Ethnic skin centers in the United States: Where are we in 2020?

Tull, Rechelle; Kerby, Eva; Subash, Jacob; McMichael, Amy J.

doi:10.1016/j.jaad.2020.03.054

Cited by 18 publications

(10 citation statements)

References 2 publications

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“…13 Additionally, clinics specialized in the care of patients with lupus also improve patients' satisfaction, trust in health care providers, and health outcomes. 9,10,14 In combination with dedicated didactic teaching, such clinical experiences increase trainees' exposure to less common patient populations and conditions, thereby consolidating their learning and enhancing their training. Independently practicing clinicians likely would appreciate similar opportunities in continuing medical education as more than 90% of survey respondents voiced interest in additional education about lupus-related rashes in P-SOC.…”

Section: Discussionmentioning

confidence: 99%

Health care practitioners’ confidence assessing lupus-related rashes in patients of color

Kannuthurai

Murray

Chen

et al. 2021

Lupus

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Background: Patients with skin of color (P-SOC) are disproportionately burdened by lupus and often have worse disease outcomes than white patients. This is partly because educational materials underrepresent P-SOC, thereby promoting unconscious bias and clinical deficiencies among practitioners. Purpose: We sought to measure providers' confidence in diagnosing the cutaneous manifestations of lupus (i.e., lupus-related rashes) in P-SOC and to assess which factors influenced their confidence. Research Design: We created and distributed a survey that gathered information about participants' personal characteristics, clinical specialty, training, and current practice as well as measuring their confidence assessing lupus-related rashes in various skin tones. Study Sample: Practitioners from the fields of rheumatology, dermatology, and internal medicine in the greater St. Louis area (Missouri, USA) participated in the survey. Analysis: We compared practitioners' mean confidence levels assessing lupus-related rashes in patients with fair skin and P-SOC with a linear mixed effects model and used univariate and multivariate linear regression models to determine if the aforementioned factors correlated with confidence. Results: Participants' mean confidence in diagnosing lupus-related rashes in P-SOC was significantly lower than assessing such findings in patients with fair skin ( p = .009). Several factors correlated with confidence level at a univariate level; however, the multivariate model revealed experience as the only factor significantly associated with confidence ( p = .001). Conclusions: Providers report significantly less confidence assessing lupus-related rashes in P-SOC than in patients with fair skin. Our analysis demonstrates that experience positively correlates with confidence and suggests that interventions which enhance practitioners' exposure to and experience with these rashes in P-SOC can improve clinical confidence as well as patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Health care practitioners’ confidence assessing lupus-related rashes in patients of color

Kannuthurai

Murray

Chen

et al. 2021

Lupus

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“…Clearly improving training in recognizing and treating disorders across a range of skin tones will be an important step forward in addressing some of the disparities that the over‐emphasis on lighter skin has caused. Already established “Ethnic Skin Centers” at universities across the United States (Tull, Kerby, Subash, & McMichael, 2020) will need continued, if not expanded, institutional support of their research and education missions. Ultimately, however, making the knowledge and training provided by such centers integrated into the broader curriculum will be crucial.…”

Section: Discussionmentioning

confidence: 99%

The color of normal: How a Eurocentric focus erases pigmentation complexity

Norton

2020

American J Hum Biol

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Objectives Skin pigmentation is both a highly variable and highly visible human phenotypic trait. Investigations into the biology and origins of this variation have been the focus of research in the fields of dermatology, anthropology, and forensic science, among others. This manuscript explores how much of what we know about the biology, genetics, and evolutionary origins of pigmentation has been strongly influenced by investigations and applications that focus on lighter skin. Methods I reviewed literature from the fields of dermatology, anthropology and evolutionary genetics, and forensic science to assess how perceptions of lighter skin as the “normal” state in humans can shape the ways that knowledge is gathered and applied in these fields. Results This normalization of lighter skin has impacted common tools used in dermatology and shaped the framework of dermatological education. A strong Eurocentric bias has shaped our understanding of the genetic architecture of pigmentary traits, which influences the ways in we understand the evolutionary processes leading to modern pigmentation diversity. Finally, I discuss how these biases in pigmentation genetics work in combination with phenotypic systems that privilege predicting lighter pigmentation variation to impede accurate prediction of intermediate phenotypes, particularly in individuals with ancestry from multiple populations. This can lead to a disproportionate targeting of already over‐policed populations with darker skin. Conclusions Potential changes to how we conceptualize clinical and basic pigmentation research may help to reduce existing health disparities and improve understanding of pigmentation genetic architecture and how this knowledge is applied in forensic contexts.

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“…To the Editor: Barriers to self-care and health care in the homeless population are associated with increased morbidity and mortality. 1 To determine the impact of homelessness on skin health, we characterized skin-associated health-related quality of life (HRQL) and resource access in dermatology patients experiencing homelessness.…”

Section: A Survey Of Dermatologic Healthrelated Quality Of Life and Resource Access In Patients Experiencing Homelessnessmentioning

confidence: 99%

“…To the Editor: Cutaneous squamous cell carcinoma (cSCC) usually occurs on sun-exposed skin, with 700,000 cases diagnosed annually in the United States. 1 The risk of local recurrence, metastasis, and death from cSCC of high-risk sites has been thoroughly detailed in the literature and directs treatment plans for patients who may benefit from definitive surgical therapy to obtain clear margins. 2 Outcomes for the forearm, a low-risk, yet high-frequency site, have previously been reported only in aggregate with data from the hand under the…”

Section: A Survey Of Dermatologic Healthrelated Quality Of Life and Resource Access In Patients Experiencing Homelessnessmentioning

confidence: 99%

A survey of dermatologic health-related quality of life and resource access in patients experiencing homelessness

Truong

Secrest

Zhang

et al. 2021

Journal of the American Academy of Dermatology

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Ethnic skin centers in the United States: Where are we in 2020?

Cited by 18 publications

References 2 publications

Health care practitioners’ confidence assessing lupus-related rashes in patients of color

Health care practitioners’ confidence assessing lupus-related rashes in patients of color

The color of normal: How a Eurocentric focus erases pigmentation complexity

A survey of dermatologic health-related quality of life and resource access in patients experiencing homelessness

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