Postgraduate Program in Child and Adolescent Health, Complexo Hospital de Clínicas of the Federal University of Paraná, UFPR, Rua General Carneiro, 181, Alto da Glória, Curitiba, Paraná, 80060900, Brazil.
Medical School at Faculdade Ceres - FACERES, São José do Rio Preto, Brazil.
Arch Dermatol Res. 2024 Nov 29;317(1):56. doi: 10.1007/s00403-024-03541-9.
Skin diseases have different visual characteristics in skin of color, making recognition a challenge. Pictures and illustrations of darker skin tones in the literature are scarce. In American pediatric dermatology books, less than 40% of photographs depict skin of color. No similar studies have been conducted for South American pediatric dermatology books. This study evaluates the frequency of photographs of skin of color in pediatric dermatology textbooks and atlases. A prospective documentary study was conducted on the skin color of clinical photographs from 5 pediatric dermatology books (4 Brazilian, 1 Argentinian). All photographs were evaluated by three researchers and classified using the Massey-Martin scale (white 1-2, light brown 3-5, dark brown 6-8, black 9-10). Out of 3,471 photographs, 1,000 were excluded, and skin color was determined in 2,471 photographs. White was identified in 1,403 (56%), light brown in 1,044 (42%), dark brown in 24 (1%), and 0 (0%) in black. Atopic dermatitis, contact dermatitis, and psoriasis were the most common diagnoses; however, no dark brown or black skin was represented. In conclusion, photographs of skin of color were less frequent, despite most of the Brazilian population (55.5%) identifying as Black, and in Argentina, 0.7%, though hindered by the lack of self-identification questions before the 2022 census. This disparity undermines education, highlighting the need to increase representation of skin of color in educational materials to improve healthcare for these populations.
皮肤疾病在有色人种的皮肤中具有不同的视觉特征，这使得识别具有挑战性。文献中关于较深肤色的图片和插图很少。在美国儿科学皮肤科书籍中，不到 40%的照片描绘了有色人种的皮肤。没有类似的研究针对南美洲儿科学皮肤科书籍进行过。本研究评估了儿科学皮肤科教科书和图谱中有色人种皮肤照片的频率。对 5 本儿科学皮肤科书籍（4 本巴西，1 本阿根廷）的临床照片的肤色进行了前瞻性文献研究。三位研究人员对所有照片进行评估，并使用 Massey-Martin 量表（白色 1-2，浅棕色 3-5，深棕色 6-8，黑色 9-10）进行分类。在 3471 张照片中，有 1000 张被排除在外，2471 张照片确定了肤色。其中 1403 张（56%）为白色，1044 张（42%）为浅棕色，24 张（1%）为深棕色，0 张（0%）为黑色。特应性皮炎、接触性皮炎和银屑病是最常见的诊断；然而，没有深棕色或黑色皮肤的代表。总之，尽管巴西人口（55.5%）中有大多数人认定为黑人，而在阿根廷，0.7%的人认定为黑人，但由于 2022 年人口普查前缺乏自我认定问题，有色人种的照片仍然较少。这种差异削弱了教育，突出表明需要增加有色人种在教育材料中的代表性，以改善这些人群的医疗保健。
