73.

    Article  CAS  PubMed  Google Scholar 

  140. Syed ZU, Hamzavi IH. Role of phototherapy in patients with skin of color. Semin Cutan Med Surg. 2011;30(4):184–9.

    Article  CAS  PubMed  Google Scholar 

  141. Wong Y, Koh MJ, Chong WS. Role of narrowband ultraviolet B phototherapy in the treatment of childhood psoriasis in Asian children. Pediatr Dermatol. 2015;32(5):e221–3.

  142. Kaur J, Sharma VK, Sethuraman G, Tejasvi T. Comparison of the efficacy of psoralen ultraviolet A with narrowband ultraviolet B phototherapy for the treatment of chronic plaque psoriasis in patients with skin types IV and V. Clin Exp Dermatol. 2008;33(4):513–5.

    Article  CAS  PubMed  Google Scholar 

  143. Chauhan PS, Kaur I, Dogra S, De D, Kanwar AJ. Narrowband ultraviolet B versus psoralen plus ultraviolet A therapy for severe plaque psoriasis: an Indian perspective. Clin Exp Dermatol. 2011;36(2):169–73.

    Article  CAS  PubMed  Google Scholar 

  144. Kwon IH, Woo SM, Choi JW, Kwon HH, Youn JI. Recovery from tanning induced by narrow-band UVB phototherapy in brown-skinned individuals with psoriasis: twelve-month follow-up. J Dermatol Sci. 2010;57(1):12–8.

    Article  PubMed  Google Scholar 

  145. Jo SJ, Yoon HS, Woo SM, Youn JI. Time course of tanning induced by narrow-band UVB phototherapy in Korean psoriasis patients. Photodermatol Photoimmunol Photomed. 2006;22(4):193–9.

    Article  PubMed  Google Scholar 

  146. Talakoub L, Wesley NO. Differences in perceptions of beauty and cosmetic procedures performed in ethnic patients. Semin Cutan Med Surg. 2009;28(2):115–29.

    Article  CAS  PubMed  Google Scholar 

  147. Ranganathan P, Culverhouse R, Marsh S, Mody A, Scott-Horton TJ, Brasington R, et al. Methotrexate (MTX) pathway gene polymorphisms and their effects on MTX toxicity in Caucasian and African American patients with rheumatoid arthritis. J Rheumatol. 2008;35(4):572–9.

    CAS  PubMed  Google Scholar 

  148. Foulkes AC, Warren RB. Pharmacogenomics and the resulting impact on psoriasis therapies. Dermatol Clin. 2015;33(1):149–60.

    Article  CAS  PubMed  Google Scholar 

  149. Hashiguchi M, Shimizu M, Hakamata J, Tsuru T, Tanaka T, Suzaki M, et al. Genetic polymorphisms of enzyme proteins and transporters related to methotrexate response and pharmacokinetics in a Japanese population. J Pharm Health Care Sci. 2016;2:35.

    Article  PubMed  PubMed Central  Google Scholar 

  150. Warren RB, Smith RL, Campalani E, Eyre S, Smith CH, Barker JN, et al. Genetic variation in efflux transporters influences outcome to methotrexate therapy in patients with psoriasis. J Invest Dermatol. 2008;128(8):1925–9.

    Article  CAS  PubMed  Google Scholar 

  151. Hughes LB, Beasley TM, Patel H, Tiwari HK, Morgan SL, Baggott JE, et al. Racial or ethnic differences in allele frequencies of single-nucleotide polymorphisms in the methylenetetrahydrofolate reductase gene and their influence on response to methotrexate in rheumatoid arthritis. Ann Rheum Dis. 2006;65(9):1213–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  152. Indhumathi S, Rajappa M, Chandrashekar L, Ananthanarayanan PH, Thappa DM, Negi VS. Pharmacogenetic markers to predict the clinical response to methotrexate in south Indian Tamil patients with psoriasis. Eur J Clin Pharmacol. 2017;73(8):965–71.

    Article  CAS  PubMed  Google Scholar 

  153. Li X, Hu M, Li W, Gu L, Chen M, Ding H, et al. The association between reduced folate carrier-1 gene 80G/A polymorphism and methotrexate efficacy or methotrexate related-toxicity in rheumatoid arthritis: a meta-analysis. Int Immunopharmacol. 2016;38:8–15.

