{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T09:27:47Z","timestamp":1794043667790,"version":"4.8.0"},"reference-count":60,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.es","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Anais Brasileiros de Dermatologia"],"published-print":{"date-parts":[[2026,5]]},"DOI":"10.1016\/j.abd.2026.501365","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T06:04:54Z","timestamp":1779084294000},"page":"501365","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"title":["Psoriasis in skin of color: clinical presentation, diagnostic challenges, and therapeutic considerations"],"prefix":"10.1016","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0504-2472","authenticated-orcid":false,"given":"Anderson","family":"Costa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Romiti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.abd.2026.501365_bib0005","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1001\/jama.2020.4006","article-title":"Pathophysiology, clinical presentation, and treatment of psoriasis: a review","volume":"323","author":"Armstrong","year":"2020","journal-title":"JAMA"},{"key":"10.1016\/j.abd.2026.501365_bib0010","doi-asserted-by":"crossref","first-page":"26","DOI":"10.12788\/cutis.0576","article-title":"Racial disparities in the diagnosis of psoriasis","volume":"110","author":"Dickerson","year":"2022","journal-title":"Cutis"},{"key":"10.1016\/j.abd.2026.501365_bib0015","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1038\/jid.2012.339","article-title":"Global epidemiology of Psoriasis: a systematic review of incidence and prevalence","volume":"133","author":"Parisi","year":"2013","journal-title":"J Invest Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0020","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1007\/s40257-017-0332-7","article-title":"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","volume":"19","author":"Kaufman","year":"2018","journal-title":"Am J Clin Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0025","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1111\/ijd.17651","article-title":"Psoriasis in people with skin of color: an evidence\u2010based update","volume":"64","author":"Gkini","year":"2025","journal-title":"Int J Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0030","doi-asserted-by":"crossref","first-page":"2401","DOI":"10.1007\/s13555-022-00811-0","article-title":"Unmet need in people with Psoriasis and skin of color in Canada and the United States","volume":"12","author":"Yadav","year":"2022","journal-title":"Dermatol Ther"},{"key":"10.1016\/j.abd.2026.501365_bib0035","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1590\/abd1806-4841.20174846","article-title":"Refining the ideas of \u201cethnic\u201d skin","volume":"92","author":"Torres","year":"2017","journal-title":"An Bras Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0040","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1016\/j.jaad.2017.01.028","article-title":"Should we refer to skin as \u201cethnic?\u201d","volume":"76","author":"Adamson","year":"2017","journal-title":"J Am Acad Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0045","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1007\/s40257-023-00800-9","article-title":"Capturing the diversity of dermatology \u2012 what\u2019s in a name?","volume":"24","author":"Erickson","year":"2023","journal-title":"Am J Clin Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0050","doi-asserted-by":"crossref","DOI":"10.1126\/science.adl3564","article-title":"Admixture\u2019s impact on brazilian population evolution and health","volume":"388","author":"Nunes","year":"2025","journal-title":"Science"},{"key":"10.1016\/j.abd.2026.501365_bib0055","series-title":"Caracterist\u00edcas \u00e9tnico-raciais da popula\u00e7\u00e3o: classifica\u00e7\u00f5es e identidades","author":"Petruccelli","year":"2013"},{"key":"10.1016\/j.abd.2026.501365_bib0060","unstructured":"Instituto Brasileiro de Geografia e Estat\u00edstica [Internet]. Pesquisa nacional por amostra de domic\u00edlios cont\u00ednua terceiro trimestre de 2024. Rio de Janeiro (RJ): IBGE; 2024 [cited 2025 Aug 16]. Available from: https:\/\/ftp.ibge.gov.br\/Trabalho_e_Rendimento\/Pesquisa_Nacional_por_Amostra_de_Domicilios_continua\/Trimestral\/Fasciculos_Indicadores_IBGE\/2024\/pnadc_202403_trimestre_caderno.pdf."