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Original Investigation
June 30, 2021

Psoriasis Prevalence in Adults in the United States

Author Affiliations
  • 1Department of Dermatology, University of Southern California Keck School of Medicine, Los Angeles
  • 2Modernizing Medicine, Boca Raton, Florida
  • 3National Psoriasis Foundation, Portland, Oregon
  • 4Dermatology Centre, Salford Royal Hospital, National Institute for Health Research, Manchester Biomedical Research Centre, University of Manchester, Manchester, United Kingdom
JAMA Dermatol. 2021;157(8):940-946. doi:10.1001/jamadermatol.2021.2007
Key Points

Question  What is the prevalence of psoriasis in adults in the US, and how has prevalence changed since 2003?

Findings  In this nationally representative cross-sectional study including 12 625 participants, the prevalence of psoriasis in adults in the US was 3.0%, indicating that more than 7.5 million adults 20 years or older have psoriasis. Psoriasis was most common in non-Hispanic White individuals, and the prevalence of psoriasis has not significantly changed since 2003 in the US.

Meaning  Study results suggest that psoriasis remains one of the most common immune-mediated diseases affecting US adults; prevalence data are foundational to determining the burden of disease.

Abstract

Importance  Determining psoriasis prevalence is fundamental to understanding the burden of the disease, the populations most affected, and health policies to address the disease.

Objective  (1) To determine the prevalence of psoriasis among adults in the US and (2) to evaluate the change in psoriasis prevalence over time since the 2003-2004 National Health and Nutrition Examination Survey (NHANES) data.

Design, Setting, and Participants  This population-based cross-sectional study used 2011-2014 NHANES data (collected from January 1, 2011, to December 31, 2014) with sampling from a general, noninstitutionalized US civilian population. Participants were 20 years or older and were selected via a multistage probability sampling design to ensure that surveys were nationally representative. Eligible participants had an in-person interview followed by a medical examination by medical professionals. Data were analyzed from July 15, 2019, to December 23, 2020.

Exposures  None.

Main Outcomes and Measures  Psoriasis prevalence in the US, as measured by the percentage of people in the representative sample with psoriasis, and trend statistics comparing prevalence estimates from the 2003-2004, 2009-2010, and 2011-2014 NHANES cycles.

Results  A total of 12 625 participants (mean [SD] age, 32.8 [24.1] years; 6492 women [51.4%]; and 4828 non-Hispanic White participants [38.2%]) answered the question of whether they were given the diagnosis of psoriasis by a physician or another health care professional. Psoriasis prevalence among US adults 20 years or older was 3.0% (95% CI, 2.6%-3.4%). Based on the 2020 US census data, this outcome translates to an estimated 7.55 million US adults with psoriasis. Psoriasis prevalence was similar between women and men, with 3.2% (95% CI, 2.6%-3.8%) in women and 2.8% (95% CI, 2.4%-3.3%) in men. Psoriasis prevalence was highest in White individuals at 3.6% (95% CI, 2.9%-4.2%), followed by other racial/ethnic groups (non-Hispanic, including multiracial) at 3.1% (95% CI, 1.2%-5.1%), Asian individuals at 2.5% (95% CI, 1.6%-3.3%), Hispanic individuals (including Mexican American and other Hispanic individuals) at 1.9% (95% CI, 1.3%-2.5%), and Black individuals at 1.5% (95% CI, 1.0%-2.0%). Psoriasis prevalence was not different based on patients’ marital status, education, income, or medical insurance status. The prevalence of psoriasis among US adults did not differ significantly since 2003.

Conclusions and Relevance  The results of this cross-sectional study suggest that psoriasis remains a common, immune-mediated disease that affects 3.0% of the US adult population, or more than 7.5 million adults. Its prevalence has not differed since evaluation in 2003. These prevalence data are foundational to determining the burden of psoriasis and for supporting efforts in research, education, and health policy.

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