Socioeconomic Inequalities and Severity of Plaque Psoriasis at a First Consultation in Dermatology Centers
Emmanuel Mahé, Alain Beauchet, Ziad Reguiai, François Maccari, Mireille Ruer-Mulard, Guillaume Chaby, Thierry Le Guyadec, Eric Estève, Catherine Goujon-Henry, Josiane Parier, Hugues Barthelemy, Edouard Bégon , Henri-Georges Steiner, Nathalie Bénéton, Thierry Boyé, Laure Mery-Bossard, Jean-Luc Schmutz, Pierre Bravard, Michèle-Léa Sigal and the GEM RESOPSO
Psoriasis has major physical, psychological, and social impacts: its management should not be restricted by individual financial considerations in Western countries as these have well-structured health systems and social/insurance coverage. We investigated if the socioeconomic characteristics of patients were associated with severity of psoriasis and access to healthcare. In a cross-sectional study, we included 903 patients with psoriasis that were consulting for the first time. We showed that low educational level was associated with severity of disease in multivariate analyses. Moreover, patients of lower class and lower educational level, with severe psoriasis, had seen fewer physicians and had less frequently received a systemic treatment. Thus, physicians need to be vigilante of patients with a low socioeconomic status. Both low socioeconomic status and less access to dermatologists are associated with clinical severity of psoriasis at a first consultation.