Psoriasis is a chronic inflammatory skin disease affecting 2% to 3% of individuals worldwide. However, the majority of clinical data are in white patients, with limited data in patients of color. We present 3 cases of psoriasis representative of patients presenting to an urban and racially diverse hospital-based dermatology clinic in Toronto, Ontario, Canada, to illustrate the differences in psoriasis in patients of color compared to white patients. We review the differences in the morphology, presentation, treatment, and psychosocial impact of psoriasis in this population. We also discuss the importance of early diagnosis, treatment considerations, and education in dermatology training programs regarding psoriasis in patients of color. Cutis. 2020;106(suppl 2):7-10. • Advocating further education on these differences in residency training and continuing medical education programs may help physicians make earlier diagnoses and personalize physician-patient conversations.
69-year-old man with long-standing type 2 diabetes presented with a 2-year history of developing brown lesions on his abdomen and right thigh. He had received insulin injections subcutaneously at these sites for the past 15 years. Individual lesions started small, enlarged progressively and finally coalesced. They were largely asymptomatic. He was otherwise well. Physical examination showed brown, velvety verrucous plaques on the patient's lower abdomen (Figure 1A) and right thigh. We also noted brown verrucous plaques on his knuckles, axillae and groin, but to a lesser degree. Screening for malignant tumour was negative. Glycosylated hemoglobin was 8.8%
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