{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:05:10Z","timestamp":1792004710305,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Psoriasis is a chronic immune\u2010mediated disease associated with multiple systemic comorbidities. Biologic therapies have transformed the management of moderate\u2010to\u2010severe psoriasis; however, their high cost remains a major barrier for uninsured and socioeconomically disadvantaged individuals. The Psoriasis Biologics Center for Indigent Patients at Jackson Memorial Hospital provides a structured dermatology access model for underserved populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a descriptive retrospective cohort study of patients with moderate\u2010to\u2010severe psoriasis receiving biologic therapy through a dedicated safety\u2010net access program between 2005 and 2025. Patient demographics, comorbidities, and management strategies were obtained from electronic medical records and standardized intake questionnaires. Only descriptive statistics were performed; standardized disease severity and quality\u2010of\u2010life measures such as the Psoriasis Area and Severity Index (PASI) or the Dermatology Life Quality Index (DLQI) were not available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 450 patients (mean age 52.6\u2009years; 54% female) were included. Nearly half (49.8%) presented with at least one systemic comorbidity. The most common were psoriatic arthritis (35.1%), hypertension (31.3%), diabetes mellitus (20%), cardiovascular disease (19.1%), obesity (13.8%), and dyslipidemia (12.2%). Psychiatric comorbidities included depression (9.6%) and anxiety (3.8%). Infectious conditions occurred at higher\u2010than\u2010expected frequencies, including hepatitis B\/C (3.8%), latent tuberculosis (3.6%), and human immunodeficiency virus (HIV) (2.7%). Care delivery was organized within a structured safety\u2010net model that incorporated standardized screening protocols, referral pathways, and multidisciplinary coordination to support biological access for uninsured patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This 20\u2010year descriptive cohort characterizes comorbidity burden and biologic access within an indigent psoriasis population. This study does not assess clinical outcomes or treatment effectiveness. These findings describe a care delivery framework that may inform future health system and health equity\u2010focused initiatives.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijd.70306","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T15:20:16Z","timestamp":1769700016000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comorbidity Burden and Biologic Access in an Uninsured Psoriasis Population: A 20\u2010Year Descriptive Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5173-0698","authenticated-orcid":false,"given":"Simonetta I.","family":"Gaumond","sequence":"first","affiliation":[{"name":"Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine  Miami Florida USA"},{"name":"Department of Biochemistry and Molecular Biology University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sammya","family":"Mufarrej","sequence":"additional","affiliation":[{"name":"Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna M.","family":"Angioli","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Campus Biom\u00e9dico di Roma  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rama","family":"Abdin","sequence":"additional","affiliation":[{"name":"Charles E. Schmidt College of Medicine Florida Atlantic University  Boca Raton Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Billero","sequence":"additional","affiliation":[{"name":"Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Rongioletti","sequence":"additional","affiliation":[{"name":"Unit of Clinic Dermatology Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Levy","sequence":"additional","affiliation":[{"name":"Schiff Center for Liver Diseases University of Miami Miller School of Medicine  Miami Florida USA"},{"name":"Department of Medicine, Division of Digestive Health and Liver Diseases University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"De Marchena","sequence":"additional","affiliation":[{"name":"Department of Cardiology University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Romanelli","sequence":"additional","affiliation":[{"name":"Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2004.04.014"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2012.339"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(14)61909\u20107"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2021.2007"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.4006"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmed.2021\u20100257"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2014.09.009"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.12788\/j.sder.0098"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2014.08.002"},{"key":"e_1_2_9_11_1","unstructured":"Jackson Health System \u201cJackson Health System's Financial Assistance [Internet]. 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FDA \u201d(2018) https:\/\/www.fda.gov\/drugs\/postmarket\u2010drug\u2010safety\u2010information\u2010patients\u2010and\u2010providers\/fda\u2010statement\u2010voluntary\u2010withdrawal\u2010raptiva\u2010us\u2010market."},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2024.1279525"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen\u20102019\u2010001117"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12045"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.5114\/ada.2020.96155"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i44.7867"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40257\u2010024\u201000845\u20104"},{"key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"37","DOI":"10.15570\/actaapa.2024.8","article-title":"Treatment of Plaque\u2010Psoriasis in HIV\u2010Positive Patients","volume":"33","author":"Jugovac V.","year":"2024","journal-title":"Acta Dermatovenerologica Alpina, Pannonica et Adriatica"},{"key":"e_1_2_9_20_1","doi-asserted-by":"crossref","DOI":"10.5070\/D32411041999","article-title":"Current Biological Therapies for Use in HIV\u2010Positive Patients With Psoriasis: Case Report of Gesulkumab Used and Review","volume":"24","author":"Bartos G.","year":"2018","journal-title":"Dermatology Online Journal"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555\u20102698"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/09546634.2018.1535690"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2015.11.043"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.19177"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1505557"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000286131"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2410.180716"},{"issue":"38","key":"e_1_2_9_28_1","first-page":"42","article-title":"Psoriasis Treatment in HIV\u2010Positive Patients: A Systematic Review of Systemic Immunosuppressive Therapies","volume":"101","author":"Nakamura M.","year":"2018","journal-title":"Cutis"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.70306","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ijd.70306","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.70306","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T15:20:18Z","timestamp":1769700018000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijd.70306"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,29]]},"references-count":27,"alternative-id":["10.1111\/ijd.70306"],"URL":"https:\/\/doi.org\/10.1111\/ijd.70306","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,29]]},"assertion":[{"value":"2025-09-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ijd.70306"}}