    Article  CAS  PubMed  Google Scholar 

  154. Helliwell PS, Ibrahim G. Ethnic differences in responses to disease modifying drugs. Rheumatology. 2003;42(10):1197–201.

    Article  CAS  PubMed  Google Scholar 

  155. Yeo CM, Chong VH, Earnest A, Yang WL. Prevalence and risk factors of methotrexate hepatoxicity in Asian patients with psoriasis. World J Hepatol. 2013;5(5):275–80.

    Article  PubMed  PubMed Central  Google Scholar 

  156. Wei N, Chen Z, Xue Z, Zhu Y. Polymorphism of VEGF gene in susceptibility to chronic immune-mediated inflammatory diseases: a meta-analysis. Rheumatol Int. 2015;35(8):1351–60.

    Article  CAS  PubMed  Google Scholar 

  157. Young HS, Summers AM, Read IR, Fairhurst DA, Plant DJ, Campalani E, et al. Interaction between genetic control of vascular endothelial growth factor production and retinoid responsiveness in psoriasis. J Invest Dermatol. 2006;126(2):453–9.

    Article  CAS  PubMed  Google Scholar 

  158. Papp K, Reich K, Leonardi CL, Kircik L, Chimenti S, Langley RG, et al. Apremilast, an oral phosphodiesterase 4 (PDE4) inhibitor, in patients with moderate to severe plaque psoriasis: results of a phase III, randomized, controlled trial (Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis [ESTEEM]. 1). J Am Acad Dermatol. 2015;73(1):37–49.

    Article  CAS  PubMed  Google Scholar 

  159. Paul C, Cather J, Gooderham M, Poulin Y, Mrowietz U, Ferrandiz C, et al. Efficacy and safety of apremilast, an oral phosphodiesterase 4 inhibitor, in patients with moderate-to-severe plaque psoriasis over 52 weeks: a phase III, randomized controlled trial (ESTEEM 2). Br J Dermatol. 2015;173(6):1387–99.

    Article  CAS  PubMed  Google Scholar 

  160. Bachelez H, van de Kerkhof PC, Strohal R, Kubanov A, Valenzuela F, Lee JH, et al. Tofacitinib versus etanercept or placebo in moderate-to-severe chronic plaque psoriasis: a phase 3 randomised non-inferiority trial. Lancet. 2015;386(9993):552–61.

    Article  CAS  PubMed  Google Scholar 

  161. Papp KA, Menter MA, Abe M, Elewski B, Feldman SR, Gottlieb AB, et al. Tofacitinib, an oral Janus kinase inhibitor, for the treatment of chronic plaque psoriasis: results from two randomized, placebo-controlled, phase III trials. Br J Dermatol. 2015;173(4):949–61.

    Article  CAS  PubMed  Google Scholar 

  162. Ohtsuki M, Okubo Y, Komine M, Imafuku S, Day RM, Chen P, et al. Apremilast, an oral phosphodiesterase 4 inhibitor, in the treatment of Japanese patients with moderate to severe plaque psoriasis: efficacy, safety and tolerability results from a phase 2b randomized controlled trial. J Dermatol. 2017;44(8):873–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  163. Zhang J, Tsai TF, Lee MG, Zheng M, Wang G, Jin H, et al. The efficacy and safety of tofacitinib in Asian patients with moderate to severe chronic plaque psoriasis: a phase 3, randomized, double-blind, placebo-controlled study. J Dermatol Sci. 2017;88(1):36–45.

    Article  CAS  PubMed  Google Scholar 

  164. Asahina A, Etoh T, Igarashi A, Imafuku S, Saeki H, Shibasaki Y, et al. Oral tofacitinib efficacy, safety and tolerability in Japanese patients with moderate to severe plaque psoriasis and psoriatic arthritis: a randomized, double-blind, phase 3 study. J Dermatol. 2016;43(8):869–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  165. Winthrop KL, Yamanaka H, Valdez H, Mortensen E, Chew R, Krishnaswami S, et al. Herpes zoster and tofacitinib therapy in patients with rheumatoid arthritis. Arthritis Rheumatol. 2014;66(10):2675–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  166. Winthrop KL, Lebwohl M, Cohen AD, Weinberg JM, Tyring SK, Rottinghaus ST, et al. Herpes zoster in psoriasis patients treated with tofacitinib. J Am Acad Dermatol. 2017;77(2):302–9.

