Why Trust and Timing Shape Psoriasis Outcomes in Skin of Color

Building trust with patients who have diverse skin tones, and addressing psoriasis as a condition that reaches beyond the skin, were the focus of this segment of the most recent episode of Skin of Color Savvy podcast featuring Jennifer Soung, MD, and Mona Shahriari, MD.

Soung is known for her work as a board-certified dermatologist and as the director of clinical research at Southern California Dermatology in Santa Ana, California. Shahriari is an associate clinical professor of dermatology at Yale University and the host of HCPLive’s The Medical Sisterhood podcast. Both spoke in this new episode of Skin of Colorsavvy, a podcast hosted by Skin of Color Society (SOCS) leaders.

Why Does Early Psoriasis Diagnosis Matter?

Shahriari opened by asking how clinicians can get patients into the office sooner for an accurate diagnosis, noting that delayed diagnosis in patients with diverse skin tones can leave disease harder to treat and less likely to reach remission. Soung said the current health care system is largely built around catastrophic care, responding once a patient has extensive body surface area involvement or can no longer work, rather than intervening early. She noted that early treatment improves outcomes across skin tones, but patients with diverse skin tones often face additional barriers to access and may distrust the health care system.

Soung said addressing that gap starts with meeting patients in their communities and building trust through cultural curiosity, including simple open-ended questions about a patient's skincare routines or cultural background. She described using telehealth in her own practice to reduce travel time and time away from work for patients, calling personalized, culturally sensitive care the future of the specialty.

How Can Clinicians Build Trust With Diverse Patient Populations?

Shahriari said patients increasingly assume a shared background signals expertise in treating their skin, recalling a patient who told her she must understand his skin because she looked like him. She said that assumption can be leveraged productively, but clinicians without shared backgrounds can build similar trust through curiosity and cultural sensitivity rather than assumed cultural knowledge. Both agreed that as demographics shift, patients with diverse skin tones will represent a growing share of dermatology practices, making early, trust-based diagnosis increasingly important to patient outcomes.

What Psychosocial Burdens Should Clinicians Watch For?

Shahriari asked how Soung addresses the psychosocial impact of psoriasis and connects patients with mental health support when needed. Soung said she now opens visits by asking patients how psoriasis has affected them, a question that can prompt strong emotional responses, including embarrassment and social stigma tied to visible plaques. She described a patient in his mid-30s who avoided removing his shirt at the beach for years until a stranger, noticing his discomfort, urged him to see a dermatologist.

Soung said moments like that reflect why many clinicians entered medicine, the ability to help patients feel normal again through connection and collaboration. Shahriari said she sometimes splits diagnosis and broader psoriasis-related counseling across separate visits so patients are not overwhelmed by comorbidity discussions on day one, an approach her schedule as a practice owner allows her the flexibility to offer.

How Should Treatment Plans Account for Patient Routines?

Soung noted that patients are often reluctant to admit dissatisfaction with an otherwise effective treatment unless directly asked, and that she has learned the most by asking patients at follow-up visits whether they are happy with their treatment. Shahriari raised the example of scalp psoriasis treatments that require daily shampoo use, noting that regimen is often unrealistic for patients with afro-textured or tightly coiled hair, and asked how treatment routes can better match a patient's daily routine and long-term adherence. Both agreed that efficacy alone does not determine whether a patient continues a treatment, and that the confidence and trust built during a visit often shape treatment success as much as the medication itself.

Editor's note: This summary was edited with the help of AI tools.

References

1. Soung J, Shahriari M. Skin of Color Savvy: Advice on Diagnosing Psoriasis in Diverse Skin Tones. HCPLive. August 26, 2026. Accessed September 22, 2026. https://www.hcplive.com/view/skin-color-savvy-advice-diagnosing-psoriasis-diverse-skin-tones.