Diversity and psoriasis

Do lesbian, gay, bisexual and other sexual diverse people with psoriasis experience worse outcomes than heterosexual people?

This question was addressed in an interesting 2021 study using data from the US National Health and Nutrition Examination Surveys. The study included heterosexual people and lesbian, gay, bisexual and other sexual minority people (aged 18–59 years). The sexual minority group included people who identified as lesbian, gay, bisexual, or “something else”. Researchers analysed responses to standard questionnaires on clinical depression, mental healthcare utilisation, overall health, and the frequency of mental and physical distress.

The study included 14,932 heterosexual participants (371 with psoriasis, 14,561 without psoriasis) and 1,004 sexual minority participants (30 with psoriasis, 974 without psoriasis).

The findings suggest that lesbian, gay, bisexual and other sexual minority people with psoriasis have poorer mental and physical health than heterosexual people with psoriasis. In particular, they had nearly a four-fold higher risk of reporting clinical depression, frequent physical distress, and poor overall health.

Perhaps surprisingly, despite these differences, lesbian, gay, bisexual and other sexual minority people with psoriasis were no more likely than heterosexual people with psoriasis to report receiving mental healthcare. This may indicate a lack of awareness among health professionals that people from sexual minorities may be at increased risk compared with their heterosexual counterparts.

The strength of the study is that the sample is nationally representative, although the number of sexual minority people with psoriasis was relatively small.

Conclusion; This is an interesting study suggesting a significantly higher risk of mental illness among lesbian, gay, bisexual and other sexual minority people with psoriasis compared with their heterosexual counterparts. Dermatologists and family doctors treating psoriasis should be aware of their patient’s sexual orientation at baseline assessment and be especially vigilant regarding mental health—such as depression and anxiety—when monitoring progress.

Author:
Dr David Ashton MD PhD.

Reference
Mansh MD, Mulick A, Langan SM. The impact of psoriasis and sexual orientation on mental and physical health among adults in the United States. J Am Acad Dermatol. 2022;87:234–237.