    Article  PubMed  Google Scholar 

  167. Na JI, Kim JH, Park KC, Youn SW. Low-dose etanercept therapy in moderate to severe psoriasis in Korean. J Dermatol. 2008;35(8):484–90.

    Article  CAS  PubMed  Google Scholar 

  168. Leonardi CL, Powers JL, Matheson RT, Goffe BS, Zitnik R, Wang A, et al. Etanercept as monotherapy in patients with psoriasis. N Engl J Med. 2003;349(21):2014–22.

    Article  CAS  PubMed  Google Scholar 

  169. Lee JH, Youn JI, Kim TY, Choi JH, Park CJ, Choe YB, et al. A multicenter, randomized, open-label pilot trial assessing the efficacy and safety of etanercept 50 mg twice weekly followed by etanercept 25 mg twice weekly, the combination of etanercept 25 mg twice weekly and acitretin, and acitretin alone in patients with moderate to severe psoriasis. BMC Dermatol. 2016;16(1):11.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  170. Langley RG, Elewski BE, Lebwohl M, Reich K, Griffiths CE, Papp K, et al. Secukinumab in plaque psoriasis: results of two phase 3 trials. N Engl J Med. 2014;371(4):326–38.

    Article  PubMed  CAS  Google Scholar 

  171. Griffiths CE, Reich K, Lebwohl M, van de Kerkhof P, Paul C, Menter A, et al. Comparison of ixekizumab with etanercept or placebo in moderate-to-severe psoriasis (UNCOVER-2 and UNCOVER-3): results from two phase 3 randomised trials. Lancet. 2015;386(9993):541–51.

    Article  CAS  PubMed  Google Scholar 

  172. Farahnik B, Beroukhim K, Abrouk M, Nakamura M, Zhu TH, Singh R, et al. Brodalumab for the treatment of psoriasis: a review of phase III trials. Dermatol Ther. 2016;6(2):111–24.

    Article  Google Scholar 

  173. Nakagawa H, Niiro H, Ootaki K. Brodalumab, a human anti-interleukin-17-receptor antibody in the treatment of Japanese patients with moderate-to-severe plaque psoriasis: efficacy and safety results from a phase II randomized controlled study. J Dermatol Sci. 2016;81(1):44–52.

    Article  CAS  PubMed  Google Scholar 

  174. Gordon KB, Blauvelt A, Papp KA, Langley RG, Luger T, Ohtsuki M, et al. Phase 3 trials of ixekizumab in moderate-to-severe plaque psoriasis. N Engl J Med. 2016;375(4):345–56.

    Article  CAS  PubMed  Google Scholar 

  175. Gordon KB, Blauvelt A, Foley P, Song M, Wasfi Y, Randazzo B, et al. Efficacy of guselkumab in subpopulations of patients with moderate-to-severe plaque psoriasis: a pooled analysis of the phase 3 VOYAGE 1 and VOYAGE 2 studies. Br J Dermatol. 2017. https://doi.org/10.1111/bjd.16008 (epub ahead of print).

  176. Saeki H, Nakagawa H, Nakajo K, Ishii T, Morisaki Y, Aoki T, et al. Efficacy and safety of ixekizumab treatment for Japanese patients with moderate to severe plaque psoriasis, erythrodermic psoriasis and generalized pustular psoriasis: results from a 52-week, open-label, phase 3 study (UNCOVER-J). J Dermatol. 2017;44(4):355–62.

    Article  CAS  PubMed  Google Scholar 

  177. Imafuku S, Honma M, Okubo Y, Komine M, Ohtsuki M, Morita A, et al. Efficacy and safety of secukinumab in patients with generalized pustular psoriasis: a 52-week analysis from phase III open-label multicenter Japanese study. J Dermatol. 2016;43(9):1011–7.

    Article  CAS  PubMed  Google Scholar 

  178. van Vugt LJ, van den Reek J, Coenen MJH, de Jong E. A systematic review of pharmacogenetic studies on the response to biologics in psoriasis patients. Br J Dermatol. 2017. https://doi.org/10.1111/bjd.15753 (epub ahead of print).

