Benjamin Lockshin, MD, FAAD, highlights diversity in clinical trials as an unmet need in approaching the treatment of plaque psoriasis.
Benjamin Lockshin, MD, FAAD: I think for a number of years, and for the past 15 years that I’ve been involved in clinical trials, trial after trial I recognize there’s an unmet need in terms of the diversity of patients. We see that patients are predominantly Caucasian with some Asians and very few Black individuals. I commend the AAD [American Academy of Dermatology] and multiple pharmaceutical companies for looking to integrate mixed patient populations into their studies, looking for new sites. We should talk about how we treat individual patients with skin of color and how that affects our decision-making process. I tend to be a little bit more aggressive because I’m more concerned about dyspigmentation, the shadows of old psoriatic lesions. How do you guys feel about this?
James Q. Del Rosso, DO: I agree with that. I think that’s very bothersome to those people. To have hyperpigmentation in areas, especially invisible areas, very similar to postinflammatory hyperpigmentation with acne. They hate that more than they hate the acne itself because the acne is going to go away. So I do agree with you. We should try to get the patients access to those therapies.
Dawn L. Sammons, DO, FAOCD, FAAD: For a lot of those patients, I think we’ve all seen this, they come back to us and they’re actually clear. But in their mind, it’s either that they have scarring because they don’t really understand, or if they understand, they recognize that this is going to take a while. In a lot of these patients, it can take months for that to fade. So I agree with you. I’m far more aggressive. Again, it’s a conversation with the patient. I talk to the patient about if we’re more aggressive, the goal is to get this clear as quickly as possible and then prevent the patient from having new lesions. That way we can minimize the hyperpigmentation and the dyspigmentation that we can see from the psoriatic lesions, or as we talked about, some of the discoloration we can get just from the steroids.
Benjamin Lockshin, MD, FAAD: I always like to say it’s better to be proactive than reactive.
Transcript edited for clarity