Gabrielle M. Grasso , 2025-05-02 13:00:00
Key takeaways:
- The top 10 dermatologic diagnoses among patients with skin of color differed from their reported concerns.
- Dermatologic diagnoses also varied by age and sex.
The most common dermatologic conditions diagnosed for patients with skin of color differed from those patients’ top reported concerns, according to a medical records review, highlighting possible practice gaps for an underserved population.
People with skin of color are projected to comprise most of the U.S. population by 2044, signaling a need to better identify the conditions that most affect these groups.
“Certain conditions are of highest concern to patients of color, and this knowledge, along with the most frequent diagnoses seen in skin of color, can allow dermatologists to be better prepared to serve patients of color,” Nada Elbuluk, MD, MSc, associate professor of dermatology at University of Southern California and founding director of the skin of color and pigmentary disorders program at Keck School of Medicine, told Healio. “Knowing the needs of this population, additional attention can also be placed on addressing gaps in knowledge that exist for diagnostic and therapeutic care of the most commonly seen conditions and concerns.”
In this retrospective study, Elbuluk and colleagues analyzed the most reported concerns and conditions among 4,572 patients with skin of color (mean age, 46 years). Patients identified as Asian (54.8%), Black (15.2%), Hispanic (less than 1%) and multiracial (9.6%).
Results showed that the top 10 most common diagnoses established by dermatologists for patients with skin of color were:
- benign nevi/neoplasms (38.8%);
- dermatitis (20.8%);
- acne (13.3%);
- eczema and/or xerosis (9%);
- dyspigmentation (7.7%);
- neoplasm of uncertain behavior (6.2%);
- hypertrophic scars or keloids (4.6%);
- alopecia (4.4%);
- seborrheic dermatitis (3.6%); and
- psoriasis (3.4%).
The top 10 chief concerns from patients with skin of color were:
- skin examination (21.5%);
- bumps/growths (20.8%);
- rash (19.8%);
- acne (10%);
- skin discoloration (8.5%);
- eczema and/or dry skin (7%);
- itching (5%);
- hair loss (4.1%);
- keloids/scars (2.9%); and
- nail discoloration (1.5%).
“The study also found that when we substratify the data based on age, gender and racial/ethnic background, there are additional unique differences in concerns and diagnoses amongst those with skin of color,” Elbuluk said.
The three chief concerns among Black patients were bumps/growths (24.4%), rash (21%) and skin examination (17.9%), whereas the top reported concerns among Asian patients were similar with bumps/growths and rash (22.8% for both), followed by skin examination (21.5%) and acne (10.7%).
Among those who identified as multiracial, the top three chief concerns were skin examination (28.9%), bumps/growths (24.8%) and rash (15.7%). Hispanic patients reported skin checks, rash and acne as their top concerns (18.8% for all), followed by itching (12.5%), skin discoloration, keloids/scars and nail discoloration (6.3% for all).
Dermatologist-led analyses of subgroups stratified by age showed pediatric patients with skin of color experienced higher rates of dermatitis (P < .001), acne (P < .001) and eczema/xerosis (P = .006), whereas those aged 19 to 39 years more commonly experienced acne (P < .001), keloids/scarring (P = .014), alopecia (P = .001) and seborrheic dermatitis (P = .002). Compared with younger patients, those aged 40 to 65 years experienced more benign nevi/neoplasms (P < .001) — a trend that persisted past aged 65 years (P < .001).
Eczema, dry skin and acne were the predominant concerns among pediatric patients; hair loss and keloids/scarring affected those aged 19 to 39 years; discoloration and skin examination were pain points for patients aged 40 to 65 years; and itching and rashes were the top issues for those older than 65 years.
According to the dermatologist-led assessment, the most common condition in both men and women with skin of color were benign nevi/neoplasms. Women received more acne, dyspigmentation and alopecia diagnoses, whereas male patients did not receive any one particular diagnosis.
According to Elbuluk, this study helps shed light on the conditions primarily affecting patients with skin of color, as well as the needs of these patients.
“My hope is that as we continue to evolve as a nation, we can make sure that all dermatologists are prepared to take care of all populations,” Elbuluk told Healio.
For more information:
Nada Elbuluk, MD, MSc, can be reached at dermatology@healio.com.