  179. Gallo E, Cabaleiro T, Roman M, Solano-Lopez G, Abad-Santos F, Garcia-Diez A, et al. The relationship between tumour necrosis factor (TNF)-alpha promoter and IL12B/IL-23R genes polymorphisms and the efficacy of anti-TNF-alpha therapy in psoriasis: a case-control study. Br J Dermatol. 2013;169(4):819–29.

    Article  CAS  PubMed  Google Scholar 

  180. Vasilopoulos Y, Manolika M, Zafiriou E, Sarafidou T, Bagiatis V, Kruger-Krasagaki S, et al. Pharmacogenetic analysis of TNF, TNFRSF1A, and TNFRSF1B gene polymorphisms and prediction of response to anti-TNF therapy in psoriasis patients in the Greek population. Mol Diagn Ther. 2012;16(1):29–34.

    Article  CAS  PubMed  Google Scholar 

  181. Nishikawa R, Nagai H, Bito T, Ikeda T, Horikawa T, Adachi A, et al. Genetic prediction of the effectiveness of biologics for psoriasis treatment. J Dermatol. 2016;43(11):1273–7.

    Article  CAS  PubMed  Google Scholar 

  182. McMichael AJ, Vachiramon V, Guzman-Sanchez DA, Camacho F. Psoriasis in African-Americans: a caregivers’ survey. J Drugs Dermatol. 2012;11(4):478–82.

    PubMed  Google Scholar 

  183. Noda S, Suárez-Fariñas M, Ungar B, Kim SJ, de Guzman Strong C, Xu H, et al. The Asian atopic dermatitis phenotype combines features of atopic dermatitis and psoriasis with increased TH17 polarization. J Allergy Clin Immunol. 2015;136(5):1254–64.

    Article  CAS  PubMed  Google Scholar 

  184. Khattri S, Brunner PM, Garcet S, Finney R, Cohen SR, Oliva M, et al. Efficacy and safety of ustekinumab treatment in adults with moderate-to-severe atopic dermatitis. Exp Dermatol. 2016;26(1):28–35.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  185. Zhou J, Sun D, Xu L, Sun L, Fu S, Li Y. ADAM33 as a psoriasis susceptibility gene in the Han population of northeastern China. Dermatology. 2011;223(4):356–62.

    Article  CAS  PubMed  Google Scholar 

  186. He L, Dang L, Zhou J, Bai J, Li YZ. Association of angiopoietin-1, angiopoietin-2 and caspase-5 polymorphisms with psoriasis vulgaris. Clin Exp Dermatol. 2015;40(5):556–63.

    Article  CAS  PubMed  Google Scholar 

  187. Villarreal-Martinez A, Gallardo-Blanco H, Cerda-Flores R, Torres-Munoz I, Gomez-Flores M, Salas-Alanis J, et al. Candidate gene polymorphisms and risk of psoriasis: a pilot study. Exp Ther Med. 2016;11(4):1217–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  188. Zuo X, Sun L, Yin X, Gao J, Sheng Y, Xu J, et al. Whole-exome SNP array identifies 15 new susceptibility loci for psoriasis. Nat Commun. 2015;9(6):6793.

    Article  CAS  Google Scholar 

  189. Feng C, Wang T, Li SJ, Fan YM, Shi G, Zhu KJ. CARD14 gene polymorphism c.C2458T (p.Arg820Trp) is associated with clinical features of psoriasis vulgaris in a Chinese cohort. J Dermatol. 2016;43(3):294–7.

    Article  CAS  PubMed  Google Scholar 

  190. Gao J, Sun L, Zhang X. The genetic progress of psoriasis in the Han Chinese population. J Investig Dermatol Symp Proc. 2015;17(1):46–7.

    Article  CAS  PubMed  Google Scholar 

  191. Tang H, Jin X, Li Y, Jiang H, Tang X, Yang X, et al. A large-scale screen for coding variants predisposing to psoriasis. Nat Genet. 2014;46(1):45–50.

    Article  CAS  PubMed  Google Scholar 

  192. Sheng Y, Jin X, Xu J, Gao J, Du X, Duan D, et al. Sequencing-based approach identified three new susceptibility loci for psoriasis. Nat Commun. 2014;9(5):4331.

