Psoriasis in the Brazilian Public Health System: A Nationwide Analysis of Healthcare Utilization and Inequalities, 2014-2024.

Background: Psoriasis (PsO) is a chronic inflammatory disease associated with substantial healthcare needs. In Brazil, nationwide evidence based on administrative data remains limited, particularly regarding healthcare utilization and inequalities in the public health system. Objectives: The objective was to analyze nationwide patterns of healthcare utilization and to explore potential regional and sociodemographic inequalities in access to care among patients with PsO within the Brazilian Unified Health System (SUS) from 2014 to 2024. Methods: This retrospective observational study used nationwide administrative data from DATASUS, the health information system of the Brazilian Unified Health System. Patients with at least one healthcare encounter coded with ICD-10 L40 between 2014 and 2024 were included. Sociodemographic characteristics, clinical subtypes, geographic distribution, and temporal trends in healthcare utilization were analyzed. Registered healthcare prevalence for 2024 was estimated. Results: A total of 54,950 unique patients were identified. Psoriasis vulgaris was the most frequent subtype (38.8%). Women accounted for 57.7% of cases, and the most represented age group was 46-60 years. Most patients were classified as White (52.7%) or mixed race (35.1%). Higher case concentrations were observed in the Southeast and Northeast, with higher healthcare prevalence in the Southeast and South. Healthcare encounters declined in 2020, followed by recovery through 2024, with regional variation in registered healthcare prevalence, highlighting persistent inequalities. Conclusions: This nationwide real-world study highlights patterns of healthcare utilization and regional inequalities in psoriasis care within Brazil's public health system. Administrative data provide valuable insights to support health policy and resource allocation in universal healthcare settings.