SKIN SPECTRUM™ QUARTERLY
THE JOURNAL OF ETHNODERMATOLOGY™
THE JOURNAL OF ETHNODERMATOLOGY™
We invite you to attend the 12th Annual Skin Spectrum™ Summit Conference on Ethnodermatology in Toronto, Canada, October 31, 2026. Agenda and registration information may be found at http://skinspectrum.ca
Our weekly newsletter on Ethnodermatology, Skin Spectrum™ Weekly. offers frequent updates on developments in this subspecialty. The latest editions are linked below. Subscribe for free at http://skinspectrum.online
SKIN SPECTRUM™ QUARTERLY FEATURED CASE REPORT
Adhora Mir, MD1 Hailey Land, RN, BScN1 Reetesh Bose, MD, FRCPC1,2 Samira Jeimy3,4, MD, PhD, FRCP
1. Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
2. Division of Dermatology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
3. Division of Clinical Immunology & Allergy, Department of Medicine, Western University, London, Ontario, Canada
4. Division of Clinical Immunology & Allergy, Department of Medicine, Lawson Health Research Institute, London, Ontario, Canada
Funding sources: None
Conflicts of Interest:
Samira Jeimy has been a member of advisory boards for Sanofi Genzyme, GSK, and ALK, received honoraria for speaking engagements from GSK and L’Oréal, and provided consultancy services for the Canadian Agency for Drugs and Technologies in Health. Dr. Jeimy has leadership roles with the Ontario Medical Association and the Canadian Society of Allergy and Clinical Immunology.
Patient consent: provided
KEY WORDS: atopic dermatitis, eczema, management, skin of color
Figure A
Eczematous rash on (A) flexural areas
Figure B
Eczematous rash on extensor areas
Figure C
Eczematous rash on of the patient's shoulder
Patients with skin of color (SOC) often present with different clinical features of atopic dermatitis (AD) than seen in Caucasian skin types, which may complicate accurate diagnosis and management. The dermatitis can be more violaceous, have a follicular phenotype, and be at higher risk for earlier and more severe post-inflammatory dyspigmentation.1 Black patients can present with greater extensor involvement and Asian patients may present with psoriasiform morphology. Current assessment tools, particularly those reliant on grading erythema, may not effectively diagnose or stratify AD severity in SOC patients due to under-appreciated clinical presentations and bias in AD scoring systems.2 This contributes to healthcare inequity. SOC patients have a disproportionate risk of negative impact on quality of life, increased risk of hospitalization with severe AD, and more missed work days related to atopic dermatitis.3
There is persistent under-representation of SOC patients in atopic dermatitis trials. In a review of 27 Phase 2 and Phase 3 randomized control trials for atopic dermatitis (spanning 2009 to 2019), only 16.2% enrolled patients identified as Asian and 8.9% as Black.4
While darker skin types are predominant globally and ever-increasing in Canada, the lack of SOC representation in medical textbooks and curricula have been implicated in the propagation of bias contributing to worse treatment, patient satisfaction, and outcomes.5 Several resources can help clinicians in management of AD in SOC, including The Skin of Color Society, and content through the American Academy of Dermatology and Canadian Dermatology Association.
References
1. Gan C, Mahil S, Pink A, Rodrigues M: Atopic dermatitis in skin of colour. Part 2: Considerations in clinical presentation and treatment options. Clinical and Experimental Dermatology Oct. 2023; 48(10):1091–1101. https://doi.org/10.1093/ced/llad162
2. Ben-Gashir MA, Hay RJ: Reliance on erythema scores may mask severe atopic dermatitis in black children compared with their white counterparts. British Journal of Dermatology 2002; 147(5):920–925. https://doi.org/10.1046/j.1365-2133.2002.04965.x
3. Narla S, Hsu DY, Thyssen JP, Silverberg JI: Predictors of hospitalization, length of stay, and costs of care among adult and pediatric in-patients with atopic dermatitis in the United States. Dermatitis 2018; 29(1):22–31. https://doi.org/10.1097/DER.0000000000000323
4. Price KN, Krase JM, Loh TY, Hsiao JL, Shi VY: Racial and ethnic disparities in global atopic dermatitis clinical trials. British Journal of Dermatology 2020; 183(2):378–380. https://doi.org/10.1111/bjd.18938
5. Perlman KL, Klein EJ, Park JH: Racial disparities in dermatology training: the impact on black patients. Cutis 2020; 106(6):300–301. https://doi.org/10.12788/cutis.0135
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Skin Spectrum™ Quarterly: Bridging the Gap
Skin Spectrum™ Quarterly is uniquely positioned to address these critical issues. Our online portal provides an accessible platform for the global dermatologic community to engage with cutting-edge research and clinical insights. By focusing on ethnodermatology, the journal aims to:
Advance Knowledge: Publish original research that deepens our understanding of dermatologic conditions in diverse populations, including genetic predispositions, clinical presentations, and treatment responses.
