Although psoriasis is one of the most common dermatological diseases, comprehensive global data on its prevalence among adults remain limited. Most studies (1–3) have been region-specific, using varied methodologies that hinder comparability. To address this gap, our objective was to expand the global understanding of psoriasis by assessing its prevalence, demographics, healthcare pathway trends, and impact on quality of life in a large-scale international study.
This research was part of “Project ALL”. The methodology used was described in earlier publications (4–6). The study, conducted by a polling company between January and April 2023, targeted individuals aged 16 years or older in 20 countries across 5 continents (Fig. 1). The population of these countries represents over 50% of the global population: The survey involved individuals ≥ 16 years old in 20 countries representing > 50% of the world’s population: United States, Canada, France, Germany, Denmark, Portugal, Poland, Italy, Spain, Israel, Arab Emirates, Mexico, Brazil, Kenya, South Africa, India, South Korea, China, and Australia. Proportional quota sampling was employed, based on age, sex, environment (urban, town, rural), and income, to ensure the national representativeness of the sample. Participants were contacted via email, without revealing the survey topic, to avoid self-selection bias. Those who agreed completed a structured digital questionnaire that gathered sociodemographic data, Fitzpatrick classification, and confirmed whether they had been diagnosed with psoriasis by a physician in the last 12 months (either new onset or recurrence). We also collected information on patients’ quality of life regarding psoriasis.
Fig. 1.
20 countries spread over the 5 continents.
Results are represented in Tables I and II. The results showed a global prevalence of psoriasis of 4.4%. In Europe, the prevalence was 4.6%. Asia had a higher prevalence of 5.7% (p < 0.001), while in Latin America it was 3.1% (p < 0.001). Conversely, the prevalence of psoriasis was lower in Africa and North America at 1.7% (p < 0.001) and 3.7% (p < 0.002), respectively. Australia and the Middle East had similar prevalences at 4.6% (p = 0.97) and 4.9% (p = 0.64). The prevalence was 4.8% in urban areas, 3.8% in semi-urban areas, and 4.3% in rural areas (p < 0.001). Fair-skinned individuals had a 4.5% prevalence vs 4% for those who were dark-skinned.
Table I.
Prevalence, visited healthcare professional, and impact on quality of life according to geographic regions
| North America | East Asia | Latin America | Europe | Australia | Africa | Middle East | Total worldwide | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Total sample | 7,500 | 10,500 | 6,501 | 20,501 | 2,000 | 1,800 | 1,750 | 50,552 | ||||||||
| Psoriasis prevalence | 3.7% | 5.7% | 3.1% | 4.6% | 4.6% | 1.7% | 4.9% | 4.4% | ||||||||
| Psoriasis prevalence male* | 4.1% | 5.9% | 3.1% | 4.8% | 4.3% | 2.4% | 4.5% | 4.6% | ||||||||
| Psoriasis prevalence female* | 3.4% | 5.5% | 3.2% | 4.4% | 4.9% | 1.0% | 5.3% | 4.2% | ||||||||
| Visited HCP, n (%) | 75 | 56.8% | 110 | 62.5% | 60 | 77.9% | 384 | 72.3% | 26 | 61.9% | 5 | 55.6% | 17 | 70.8% | 677 | 68.3% |
| Doctor | 67 | 50.8% | 90 | 51.1% | 54 | 70.1% | 333 | 62.7% | 21 | 50.0% | 4 | 44.4% | 15 | 62.5% | 584 | 58.9% |
| Pharmacist | 8 | 6.1% | 28 | 15.9% | 9 | 11.7% | 63 | 11.9% | 5 | 11.9% | 3 | 33.3% | 3 | 12.5% | 119 | 12.0% |
| Nurse | 5 | 3.8% | 4 | 2.3% | 1 | 1.3% | 13 | 2.4% | 1 | 2.4% | 1 | 11.1% | 1 | 4.2% | 26 | 2.6% |
| No consultation | 57 | 43.2% | 66 | 37.5% | 17 | 22.1% | 147 | 27.7% | 16 | 38.1% | 4 | 44.4% | 7 | 29.2% | 314 | 31.7% |
| If visited HCP is a doctor: n (%) | 67 | 50.8% | 90 | 51.1% | 54 | 70.1% | 333 | 62.7% | 21 | 50.0% | 4 | 44.4% | 15 | 62.5% | 584 | 58.9% |
| Dermatologist | 39 | 58.2% | 67 | 74.4% | 37 | 68.5% | 238 | 71.5% | 3 | 14.3% | 2 | 50.0% | 15 | 100.0% | 401 | 68.7% |
| General physician | 30 | 44.8% | 13 | 14.4% | 12 | 22.2% | 125 | 37.5% | 18 | 85.7% | 2 | 50.0% | 0 | 0.0% | 200 | 34.2% |
Total prevalence is weighted according to the countries’ population. North America: United States, Canada. Europe: France, Germany, Denmark, Portugal, Poland, Italy, Spain. Middle East: Israel, Arab Emirates. Latin America: Mexico, Brazil. Africa: Kenya, South Africa. East Asia: India, South Korea, China.
