Beer Jacob I, Downie Jeanine, Nogueira Alessandra, Meckfessel Matthew
J Drugs Dermatol. 2023 Jul 1;22(7):635-640. doi: 10.36849/JDD.7435.
Patients with skin of color (SOC), defined as Fitzpatrick skin types IV to VI, and of varying ethnicities are under-represented in dermatology. This includes practitioners, trainees, dermatologic teaching materials, and clinical studies. Methods: Online survey study to assess dermatologists’ perceptions that could impact patient care. Participants were screened for providers that spent ≥80% of their time in direct patient care; managed ≥100 unique patients per month; and had ≥20% aesthetic patients.
A total of 220 dermatologists participated; 50 with SOC, 152 non-SOC, and 18 other. SOC dermatologists had a more diverse patient population by racial/ethnic background, but there was no difference in proportion of patients by Fitzpatrick skin phototype categories. While race/ethnicity is not considered a primary factor in clinical decision making, Fitzpatrick skin type is for many dermatologists. Most dermatologists agree that more diversity in medical training for dermatologic conditions would be beneficial. Dermatologists report that adding before and after photos of different skin types in educational materials and increasing training on cultural competency are likely to be the most effective strategies for improvement.
Although racial/ethnic diversity shows differences based on location of practice and the race of dermatologists, diversity of skin type based on Fitzpatrick scale is virtually identical across practices, illustrating the challenge of categorizing patients by this scale alone. Beer J, Downie J, Noguiera A, et al. Assessing implicit bias in dermatology. J Drugs Dermatol. 2023;22(7):635-640. doi:10.36849/JDD.7435.
肤色较深（SOC）的患者，即菲茨帕特里克皮肤类型为IV至VI型且种族各异的患者，在皮肤科领域的代表性不足。这包括从业者、实习生、皮肤科教材以及临床研究。方法：开展在线调查研究，以评估可能影响患者护理的皮肤科医生的看法。对参与者进行筛选，要求其80%以上的时间用于直接患者护理；每月管理100名以上不同的患者；且美容患者占比20%以上。
共有220名皮肤科医生参与；其中50名治疗SOC患者，152名治疗非SOC患者，18名治疗其他患者。治疗SOC患者的皮肤科医生的患者种族/族裔背景更为多样，但按菲茨帕特里克皮肤光型类别划分的患者比例没有差异。虽然种族/族裔在临床决策中不被视为主要因素，但对许多皮肤科医生来说，菲茨帕特里克皮肤类型是主要因素。大多数皮肤科医生认为，增加皮肤病医学培训的多样性将有益处。皮肤科医生报告称，在教育材料中添加不同皮肤类型的前后对比照片以及增加文化能力培训可能是最有效的改进策略。
尽管种族/族裔多样性因执业地点和皮肤科医生的种族而存在差异，但基于菲茨帕特里克量表的皮肤类型多样性在各执业机构中几乎相同，这说明了仅按此量表对患者进行分类的挑战。比尔·J、唐尼·J、诺盖拉·A等。评估皮肤科中的隐性偏见。《药物皮肤病学杂志》。2023；22(7)：635 - 640。doi:10.36849/JDD.7435 。