Promote Best Practices: Disseminate evidence-based reviews and clinical observations that guide dermatologists in providing culturally competent and effective care for all patients.
Foster Collaboration: Serve as a hub for international collaboration, connecting researchers and clinicians dedicated to improving dermatologic health equity worldwide.
Educate and Empower: Provide educational resources that enhance the diagnostic acumen and therapeutic skills of dermatologists when treating patients across the full spectrum of skin tones.
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An Introduction to Skin Spectrum™ Quarterly: The Journal of Ethnodermatology™ Online Portal
A New Era in Dermatologic Research and Practice
In an increasingly interconnected world, the practice of dermatology demands a nuanced understanding of skin conditions across all populations. Traditional dermatological education and research have historically focused on Caucasian skin, leading to significant gaps in knowledge and disparities in care for individuals with skin of colour and diverse ethnic backgrounds. Recognizing this critical need, we are proud to introduce the online portal for Skin Spectrum™ Quarterly: The Journal of Ethnodermatology™ (available at skinspectrum.co and ethnodermatology.com).
This portal serves as a vital resource for international dermatologists, offering timely publication and dissemination of original research, comprehensive reviews, and insightful clinical observations specifically pertaining to dermatologic issues across all ethnicities. Our particular emphasis lies in addressing the unique challenges and presentations of skin conditions in patients with skin of colour.
The Imperative of Ethnodermatology
Ethnodermatology is a rapidly evolving subspecialty dedicated to the study of skin, hair, and nail disorders as they manifest in different racial and ethnic groups. It encompasses not only the biological variations in skin structure and function but also the cultural, environmental, and genetic factors that influence dermatologic health. The importance of ethnodermatology cannot be overstated, as evidenced by the persistent health disparities observed globally.
For instance, certain dermatologic conditions present differently in pigmented skin, making diagnosis challenging for practitioners primarily trained on lighter skin types. Conditions like post-inflammatory hyperpigmentation, keloids, and sarcoidosis are more prevalent or manifest uniquely in skin of colour. Furthermore, common conditions such as acne, eczema, and psoriasis can have distinct clinical features and treatment responses in diverse ethnic groups, often leading to misdiagnosis or suboptimal management when these differences are not recognized.
Challenges in Dermatologic Care for Diverse Populations
Research highlights several systemic challenges in providing equitable dermatologic care:
Diagnostic Difficulties: Visual cues for inflammation, such as erythema (redness), are often subtle or absent in darker skin tones, leading to delayed or missed diagnoses.
Treatment Disparities: Therapeutic approaches effective in Caucasian skin may not be equally efficacious or may carry different risks (e.g., dyspigmentation) in skin of colour.
Underrepresentation in Research and Education: Historically, clinical trials and medical textbooks have lacked adequate representation of diverse skin types, perpetuating a knowledge gap among practitioners. This also extends to the lack of dermatologists from underrepresented racial and ethnic groups, which can impact access to care and patient comfort.
Socioeconomic and Cultural Factors: Access to specialized care, cultural beliefs about health and illness, and socioeconomic determinants of health all play a significant role in dermatologic outcomes across different ethnicities.
What You Will Find on this Portal
The Skin Spectrum Quarterly™ online portal offers a rich array of content designed to meet the needs of busy practitioners and researchers:
Original Research: Peer-reviewed articles presenting novel findings on dermatologic conditions in various ethnic groups.
Review Articles: Comprehensive syntheses of existing literature, offering in-depth perspectives on specific topics in ethnodermatology.
Clinical Observations and Case Studies: Practical insights derived from real-world clinical experience, highlighting diagnostic pearls and management strategies for challenging cases.
Expert Commentaries: Perspectives from leading experts in the field, offering critical analysis and future directions.
Educational Resources: Access to supplementary materials, webinars, and continuing medical education (CME) opportunities focused on ethnodermatology.
We invite all international dermatologists to explore skinspectrum.co and ethnodermatology.com. Join us in our mission to advance the science and practice of ethnodermatology, ensuring that every patient, regardless of their ethnic background or skin type, receives the highest standard of dermatologic care.
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