P106 A national survey exploring experiences of eczema, acne and psoriasis across different ethnic groups in the UK

Abstract

Inflammatory dermatoses have a varied prevalence and appearance in diverse skin tones. The under-representation of people with skin of colour in medical education and clinical trials is widely acknowledged. However, there is limited research on experiences from a patient perspective. Our aim was to explore and compare experiences of eczema, acne and psoriasis in adults in the UK across varying skin tones and ethnicities. Adults in the UK with acne, eczema or psoriasis were recruited for a cross-sectional survey. Online recruitment methods were used with assistance of charities, research organizations and social media channels. The survey explored experiences of diagnosis and management and included dichotomous, ranking style and open-ended questions. Stata was used for statistical analysis, using χ2-tests and Mann–Whitney U-tests for categorical and continuous data, respectively. The survey generated responses from 135 patients, 54% (73) of whom had skin of colour. Their mean age was 34.5 years, 73% (99) were female and 59% (80) had eczema. Compared with White participants, respondents with skin of colour had greater odds of diagnostic delay [odds ratio (OR) 5.4, 95% confidence interval (CI) 2.2–13.1, P < 0.001] and reported lower scores on a 10-point scale regarding their clinicians’ confidence diagnosing, understanding and managing their condition (P < 0.001). Respondents with skin of colour were more likely to report alternative medicine use (OR 2.8, 95% CI 1.4–5.6, P = 0.005), difficulty sourcing online information (OR 31.6, 95% CI 10.1–98.3, P < 0.001) and secondary dyspigmentation (OR 8.5, 95% CI 3.3–21.8, P < 0.001). Respondents with skin of colour had a higher mean Dermatology Life Quality Index score, indicating a greater effect on their quality of life (mean difference 2.8 points, P = 0.04). This study is the first to directly compare experiences of living with an inflammatory dermatosis across ethnic groups in the UK. Our results suggest a disproportionate disease burden on individuals with skin of colour, with ongoing barriers to effective diagnosis and management.