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Abstract

Rash was identified less frequently in black children in the study. 1 Research shows erythema migrans is identified less often in black individuals, leading to a higher incidence of late stage Lyme disease presentations. 5,6 Racial bias in medical resources and education means that dermatologic conditions are less likely to be identified on black skin, further exacerbating health disparities. 7 It is important to acknowledge the possible impacts of this phenomenon in Kawasaki disease.Although genetics have been shown to play a role in some individuals' susceptibility to Kawasaki disease, the cause of Kawasaki disease remains unknown and genetics do not explain all cases. 8 Further, the scientific literature continues to show that race cannot be used as a proxy for genetics. 9,10 Thus, the authors' recommendation to include race in treatment algorithms for Kawasaki disease warrants caution. The use of race in diagnostic or therapeutic decision making can exacerbate disparities by providing different care based on race. 11 Racial and ethnic disparities are not intrinsic to the individual's biology, but rather the systemic inequity and racism that plagues our society.