Julien C. Bourgeois MDa, Jacob Beer MDb, Soo Hyun Choi MDc, Carole Bitar MDc
aCreighton University Health Sciences, Phoenix, AZ
bUniversity of Miami, Department of Dermatology, Miami, FL
cTulane University, New Orleans, LA
Abstract
Across the board, common dermatologic conditions disproportionately affect patients of color. While the causes of these disparities have been tied to the environment, societal structure, access to care, health literacy, and biological factors, there is limited understanding of the extent and impact of dermatologic healthcare inequity. This study provides a resource on the epidemiology of common dermatologic diseases across racial lines and points out current lapses in scientific understanding of the disparate impact of certain conditions. This study will review epidemiological data on atopic dermatitis (AD), adult acne, pseudofolliculitis, dermatophytosis, psoriasis, vitiligo, melasma, hyperpigmentation, keloids, hidradenitis suppurativa (HS), basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma.
Traditionally, the highly visual field of dermatology has relied on textbooks and images of diverse pathologies in lighter skin. In recent years, this lapse in education has been highlighted in numerous commentaries and publications.1,2 Textbooks have begun to address the need to present dermatologic pathologies in skin of color (SOC).3 These changes are key to addressing disparities in dermatologic outcomes, with prior research showing delayed diagnosis and worse outcomes in patients with Fitzpatrick skin types (FPS) IV-VI.4-7
Certain conditions such as atopic dermatitis (AD), acne, tinea, and psoriasis have varied or distinct appearances in SOC compared to their presentation in white skin.8-11 Also, conditions such as vitiligo, melasma, and post-inflammatory hyperpigmentation may be more noticeable in SOC due to
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