Case reports in which the text or an image presents a patient with SoC in a non-SOC country (i.e., patient with SoC presented in countries in which the majority of the population has Fitzpatrick skin type I to II, such as Sweden or the United States, or a case report from France presenting a Black patient) For tier 2, the journal title specifically addresses pigmentary skin and hair diseases that are particularly relevant to patients with Fitzpatrick skin types III to VI because of hair type (curl pattern types 3-4) and pigmentation presence in the skin. Conditions meeting this criterion and captured in this study include skin and hair discoloration, postinflammatory hyperpigmentation, melasma, vitiligo, erythema dyschromicum perstans, lichen planus pigmentosus, central centrifugal cicatricial alopecia, tinea capitis, acne keloidalis nuchae, folliculitis decalvans, dissecting cellulitis of the scalp, tinea barbae, and Mongolian spot. Note that we did not include topics that may have a predilection toward patients with SoC if the skin or hair condition itself was not directly related to the patient's pigmentary skin or hair curl type. For this reason, conditions such as discoid lupus, atopic dermatitis, intrahepatic cholestasis of pregnancy, and hidradenitis suppurativa, were not included in this study. Using these criteria, all journals were classified and examined for SoC-relevant articles and CME. All statistical analyses were conducted in R statistical software, version 4.0.2. Fifty-two academic dermatology journals were included in our study. Scopus CiteScore information was publicly available for all journals, with the exception of Journal der Deutschen Dermatologischen Gesellschaft. The majority of journals originated from multiple continents (30.8%), North America (26.9%), or Europe (25.0%). Based on the described criteria, seven journals (13.5%) were classified as covering SoC, 33 journals (63.5%) as international, and 11 journals (21.2%) as scientific, while 41 journals (78.8%) focused on clinical topics. Skin of color relevance Journals were ranked by their total percentage of articles on SoC relative to the total number of articles published from 2018 to 2020 (Table 1). Across all journals, the mean percentage of articles on SoC was 16.8% and ranged from 2.04% to 61.81%. In four journals, the percentage of articles on SoC published was within 0.05% of or >50%: Indian Journal of Dermatology, Venereology and Leprology; Journal of Cosmetic and Laser Therapy; and Leprosy Review. These top-ranked journals were all classified as having a clinical focus. Two of the four journals originated from Asia. Ten journals exhibited SoC article percentages of <5%. Ten journals, none of which were from countries with populations with SoC and the majority of which originated from Europe and North America, exhibited the lowest SoC article percentages of <5%. Analysis of skin of color article tiers We calculated the percentage of articles on SoC in each SoC tier across all journals (Fig. 1). Nearly two-thirds (61.88%) of all articles on SoC were Tier 1B, meaning they originated from a country with a population where the majority of people had SoC. A significantly lower percentage of SoC publications came from non-SoC countries (Tier 1E) compared with SoC countries (tier 1B: 61.88% vs. tier 1E: 12.07%; p < .05). The next most frequent tier types were Tier 1A (12.21%) and Tier 2 (12.13%), corresponding to articles with titles specifically addressing SoC, skin type, or race and ethnicity and titles specifically addressing pigmentary skin and hair diseases that are particularly relevant to patients with Fitzpatrick skin types III to VI, respectively. Similar results were found in a subgroup analysis based on journal category (Table 2). In every journal category, Tier 1B articles comprised the largest proportion of publications relevant to SoC. Tier 1C and Tier 1D articles were the least common across all categories, representing <2% of articles on SoC. Interestingly, the percentage of Tier 1A articles was lowest in journals covering SoC (5.44%). The proportion of Tier 2 articles differed substantially between non-SoC and SoC journals, as well as between non-international and international journals. Geographical analysis of published articles on