Sociodemographic Factors Associated With Diagnosed Psoriasis in U.S. Adults: Patterns and Trends From NHANES and NHIS, 2003-2024.

Objective: To quantify sociodemographic differences in the prevalence of diagnosed psoriasis and to evaluate temporal trends in its epidemiologic distribution.

Methods: Data from the 2003-2006 and 2009-2014 National Health and Nutrition Examination Survey and the 2023-2024 National Health Interview Survey were analyzed. Meta-analysis was performed to determine whether age, sex, race/ethnicity, interview language, marital status, BMI, education, income, and health insurance are independently associated with odds of diagnosed psoriasis. Estimates from each survey period were tested for linear trends over time.

Results: The total sample included 53,225 participants. Spanish speakers, compared to English speakers, demonstrated markedly lower prevalence of diagnosed psoriasis (pooled aOR = 0.40, 95% CI = 0.25-0.65), even after adjusting for other sociodemographic factors including race/ethnicity. Other factors independently associated with psoriasis were older age, non-Hispanic White race/ethnicity, and higher BMI (all P < 0.001). No temporal trends in prevalence were found in any sociodemographic subgroup.

Conclusion: This analysis of national data covering an almost 25-year period indicates psoriasis has consistently been one of the most common inflammatory skin diseases with a stable sociodemographic distribution over this time. High rates of potentially undiagnosed psoriasis among vulnerable sociodemographic subgroups may be a persistent issue spanning over 2 decades. Patients with limited English proficiency may have difficulty interacting with the healthcare system, leading to undiagnosed psoriasis. Difficulty of diagnosis in patients with skin of color may also contribute. Given that psoriasis is a condition with systemic effects, including impacts on cardiovascular risk, accurate and timely diagnosis is essential to ensure appropriate clinical management.