Are there regional differences in health issues for people with psoriasis?

Psoriasis is a chronic inflammatory skin disease that can affect more than just the skin. People with psoriasis may have higher risks for other health problems, such as heart disease, diabetes, and depression. Research shows that these health issues can vary depending on where a person lives. Factors like genetics, environment, healthcare systems, and lifestyle likely play a role. This answer looks at what studies from different regions reveal about these differences.

What the research says

A systematic review found significant regional differences in comorbidities among people with hidradenitis suppurativa (HS), a related inflammatory skin condition. North American patients had higher odds of diabetes compared to Europe, and higher odds of hypertension compared to the Middle East/Asia. Depression and thyroid disorders were more common in North America and Europe than in the Middle East/Asia. Smoking was more prevalent in Europe compared to North America and the Middle East/Asia ³. While this study focused on HS, it highlights that regional variation in comorbidities is an important consideration for inflammatory skin diseases like psoriasis.

In Germany, a study of health insurance data from 2004-2007 showed that most psoriasis patients initially saw a dermatologist (68%), but over time, more were treated by general practitioners. There were also significant regional differences in prescription behavior for psoriasis treatments ¹⁰. This suggests that healthcare access and treatment patterns vary within a single country, which could affect health outcomes.

A study in rural South Africa found a high point prevalence of any skin disease (62.9%) among residents, with tinea capitis (a fungal infection) being the most common in children. Psoriasis was not among the top conditions reported, but the study highlights that skin disease burden and types differ greatly in under-resourced regions compared to wealthier areas ¹¹. This points to regional differences in both the prevalence and types of skin conditions, which may influence how psoriasis is diagnosed and managed.

Other research has examined specific health issues in psoriasis patients. For example, a study from Israel found that the risk of cardiovascular disease increases with age in women with psoriasis, and menopause may add to that risk ⁹. A study in China showed that secukinumab improved skin symptoms in patients with psoriatic arthritis ⁶. These studies do not directly compare regions, but they illustrate that research on psoriasis-related health issues is conducted worldwide, and findings may not apply uniformly across populations.

What to ask your doctor

• Are there any regional or ethnic factors that might affect my psoriasis or my risk for related health problems?
• Based on where I live, what are the most common health issues I should watch for with psoriasis?
• How does my healthcare access (e.g., seeing a dermatologist vs. a general practitioner) affect my treatment options?
• Should I be screened for conditions like heart disease, diabetes, or depression given my psoriasis and where I live?
• Are there any local resources or support groups for people with psoriasis in my area?