},{"key":"10.1016\/j.abd.2026.501365_bib0065","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1016\/S0140-6736(20)32549-6","article-title":"Psoriasis","volume":"397","author":"Griffiths","year":"2021","journal-title":"Lancet"},{"key":"10.1016\/j.abd.2026.501365_bib0070","series-title":"Taylor and Kelly\u2019s dermatology for skin of color","author":"Taylor","year":"2025"},{"key":"10.1016\/j.abd.2026.501365_bib0075","first-page":"16","article-title":"Psoriasis in skin of color: epidemiology, genetics, clinical presentation, and treatment nuances","volume":"7","author":"Alexis","year":"2014","journal-title":"J Clin Aesthet Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0080","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/bjd\/ljad165","article-title":"Prevalence of psoriasis and other autoimmune skin diseases in a recently contacted indigenous community in the Auaris region, Yanomami Indigenous Territory, Brazil","volume":"189","author":"Romiti","year":"2023","journal-title":"Br J Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0085","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.jaad.2004.07.045","article-title":"The prevalence of Psoriasis in african americans: results from a population-based study","volume":"52","author":"Gelfand","year":"2005","journal-title":"J Am Acad Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0090","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1126\/science.1172257","article-title":"The genetic structure and history of africans and african americans","volume":"324","author":"Tishkoff","year":"2009","journal-title":"Science"},{"key":"10.1016\/j.abd.2026.501365_bib0095","doi-asserted-by":"crossref","first-page":"e167","DOI":"10.1111\/ijd.13604","article-title":"Prevalence of psoriasis in Brazil \u2013 a geographical survey","volume":"56","author":"Romiti","year":"2017","journal-title":"Int J Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0100","doi-asserted-by":"crossref","first-page":"m1590","DOI":"10.1136\/bmj.m1590","article-title":"National, regional, and worldwide epidemiology of Psoriasis: systematic analysis and modelling study","volume":"369","author":"Parisi","year":"2020","journal-title":"BMJ"},{"key":"10.1016\/j.abd.2026.501365_bib0105","doi-asserted-by":"crossref","DOI":"10.2340\/00015555-3384","article-title":"Psoriasis and genetics","volume":"100","author":"Dand","year":"2020","journal-title":"Acta Derm Venereol"},{"key":"10.1016\/j.abd.2026.501365_bib0110","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1086\/342289","article-title":"Family-based analysis using a dense single-nucleotide polymorphism\u2013based map defines genetic variation at psors1, the major psoriasis-susceptibility locus","volume":"71","author":"Veal","year":"2002","journal-title":"Am J Hum Genet"},{"key":"10.1016\/j.abd.2026.501365_bib0115","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s40257-020-00585-1","article-title":"HLA-Cw1 and Psoriasis","volume":"22","author":"Huang","year":"2021","journal-title":"Am J Clin Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0120","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.3390\/ijms20061475","article-title":"Psoriasis pathogenesis and treatment","volume":"20","author":"Rendon","year":"2019","journal-title":"Int J Mol Sci"},{"key":"10.1016\/j.abd.2026.501365_bib0125","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1016\/j.jid.2021.09.031","article-title":"Transcriptome analysis reveals intrinsic proinflammatory signaling in healthy african american skin","volume":"142","author":"Klopot","year":"2022","journal-title":"J Invest Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0130","doi-asserted-by":"crossref","first-page":"7","DOI":"10.12788\/cutis.0038","article-title":"Psoriasis in patients of color: differences in morphology, clinical presentation, and treatment","volume":"106","author":"Nicholas","year":"2020","journal-title":"Cutis"},{"key":"10.1016\/j.abd.2026.501365_bib0135","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1038\/s41591-023-02728-3","article-title":"Deep learning-aided decision support for diagnosis of skin disease across skin tones","volume":"30","author":"Groh","year":"2024","journal-title":"Nat Med"},{"key":"10.1016\/j.abd.2026.501365_bib0140","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1016\/j.jaad.2021.03.088","article-title":"Representation and misdiagnosis of dark skin in a large-scale visual diagnostic challenge","volume":"86","author":"Diao","year":"2022","journal-title":"J Am Acad Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0145","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1111\/bjd.20660","article-title":"Why we should abandon the misused descriptor \u2018erythema\u2019","volume":"185","author":"Finlay","year":"2021","journal-title":"Br J Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0150","doi-asserted-by":"crossref","first-page":"1604","DOI":"10.3390\/life14121604","article-title":"Exploring pediatric dermatology in skin of color: focus on dermoscopy","volume":"14","author":"Karampinis","year":"2024","journal-title":"Life"},{"key":"10.1016\/j.abd.2026.501365_bib0155","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1038\/JID.2015.378","article-title":"Molecular Phenotyping small (asian) versus large (western) plaque psoriasis shows common activation of IL-17 pathway genes but different regulatory gene sets","volume":"136","author":"Kim","year":"2016","journal-title":"J Invest Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0160","first-page":"795","article-title":"Skin tone representation in dermatology textbooks: approximating the gap","volume":"21","author":"Temiz","year":"2022","journal-title":"J Drugs Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0165","first-page":"1421","article-title":"Roles of inflammation factors in melanogenesis (Review)","volume":"21","author":"Fu","year":"2020","journal-title":"Mol Med Rep"},{"key":"10.1016\/j.abd.2026.501365_bib0170","doi-asserted-by":"crossref","first-page":"66","DOI":"10.2340\/00015555-3385","article-title":"The Woronoff ring in psoriasis and the mechanisms of postinflammatory hypopigmentation","volume":"100","author":"Prinz","year":"2020","journal-title":"Acta Derm Venereol"},{"key":"10.1016\/j.abd.2026.501365_bib0175","first-page":"276","article-title":"Getting to the core of contemporary therapies for post-inflammatory hyperpigmentation","volume":"21","author":"Naik","year":"2022","journal-title":"J Drugs Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0180","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/j.jaad.2023.02.053","article-title":"Treatment recommendations for acne-associated hyperpigmentation: results of the delphi consensus process and a literature review","volume":"89","author":"Taylor","year":"2023","journal-title":"J Am Acad Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0185","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1177\/12034754241265716","article-title":"Treatment of post-inflammatory hyperpigmentation in skin of colour: a systematic review","volume":"28","author":"Mar","year":"2024","journal-title":"J Cutan Med Surg"},{"key":"10.1016\/j.abd.2026.501365_bib0190","doi-asserted-by":"crossref","first-page":"344","DOI":"10.36849\/JDD.5622","article-title":"The use of tranexamic acid to prevent and treat post-inflammatory hyperpigmentation","volume":"20","author":"Lindgren","year":"2021","journal-title":"J Drugs Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0195","doi-asserted-by":"crossref","DOI":"10.1016\/j.biopha.2023.115307","article-title":"Tranexamic acid improves psoriasis-like skin inflammation: evidence from in vivo and in vitro studies","volume":"166","author":"Hseu","year":"2023","journal-title":"Biomed Pharmacother"},{"key":"10.1016\/j.abd.2026.501365_bib0200","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1093\/rheumatology\/keae066","article-title":"Racial and ethnic determinants of psoriatic arthritis phenotypes and disease activity","volume":"64","author":"Haberman","year":"2025","journal-title":"Rheumatology"},{"key":"10.1016\/j.abd.2026.501365_bib0205","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1177\/24755303231198482","article-title":"Comorbidity burden in psoriasis patients with skin of color","volume":"9","author":"Peterson","year":"2024","journal-title":"J Psoriasis Psoriatic Arthritis"},{"key":"10.1016\/j.abd.2026.501365_bib0210","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.36849\/JDD.7090","article-title":"Evolving concepts in psoriasis: special considerations for patients with skin of color, skin barrier dysfunction, and the role of adjunctive skin care","volume":"21","author":"Alexis","year":"2022","journal-title":"J Drugs Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0215","doi-asserted-by":"crossref","first-page":"165","DOI":"10.36849\/JDD.6910","article-title":"Efficacy and safety of calcipotriene\/betamethasone dipropionate foam in the treatment of psoriasis in skin of color","volume":"22","author":"Liu","year":"2023","journal-title":"J Drugs Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0220","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.sder.2011.08.007","article-title":"Role of phototherapy in patients with skin of color","volume":"30","author":"Syed","year":"2011","journal-title":"Semin Cutan Med Surg"},{"key":"10.1016\/j.abd.2026.501365_bib0225","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1111\/j.1365-2133.2008.08776.x","article-title":"Incidence of skin cancers in 3867 patients treated with narrow-band ultraviolet B phototherapy","volume":"159","author":"Hearn","year":"2008","journal-title":"Br J Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0230","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1111\/j.1600-0781.2008.00371.x","article-title":"Different narrowband UVB dosage regimens in dark skinned psoriatics: a preliminary study","volume":"24","author":"Youssef","year":"2008","journal-title":"Photodermatol Photoimmunol Photomed"},{"key":"10.1016\/j.abd.2026.501365_bib0235","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1034\/j.1600-0781.2002.00730.x","article-title":"Quantitative assessment of narrow\u2010band UVB induced tanning during phototherapy in Korea","volume":"18","author":"Choe","year":"2002","journal-title":"Photodermatol Photoimmunol Photomed"},{"key":"10.1016\/j.abd.2026.501365_bib0240","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1136\/ard.2005.046797","article-title":"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","volume":"65","author":"Hughes","year":"2006","journal-title":"Ann