Publication date: Jan 29, 2026
Psoriasis is a chronic immune-mediated disease associated with multiple systemic comorbidities. Biologic therapies have transformed the management of moderate-to-severe psoriasis; however, their high cost remains a major barrier for uninsured and socioeconomically disadvantaged individuals. The Psoriasis Biologics Center for Indigent Patients at Jackson Memorial Hospital provides a structured dermatology access model for underserved populations. We conducted a descriptive retrospective cohort study of patients with moderate-to-severe psoriasis receiving biologic therapy through a dedicated safety-net access program between 2005 and 2025. Patient demographics, comorbidities, and management strategies were obtained from electronic medical records and standardized intake questionnaires. Only descriptive statistics were performed; standardized disease severity and quality-of-life measures such as the Psoriasis Area and Severity Index (PASI) or the Dermatology Life Quality Index (DLQI) were not available. A total of 450 patients (mean age 52. 6 years; 54% female) were included. Nearly half (49. 8%) presented with at least one systemic comorbidity. The most common were psoriatic arthritis (35. 1%), hypertension (31. 3%), diabetes mellitus (20%), cardiovascular disease (19. 1%), obesity (13. 8%), and dyslipidemia (12. 2%). Psychiatric comorbidities included depression (9. 6%) and anxiety (3. 8%). Infectious conditions occurred at higher-than-expected frequencies, including hepatitis B/C (3. 8%), latent tuberculosis (3. 6%), and human immunodeficiency virus (HIV) (2. 7%). Care delivery was organized within a structured safety-net model that incorporated standardized screening protocols, referral pathways, and multidisciplinary coordination to support biological access for uninsured patients. This 20-year descriptive cohort characterizes comorbidity burden and biologic access within an indigent psoriasis population. This study does not assess clinical outcomes or treatment effectiveness. These findings describe a care delivery framework that may inform future health system and health equity-focused initiatives.
| Concepts | Keywords |
|---|---|
| 6years | arthritis |
| Biologics | biologics |
| Diabetes | cardiovascular |
| Psychiatric | comorbidities |
| Socioeconomically | diabetes |
| dyslipidemia | |
| hepatitis | |
| HIV | |
| psoriasis | |
| tuberculosis |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | Psoriasis |
| disease | MESH | included |
| disease | MESH | psoriatic arthritis |
| disease | MESH | hypertension |
| disease | MESH | diabetes mellitus |
| disease | MESH | cardiovascular disease |
| disease | MESH | obesity |
| disease | MESH | dyslipidemia |
| disease | MESH | anxiety |
| disease | MESH | hepatitis B |
| pathway | KEGG | Hepatitis B |
| disease | MESH | latent tuberculosis |
| disease | MESH | arthritis |
| disease | MESH | hepatitis |
| disease | MESH | tuberculosis |
| pathway | KEGG | Tuberculosis |