Table II.
Impact of psoriasis on quality of life and stigmatization according to gender and age
| Personal life embarrassment degree (responded to these questions) | Global n = 991 |
Men n = 541 |
Women n = 450 |
p-value | 16-34 n = 226 |
35–54 n = 272 |
> = 55 n = 493 |
p-value |
|---|---|---|---|---|---|---|---|---|
| Very embarrassing | 120 (12.12%) | 58 (10.72%) | 62 (13.78%) | 0.431 | 39 (17.26%) | 37 (13.6%) | 44 (8.92%) | < 0.001 |
| Quite embarrassing | 321 (32.42%) | 173 (31.98%) | 148 (32.89%) | 89 (39.38%) | 103 (37.87%) | 129 (26.17%) | ||
| Not very embarrassing | 365 (36.87%) | 204 (37.71%) | 161 (35.78%) | 60 (26.55%) | 88 (32.35%) | 217 (44.02%) | ||
| Not embarrassing at all | 185 (18.59%) | 106 (19.59%) | 79 (17.56%) | 38 (16.81%) | 44 (16.18%) | 103 (20.89%) | ||
|
| ||||||||
| Professional life embarrassment degree (responded to these questions) | Global n = 950 |
Men n = 523 |
WoMen n = 427 |
p-value | 16-34 n = 219 |
35-54 n = 269 |
> = 55 n = 462 |
p-value |
|
| ||||||||
| Very embarrassing | 73 (7.69%) | 30 (5.74%) | 43 (10.07%) | 0.085 | 21 (9.59%) | 24 (8.92%) | 28 (6.06%) | < 0.001 |
| Quite embarrassing | 272 (28.66%) | 154 (29.45%) | 118 (27.63%) | 87 (39.73%) | 90 (33.46%) | 95 (20.56%) | ||
| Not very embarrassing | 347 (36.56%) | 199 (38.05%) | 148 (34.66%) | 61 (27.85%) | 107 (39.78%) | 179 (38.74%) | ||
| Not embarrassing at all | 253 (26.55%) | 136 (26.0%) | 117 (27.4%) | 48 (21.92%) | 48 (17.84%) | 157 (33.98%) | ||
|
| ||||||||
| Specific impact (responded to these questions) | Global n = 991 |
Men n = 541 |
WoMen n = 450 |
p-value | 16-34 n = 226 |
35-54 n = 272 |
> = 55 n = 493 |
p-value |
|
| ||||||||
| I took time off work or study | 179 (18.08%) | 108 (19.96%) | 71 (15.78%) | 0.105 | 61 (26.99%) | 62 (22.79%) | 56 (11.36%) | < 0.001 |
| I feel shy about buying a treatment product | 220 (22.22%) | 119 (22.0%) | 101 (22.44%) | 0.926 | 76 (33.63%) | 71 (26.1%) | 73 (14.81%) | < 0.001 |
| I give up on family or professional events | 201 (20.3%) | 116 (21.44%) | 85 (18.89%) | 0.36 | 79 (34.96%) | 63 (23.16%) | 59 (11.97%) | < 0.001 |
| I experienced difficulties in relations | 253 (25.56%) | 143 (26.43%) | 110 (24.44%) | 0.521 | 74 (32.74%) | 90 (33.09%) | 89 (18.05%) | < 0.001 |
| I feel my sex life has been affected | 252 (25.45%) | 148 (27.36%) | 104 (23.11%) | 0.146 | 74 (32.74%) | 82 (30.15%) | 96 (19.47%) | < 0.001 |
| I give up on vacations or leisure activities | 195 (19.7%) | 110 (20.33%) | 85 (18.89%) | 0.625 | 62 (27.43%) | 67 (24.63%) | 66 (13.39%) | < 0.001 |
| I lack time for self-care | 304 (30.71%) | 149 (27.54%) | 155 (34.44%) | 0.023 | 70 (30.97%) | 108 (39.71%) | 126 (25.56%) | < 0.001 |
| I take this into account when buying clothes | 301 (30.4%) | 153 (28.28%) | 148 (32.89%) | 0.133 | 75 (33.19%) | 104 (38.24%) | 122 (24.75%) | < 0.001 |
| I gave up beauty treatments (hairdressing) | 229 (23.13%) | 103 (19.04%) | 126 (28.0%) | 0.001 | 69 (30.53%) | 80 (29.41%) | 80 (16.23%) | < 0.001 |
| I tend to check my appearance every time I pass a mirror | 418 (42.22%) | 207 (38.26%) | 211 (46.89%) | 0.008 | 114 (50.44%) | 130 (47.79%) | 174 (35.29%) | < 0.001 |
| I feel that people look at me with disgust | 193 (19.49%) | 110 (20.33%) | 83 (18.44%) | 0.505 | 68 (30.09%) | 64 (23.53%) | 61 (12.37%) | < 0.001 |