Rheum Dis"},{"key":"10.1016\/j.abd.2026.501365_bib0245","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/MAJ.0000000000000308","article-title":"Racial differences in hypertension: implications for high blood pressure management","volume":"348","author":"Lackland","year":"2014","journal-title":"Am J Med Sci"},{"key":"10.1016\/j.abd.2026.501365_bib0250","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1177\/12034754241260023","article-title":"Response to biologic therapy in skin of colour participants with moderate-to-severe psoriasis and atopic dermatitis: a systematic review","volume":"28","author":"Rijal","year":"2024","journal-title":"J Cutan Med Surg"},{"key":"10.1016\/j.abd.2026.501365_bib0255","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s00403-022-02324-4","article-title":"Racial\/ethnic differences in treatment efficacy and safety for moderate-to-severe plaque psoriasis: a systematic review","volume":"315","author":"Ferguson","year":"2023","journal-title":"Arch Dermatol Res"},{"key":"10.1016\/j.abd.2026.501365_bib0260","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1001\/jamadermatol.2024.5103","article-title":"Improving diversity in a novel psoriasis study: visible as a framework for clinical trial quality improvement","volume":"161","author":"Alexis","year":"2025","journal-title":"JAMA Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0265","doi-asserted-by":"crossref","DOI":"10.1016\/j.abd.2025.501242","article-title":"Highlights of the Brazilian Society of Dermatology\u2019s brazilian consensus on psoriasis","volume":"100","author":"Romiti","year":"2025","journal-title":"An Bras Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0270","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.jaad.2023.09.080","article-title":"Generalized pustular psoriasis: a consensus statement from the national psoriasis foundation","volume":"90","author":"Armstrong","year":"2024","journal-title":"J Am Acad Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0275","doi-asserted-by":"crossref","first-page":"13030","DOI":"10.5070\/D3247040909","article-title":"A cross-sectional study of the distribution of psoriasis subtypes in different ethno-racial groups","volume":"24","author":"Yan","year":"2018","journal-title":"Dermatol Online J"},{"key":"10.1016\/j.abd.2026.501365_bib0280","doi-asserted-by":"crossref","first-page":"2431","DOI":"10.1056\/NEJMoa2111563","article-title":"Trial of spesolimab for generalized pustular psoriasis","volume":"385","author":"Bachelez","year":"2021","journal-title":"N Engl J Med"},{"key":"10.1016\/j.abd.2026.501365_bib0285","doi-asserted-by":"crossref","first-page":"3086","DOI":"10.1080\/09546634.2022.2114783","article-title":"Racial and ethnic diversity of US participants in clinical trials for acne, atopic dermatitis, and psoriasis: a comprehensive review","volume":"33","author":"Sevagamoorthy","year":"2022","journal-title":"J Dermatol Treat"},{"key":"10.1016\/j.abd.2026.501365_bib0290","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s12939-023-01828-3","article-title":"Persistent inequalities in health care services utilisation in Brazil (1998\u20132019)","volume":"22","author":"Coube","year":"2023","journal-title":"Int J Equity Health"},{"key":"10.1016\/j.abd.2026.501365_bib0295","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1001\/jamadermatol.2025.1836","article-title":"Guselkumab for moderate to severe psoriasis across all skin tones: cohort a of the VISIBLE randomized clinical trial","volume":"161","author":"Alexis","year":"2025","journal-title":"JAMA Dermatol"},{"key":"10.1016\/j.abd.2026.501365_bib0300","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1111\/bjd.20766","article-title":"Standardized clinical photography considerations in patients across skin tones","volume":"186","author":"Oh","year":"2022","journal-title":"Br J Dermatol"}],"container-title":["Anais Brasileiros de Dermatologia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0365059626000784?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0365059626000784?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T11:40:22Z","timestamp":1781091622000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0365059626000784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":60,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["S0365059626000784"],"URL":"https:\/\/doi.org\/10.1016\/j.abd.2026.501365","relation":{},"ISSN":["0365-0596"],"issn-type":[{"value":"0365-0596","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Psoriasis in skin of color: clinical presentation, diagnostic challenges, and therapeutic considerations","name":"articletitle","label":"Article Title"},{"value":"Anais Brasileiros de Dermatologia","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.abd.2026.501365","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Sociedade Brasileira de Dermatologia. Published by Elsevier Espa\u00f1a, S.L.U.","name":"copyright","label":"Copyright"}],"article-number":"501365"}}