People with skin of color are projected to become the majority of the U.S. population by 2044. As the population diversifies, how can dermatology clinicians better understand the dermatologic concerns of people with darker skin tones? A study published in the April Journal of Drugs in Dermatology sheds light on the most common reasons why patients of color seek outpatient dermatologic care, and the authors hope this knowledge can help reduce patient care gaps.
I interviewed author Nada Elbuluk, MD, MSc, FAAD, founder of the USC Skin of Color and Pigmentary Disorders Program at Keck Medicine of USC.
What led you to want to investigate the most common outpatient dermatologic chief complaints and diagnoses in patients with skin of color?
I have always felt that in order to best serve our patients we need to know what their greatest concerns are and what most commonly affects them. I’m passionate about ensuring that we deliver the highest quality of care to all demographics of patients, including those of different ages, genders, and racial/ethnic backgrounds. As someone with greater expertise in skin of color dermatology, I felt we had a unique opportunity to study the most common diagnoses and chief complaints for skin of color patients as no such study has ever been done on the West Coast, and Los Angeles is the second largest city in the United States, making it an ideal place to conduct such a study. The results of this study are helpful in better understanding the needs of the skin of color population and which clinical and research gaps we can continue to improve.
You conducted a retrospective chart review among patients with skin of color who sought care at the USC outpatient dermatology clinics. What are some of the ways the USC patient population was ideal for this study?
Prior studies have been done in New York City, Washington, DC, and Detroit, and we feel that our study adds an important and more recent contribution to the literature by including Los Angeles. Not only is Los Angeles one of the largest cities in the United States, but LA County, where our study was done, is particularly unique as it is the most diverse county in the country with a majority skin of color population.
What are some takeaways from your results?
The key takeaways from our study are that the five most common skin concerns that brought skin of color patients in to see a dermatologist were skin examinations, evaluation of bumps/growths, rashes, acne, and skin discoloration. The five most common diagnoses made by dermatologists were benign nevi/neoplasms, followed by dermatitis, acne, eczema and/or xerosis, and dyspigmentation.
Were any of the results surprising?
Some of the results were surprising in that there were differences when we stratified the results by age, gender, and racial ethnic group. These results showed that it’s important that we don’t homogenize all the skin of color populations and recognize that other demographic factors can also make a difference in the most common concerns and diagnoses in these populations.
How is this data helpful in clinical practice?
This data can be very helpful in clinical practice as we consider what the greatest needs are of our skin of color populations, including what most commonly brings them into a dermatology clinic and their most common diagnoses. This knowledge can help us address diagnostic and therapeutic deficits that can improve health care outcomes and health equity for skin of color patients.
What else should dermatology clinicians know about common complaints and diagnoses in dermatology patients with skin of color?
The study is really meant to help dermatologists have a better understanding of what conditions are most relevant to patients of color and adds to existing literature, looking at these populations in other parts of the United States. While our study supported some of the diagnoses and chief complaints found in those studies, there were also a few differences as well.
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