    Article  CAS  Google Scholar 

  193. Li XL, Yu H, Wu GS. Investigating the genetic association of HCP5, SPATA2, TNIP1, TNFAIP3 and COG6 with psoriasis in Chinese population. Int J Immunogenet. 2014;41(6):503–7.

    Article  CAS  PubMed  Google Scholar 

  194. Al-Balbeesi AO, Halwani M, Alanazi M, Elrobh M, Shaik JP, Khan AA, et al. Novel mutations in IL-10 promoter region -377 (C>T), -150 (C>A) and their association with psoriasis in the Saudi population. Asian Pac J Cancer Prev. 2015;16(3):1247–50.

    Article  PubMed  Google Scholar 

  195. Zhang XJ, Huang W, Yang S, Sun LD, Zhang FY, Zhu QX, et al. Psoriasis genome-wide association study identifies susceptibility variants within LCE gene cluster at 1q21. Nat Genet. 2009;41(2):205–10.

    Article  CAS  PubMed  Google Scholar 

  196. Tsunemi Y, Saeki H, Nakamura K, Sekiya T, Hirai K, Fujita H, et al. Interleukin-12 p40 gene (IL12B) 3′-untranslated region polymorphism is associated with susceptibility to atopic dermatitis and psoriasis vulgaris. J Dermatol Sci. 2002;30(2):161–6.

    Article  CAS  PubMed  Google Scholar 

  197. Shi G, Wang T, Li S, Cheng Y, Sheng P, Fan Y, et al. TLR2 and TLR4 polymorphisms in Southern Chinese psoriasis vulgaris patients. J Dermatol Sci. 2016;83(2):145–7.

    Article  CAS  PubMed  Google Scholar 

  198. Lee YH, Song GG. Vascular endothelial growth factor gene polymorphisms and psoriasis susceptibility: a meta-analysis. Genet Mol Res. 2015;14(4):14396–405.

    Article  CAS  PubMed  Google Scholar 

  199. Zhang XJ, He PP, Wang ZX, Zhang J, Li YB, Wang HY, et al. Evidence for a major psoriasis susceptibility locus at 6p21(PSORS1) and a novel candidate region at 4q31 by genome-wide scan in Chinese hans. J Invest Dermatol. 2002;119(6):1361–6.

    Article  CAS  PubMed  Google Scholar 

  200. Saurat JH, Stingl G, Dubertret L, Papp K, Langley RG, Ortonne JP, et al. Efficacy and safety results from the randomized controlled comparative study of adalimumab vs. methotrexate vs. placebo in patients with psoriasis (CHAMPION). Br J Dermatol. 2008;158(3):558–66.

    Article  CAS  PubMed  Google Scholar 

  201. Menter A, Tyring SK, Gordon K, Kimball AB, Leonardi CL, Langley RG, et al. Adalimumab therapy for moderate to severe psoriasis: a randomized, controlled phase III trial. J Am Acad Dermatol. 2008;58(1):106–15.

    Article  PubMed  Google Scholar 

  202. Papp KA, Tyring S, Lahfa M, Prinz J, Griffiths CEM, Nakanishi AM, et al. A global phase III randomized controlled trial of etanercept in psoriasis: safety, efficacy, and effect of dose reduction. Br J Dermatol. 2005;152(6):1304–12.

    Article  CAS  PubMed  Google Scholar 

  203. Tyring S, Gordon KB, Poulin Y, Langley RG, Gottlieb AB, Dunn M, et al. Long-term safety and efficacy of 50 mg of etanercept twice weekly in patients with psoriasis. Arch Dermatol. 2007;143(6):719–26.

    Article  CAS  PubMed  Google Scholar 

  204. Sterry W, Ortonne JP, Kirkham B, Brocq O, Robertson D, Pedersen RD, et al. Comparison of two etanercept regimens for treatment of psoriasis and psoriatic arthritis: PRESTA randomised double blind multicentre trial. BMJ. 2010;2(340):c147.

    Article  Google Scholar 

  205. Griffiths CE, Strober BE, van de Kerkhof P, Ho V, Fidelus-Gort R, Yeilding N, et al. Comparison of ustekinumab and etanercept for moderate-to-severe psoriasis. N Engl J Med. 2010;362(2):118–28.

