University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
University of Bristol Medical School, Bristol, UK.
Clin Med (Lond). 2023 Jan;23(1):2-8. doi: 10.7861/clinmed.2022-0335.
Doctors-in-training often receive an inadequate dermatology education. Furthermore, studies have highlighted the under-representation of skin of colour (SOC) in dermatological teaching, learning resources and research. Our image-based questionnaire, distributed to all internal medicine trainees in southwest England, highlighted knowledge gaps regarding SOC among training physicians. It is intrinsically more challenging for clinicians to confidently formulate dermatological diagnoses in SOC. In this review, we provide guidance for physicians to help make the diagnostic process more straightforward. First, we outline how skin colour is determined and classified. We discuss how inflammation presents in SOC, with the typical 'erythema' that physicians often associate with inflammation being a less prominent feature in darker skin tones. We then summarise nine important conditions that we believe physicians working in all specialties should be able to identify in patients with SOC, covering both conditions encountered on the medical take and conditions disproportionately affecting individuals with SOC. The population of the UK is rapidly diversifying; thus, as physicians, we have a professional duty to educate ourselves on dermatological conditions in SOC to provide the best quality of care for all our patients, regardless of their skin type.
受训医生通常接受的皮肤科医学教育不足。此外,研究表明,在皮肤科教学、学习资源和研究中,皮肤颜色较深的人群(SOC)代表性不足。我们的基于图像的问卷分发给英格兰西南部的所有内科受训者,突出了受训医生在 SOC 方面的知识差距。对于临床医生来说,自信地对 SOC 患者进行皮肤病诊断内在地更具挑战性。在这篇综述中,我们为医生提供了指导,以帮助简化诊断过程。首先,我们概述了肤色是如何确定和分类的。我们讨论了 SOC 中的炎症表现,医生通常与炎症相关的典型“红斑”在较深肤色中不太明显。然后,我们总结了我们认为所有专科医生都应该能够在 SOC 患者中识别的九种重要疾病,涵盖了在医疗保健中遇到的疾病和不成比例地影响 SOC 患者的疾病。英国人口正在迅速多样化;因此,作为医生,我们有专业责任来教育自己关于 SOC 中皮肤病的知识,为我们所有的患者提供最佳的护理质量,无论他们的皮肤类型如何。