| I feel people avoid approaching me | 158 (15.96%) | 94 (17.38%) | 64 (14.22%) | 0.207 | 51 (22.57%) | 60 (22.06%) | 47 (9.53%) | < 0.001 |
| My skin condition prevented me from taking selfies | 213 (21.52%) | 110 (20.33%) | 103 (22.89%) | 0.69 | 74 (32.74%) | 72 (26.47%) | 67 (13.59%) | < 0.001 |
NA: non-applicable.
Most studies on the prevalence of psoriasis have been conducted in high-income countries. Unlike prior research indicating the highest prevalence in Australia, our study, applying the same methodology across all 20 countries, surprisingly revealed that prevalence is highest in East Asia., with no significant difference in prevalence between Australia, Europe, and the Middle East. This finding contrasts with previous studies reporting lower prevalence rates in Asia (1, 2). These discrepancies are mostly due to the diverse methodologies employed, which prevents accurate comparison of prevalence between different regions in previous studies. Some studies indicated a higher incidence in women compared with men, while other studies showed opposing findings. Our study shows different sex patterns across regions with a global higher prevalence in men. North America was the region in the world where individuals least visited a healthcare professional for their psoriasis. Moreover, among those who visited a doctor, the proportion visiting a dermatologist was also lowest in Australia followed by North America compared with other regions in the world, which might be attributed to higher healthcare costs.
The data show no significant differences between sexes in most aspects of psoriasis-related embarrassment and specific impacts, except for beauty treatments, where women reported significantly more impact. Age differences were more pronounced, with younger patients reporting higher embarrassment levels in personal and professional life, as well as greater avoidance behaviours, including skipping social events, vacations, and feeling looked at with disgust.
In conclusion, previous studies on psoriasis prevalence have produced inconsistent estimates. Our study offers a robust global perspective on adult psoriasis prevalence by utilizing a consistent methodology across 20 countries, addressing regional disparities often overlooked in previous research. Unlike other studies, we relied exclusively on physician-confirmed diagnoses, providing a higher standard of data reliability. This research not only confirms the rising global prevalence of psoriasis but also challenges prevailing assumptions concerning geographic and gender distribution, setting a new benchmark for future global studies of psoriasis prevalence according to types and severity.
ACKNOWLEDGEMENTS
The authors acknowledge the technical support of Helene Chevalier (HC Conseil, Paris).
Ethics statement
ID-RCB 2022-A01859-34: the individuals approached confirmed their agreement to answer the questionnaire and were informed that they could stop the questionnaire whenever they wanted without having to give any explanation.
Funding
This project was funded by Patient Centricity of Pierre Fabre.
Data availability statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Conflict of interest
CB and MSA are employees of Pierre Fabre, France. BH, CT, and CS have no conflicts of interest to declare.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.