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PURPOSEDermatologic health disparities have been well documented in patients of color. Non‐white patients have higher rates of morbidity and mortality associated with dermatologic disease than their white counterparts. A lack of diversity in dermatologic medical education is among the factors that may contribute to this disparity. Traditionally, dermatologic education in in medical school and residency has been heavily biased toward white skin, if included in the curriculum at all. This bias, along with clinicians' unawareness of this educational lapse may lead to poor confidence in evaluating patients of color, lower recognition rates of dermatologic pathology in skin of color, and a lack of awareness that one should be examine the skin of patients of color, thus contributing to poorer outcomes in non‐white patients.METHODSIn order to address this lack of exposure to skin of color, we have developed a self‐efficacy questionnaire and an educational module on skin of color to allow physicians and medical students to reflect on their own diagnostic capabilities and be exposed to common dermatologic pathology on skin of color. The questionnaire gives physicians the opportunity to grade their ability to recognize dermatologic pathology across diverse skin tones. The module was presented to fourteen medical students from LSU‐SOM New Orleans. Their pre‐intervention self‐assessment of their competency in diagnosing dermatologic pathology in skin of color was compared to their post‐intervention competency with a paired t‐test.DISCUSSIONThe data suggests that increased exposure to pathology on brown (p=.0001) and black skin (p=.0011) (as defined by the Fitzpatrick Scale), results in greater confidence in diagnosing pathology in this population. In particular, participants' confidence in ability to diagnose eczematous lesions (p=.006), psoriatic lesions (p=.0032), melanoma (p=.0261) and basal cell carcinoma (p=.0028) was significantly increased after the educational module. The data presented here represents the preliminary steps of an ongoing study. More participants are needed to fully assess the effect of the intervention. Additionally, future studies will include a quiz as an objective measure of diagnostic capabilityThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

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Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy affecting both motor and sensory peripheral nerves. Typically presenting after a gastrointestinal or a respiratory tract infection, it manifests as ascending paralysis with concomitant areflexia in patients. Cytoalbuminologic dissociation is a supportive finding on cerebrospinal fluid (CSF) analysis. Due to variability in presentation, misdiagnosis and delay in treatment can occur, and consequently, GBS can become life threatening due to respiratory failure. We report ascending paralysis in a 36-year-old woman with known history of bipolar disorder who recently recovered from aspiration pneumonia following a drug overdose event. Given her psychiatric history, she was initially misdiagnosed as conversion disorder. Intravenous immunoglobulin (IVIG) therapy was initiated at our hospital due to strong suspicion of GBS, based on history and physical examination findings consistent with flaccid quadriparesis and impending respiratory failure. CSF analysis and radiological findings subsequently supported our clinical suspicion and clinical findings. Concurrent IVIG therapy, pain management, aggressive physical and respiratory therapy, and monitoring resulted in symptom improvement. One must have a high index of suspicion for GBS when presented with acute inflammatory demyelinating neuropathies in patients who present with ascending paralysis. Early initiation of therapy is key and can prevent life-threatening complications.

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