On World Psoriasis Day, advocates Nitika Chopra and Ayesha Patrick discuss feeling dismissed and what dermatologists should know about skin of color care.
World Psoriasis Day on October 29 puts a spotlight on gaps in
Scalp involvement adds another layer of complexity. Asian and Black patients are more likely to present with scalp psoriasis, and daily shampoo-based regimens may prove impractical for patients who wash their hair once a week.² Hair care and styling practices also vary across racial groups, which can amplify the quality-of-life burden of scalp disease.³
These considerations place cultural competency and shared decision-making at the center of psoriasis management. Clinicians who ask about hair routines, family expectations, and treatment concerns are better positioned to build regimens patients can realistically follow. Patients, in turn, often describe searching through several clinicians before finding one who treats the whole person rather than the plaques alone.
Nitika Chopra, founder and CEO of Chronicon and The Chronicon Foundation, has lived with plaque psoriasis since childhood and has built a community for people navigating chronic illness. Ayesha Patrick, a psoriasis patient advocate, turned a dismissive dermatology visit during a severe flare into a platform for helping other women of color feel heard. In the following Q&A interview segment, Chopra and Patrick discuss their paths to advocacy, the moments they first felt understood by a clinician, and what they want dermatologists to know about treating patients with skin of color:
Ayesha Patrick: I’ve been living with psoriasis for nearly my entire life, and I’m in my mid-40s, so that gives you an idea of how long. When I was younger, it was pretty mild and manageable. It wasn’t until much later in life, at the start of the COVID-19 pandemic when I was 40, that I experienced my worst flare. I won’t call it a 360; it was a 180 for me living with the disease because it was completely different. It got to the point where it was really impacting my day-to-day life. Everything going on at that time with the pandemic, the stress, all of it culminated in this flare.
When I was finally able to get into my dermatologist’s office, she was dismissive of what I was dealing with at that moment, and my daughter was with me at that appointment. Because my daughter was with me, that was the catalyst for me to say, “Hey, I should be heard.” I’m her first example. I want her to know that whatever she’s experiencing, she should be heard as well. That is what really launched me into advocacy.
Nitika Chopra: I got psoriasis at a young age as well, and it was really shocking how fast it took over my whole life. It started as one tiny spot on my left arm, and before I knew it, it had spread throughout my entire body, from my scalp to the tip of my foot. It changed the way I saw myself. It also changed the way others saw me. It was such a huge part of my identity for so long, and I think it really rocked my self-confidence for a really long time. I had to go through this process of asking, okay, who am I? Even though I’m living with this condition and I’m struggling in the ways that I’m struggling, how do I overcome this? How do I become more than this?
How do I not let this hold me back? Because I am a strong person and I do have big dreams. It was a really deep process I had to go through for many years. I also realized that there are millions of people out there living with psoriasis. I didn’t know anyone else in my life who had it, and I felt like I was the only person on the planet with psoriasis. After a quick search, I realized that could not be further from the truth. So it made me feel like, if someone else is sitting there feeling all this intensity, all this heaviness, and also feels alone, I don’t want them to have to go through that. That was really the catalyst for me.
Ayesha Patrick: There’s a part of my story I didn’t mention: that provider had prescribed a medication I had to use daily to wash my hair. I said, “Hey, I’m a Black woman. I’m not sure if you’re familiar, but we don’t wash our hair every single day.” At that time, it was part of her really not having the cultural competency. In addition to her being dismissive, that’s when I decided I was going to find another provider. When I eventually did, even though I looked for providers who might be a person of color, I went to a practice owned by a person of color, but I actually see the PA, who is not a person of color. She made it her business to understand, to sit down with me, and to go over how she understands the challenges from working with other women of color. So I ended up in a place where, even though the PA I see is not a person of color, she has a complete understanding, awareness, and desire to support me and other patients differently.
Nitika Chopra: I also felt so dismissed growing up, as Ayesha was saying. I’m first-generation; my parents are from India, and my mom honestly wasn’t very used to the health care system here in the States. It’s very different, and the familial, collectivist way we do things in India is so not the case here. She felt very overwhelmed, and I think she did her best to get me care that would be okay for me, but it never really suited me, to be honest. I had to find somebody I felt a connection with, and that happened in my mid-20s, after I had been to so many different doctors and just didn’t feel understood by them.
I finally found someone who I felt cared about the whole person, not just the symptom, and that was a game changer for me. I felt like I could tell them I was nervous about trying something, or nervous about how things had spread, or that I was having emotions around this really physical experience. That also allowed me to take more ownership of what I was experiencing, so as I go through different treatments or different doctors, I can be more vocal. But similar to Ayesha, it took time. I really had to fight for and find the right person, and it took a lot of trial and error.
Ayesha Patrick: I would hope they would understand that there is definitely not a one-size-fits-all approach. Shared decision-making exists for a purpose: to connect, learn, and grow together. A lot of times, patients feel like because they don’t have those letters behind their name, they don’t have a voice. But you absolutely have a voice. If clinicians and providers can truly get to know their patients and learn about them culturally, that can truly make the difference.
Nitika Chopra: I agree. For me, going back to what I said about my family, it was really important that my parents felt comfortable, and that it was culturally comfortable for us. It’s not something I take lightly. So to have a doctor who is open to that conversation, even if it’s not where they come from or something they have an understanding of, but who is open to asking the questions, getting to know me more, and understanding my perspective, makes a world of difference. You feel a bit more like you’re not completely alone in this journey.
Editor’s note: This transcript was edited for the purposes of grammar and clarity using AI tools. Neither speaker highlighted any relevant financial disclosures of note other than their work with AbbVie.
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