    Article  CAS  PubMed  Google Scholar 

  206. Leonardi CL, Kimball AB, Papp KA, Yeilding N, Guzzo C, Wang Y, et al. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 76-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 1). Lancet. 2008;371(9625):1665–74.

    Article  CAS  PubMed  Google Scholar 

  207. Papp KA, Langley RG, Lebwohl M, Krueger GG, Szapary P, Yeilding N, et al. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 52-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 2). Lancet. 2008;371(9625):1675–84.

    Article  CAS  PubMed  Google Scholar 

  208. Thaci D, Blauvelt A, Reich K, Tsai TF, Vanaclocha F, Kingo K, et al. Secukinumab is superior to ustekinumab in clearing skin of subjects with moderate to severe plaque psoriasis: CLEAR, a randomized controlled trial. J Am Acad Dermatol. 2015;73(3):400–9.

    Article  CAS  PubMed  Google Scholar 

  209. Blauvelt A, Prinz JC, Gottlieb AB, Kingo K, Sofen H, Ruer-Mulard M, et al. Secukinumab administration by pre-filled syringe: efficacy, safety and usability results from a randomized controlled trial in psoriasis (FEATURE). Br J Dermatol. 2015;172(2):484–93.

    Article  CAS  PubMed  Google Scholar 

  210. Paul C, Lacour JP, Tedremets L, Kreutzer K, Jazayeri S, Adams S, et al. Efficacy, safety and usability of secukinumab administration by autoinjector/pen in psoriasis: a randomized, controlled trial (JUNCTURE). J Eur Acad Dermatol Venereol. 2015;29(6):1082–90.

    Article  CAS  PubMed  Google Scholar 

  211. Papp KA, Reich K, Paul C, Blauvelt A, Baran W, Bolduc C, et al. A prospective phase III, randomized, double-blind, placebo-controlled study of brodalumab in patients with moderate-to-severe plaque psoriasis. Br J Dermatol. 2016;175(2):273–86.

    Article  CAS  PubMed  Google Scholar 

  212. Lebwohl M, Strober B, Menter A, Gordon K, Weglowska J, Puig L, et al. Phase 3 studies comparing brodalumab with ustekinumab in psoriasis. N Engl J Med. 2015;373(14):1318–28.

    Article  PubMed  Google Scholar 

  213. Blauvelt A, Papp KA, Griffiths CE, Randazzo B, Wasfi Y, Shen YK, et al. Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis: results from the phase III, double-blinded, placebo- and active comparator-controlled VOYAGE 1 trial. J Am Acad Dermatol. 2017;76(3):405–17.

    Article  CAS  PubMed  Google Scholar 

  214. Reich K, Armstrong AW, Foley P, Song M, Wasfi Y, Randazzo B, et al. Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the treatment of patients with moderate to severe psoriasis with randomized withdrawal and retreatment: results from the phase III, double-blind, placebo- and active comparator-controlled VOYAGE 2 trial. J Am Acad Dermatol. 2017;76(3):418–31.

    Article  CAS  PubMed  Google Scholar 

  215. Reich K, Papp KA, Blauvelt A, Tyring SK, Sinclair R, Thaci D, et al. Tildrakizumab versus placebo or etanercept for chronic plaque psoriasis (reSURFACE 1 and reSURFACE 2): results from two randomised controlled, phase 3 trials. Lancet. 2017;390(10091):276–88.

    Article  CAS  PubMed  Google Scholar 

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  1. Mount Sinai St. Luke’s, 1090 Amsterdam Avenue, Suite 11B, New York, NY, 10025, USA

    Bridget P. Kaufman & Andrew F. Alexis

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Correspondence to Bridget P. Kaufman.

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Bridget P. Kaufman has no conflict of interest or financial disclosures to report. Andrew F. Alexis reports the following conflicts of interest and financial disclosures: a grant to Mount Sinai St. Luke’s for clinical trials studying psoriasis (Novartis and Dermira).

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Kaufman, B.P., Alexis, A.F. 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. Am J Clin Dermatol 19, 405–423 (2018). https://doi.org/10.1007/s40257-017-0332-7

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