Understanding the Evolving Burden of Psoriasis: Global and Regional Insights, 1990–2021

The Global Burden of Disease study (GBD 1990–2021) — a comparative epidemiologic analysis across 204 countries and territories using standardized case definitions and modeling with 95% uncertainty intervals — reports substantial shifts in psoriasis prevalence and disability-adjusted life years (DALYs) between 1990 and 2021. The rising burden is concentrated in higher-income regions and older age groups, findings with direct implications for age-dependent morbidity planning.

Regionally, age-standardized DALYs increased most in Western Europe and parts of North America, with Germany among the highest, and remained lowest in several sub-Saharan countries such as Somalia, producing a clear north–south gradient. These geographic patterns suggest surveillance and resource-allocation efforts will need to align with areas showing the greatest absolute increases to meet changing service demand.

Age-stratified analyses identify the largest psoriasis burden in adults aged 50–69 and those ≥70; middle-aged men account for notably higher incidence in multiple national comparisons across the 204 territories. Because these older cohorts carry the largest share of DALYs, public-health planning should foreground age-specific service models and capacity for comorbidity management.

A positive correlation between the socio-demographic index (SDI) and reported psoriasis burden was evident. The GBD used SDI-stratified estimates and regression-adjusted comparisons (results reported with 95% uncertainty intervals), finding higher reported prevalence in more developed settings—likely reflecting greater diagnostic capacity, broader healthcare access, and lifestyle-related exposures. These SDI-associated patterns highlight equity and prioritization challenges when distributing prevention and treatment resources.

Key Takeaways:

• GBD 1990–2021 data indicate a rising concentration of psoriasis burden in high-SDI regions and older adults, with important national contrasts.
• Adults aged 50–69 and those ≥70 carry the largest share of DALYs, underscoring age-focused public-health needs.
• SDI correlates positively with reported burden, signaling equity and prioritization challenges for resource allocation.