INTRODUCTION
Dermatology heavily relies on photographs in its literature to depict diseases and demonstrate treatment modalities. Previous studies have established that general medical and dermatology textbooks have limited photographic representation of individuals with skin of color (SOC), even those diseases highly prevalent in these populations.1,2 As the US population continues to grow and diversify, there is an increase in individuals with SOC seeking cosmetic and procedural services.3 We set out to investigate the current trends of SOC representation in the surgical and cosmetic sections of current dermatology textbooks.
The latest editions of three dermatologic textbooks, Dermatology 4th Edition, Andrews’ Diseases of the Skin: Clinical Dermatology 13th Edition, and its corresponding Clinical Atlas, were assessed to find the skin tones represented in each photograph or anatomical schematic, with a particular focus on the surgical and cosmetic sections. The photographs of varying skin tones were assigned a numerical value on a scale of I to VI with the following variables: I as white skin; II as white with yellow tones; III as olive skin tones; IV as light brown; V as dark brown with red undertones; and VI as dark brown/black with blue undertones. The percentage of each skin tone depicted was calculated per diagnostic or procedural category. The images represented among the three dermatology textbooks were 79.9% skin tones I-III and 20.1% skin tones IV-VI. Similar outcomes were found when evaluating the procedural categories. Skin tones I-III represented 97.2% of surgical images and 95.3% of cosmetic images. 100% of anatomical schematics were represented as skin tones
I-III (Figure 1).
The latest editions of three dermatologic textbooks, Dermatology 4th Edition, Andrews’ Diseases of the Skin: Clinical Dermatology 13th Edition, and its corresponding Clinical Atlas, were assessed to find the skin tones represented in each photograph or anatomical schematic, with a particular focus on the surgical and cosmetic sections. The photographs of varying skin tones were assigned a numerical value on a scale of I to VI with the following variables: I as white skin; II as white with yellow tones; III as olive skin tones; IV as light brown; V as dark brown with red undertones; and VI as dark brown/black with blue undertones. The percentage of each skin tone depicted was calculated per diagnostic or procedural category. The images represented among the three dermatology textbooks were 79.9% skin tones I-III and 20.1% skin tones IV-VI. Similar outcomes were found when evaluating the procedural categories. Skin tones I-III represented 97.2% of surgical images and 95.3% of cosmetic images. 100% of anatomical schematics were represented as skin tones
I-III (Figure 1).
