Skin across the spectrum: Dermatology education resources turn attention to caring for people with skin of colour

More and more dermatology resources are focusing on people with skin of colour. From medical students creating new learning modules, to patient groups offering webinars to a new learning series from the Canadian Dermatology Association (CDA), more information is being shared about this type of care. New initiatives began popping up after an increased focus on equity, diversity and inclusion in the study and practice of dermatology in 2020 and 2021, including two high profile articles in The Guardian and The New York Times. In The Guardian article, author Dr. Neil Singh quotes a Twitter thread by Canadian Dr. Michael Mackley, then a medical student, who posted in about how unprepared he was to care for a patient with Black skin after being educated with photos of white skin. In June 2020, the Canadian Dermatology Association (CDA) made a commitment to diversity and inclusion, including a promise to educate CDA members. The CDA is now hosting an online learning series for dermatologists called the Skin Diversity Learning Series: Expanding Perspectives in Dermatology, sponsored by Johnson & Johnson. “This program is an important step forward in supporting both the CDA’s and Johnson & Johnson Inc.’s diversity, equity and inclusion commitments,” Dr. Catherine McCuaig, president of the CDA, said in a statement to the Medical Post. “With Canada’s sizeable and growing multicultural population, dermatologists are looking to expand and update their knowledge of skin of colour, so that all patients receive representative, optimal care." The six-part learning series runs from Sept. 23 to Dec. 16, 2021. Sessions include information on hair loss, skin and nail conditions, pediatric dermatology, aesthetic dermatology and skin cancer in dark skin and across the skin colour spectrum. “We’re educating ourselves to be a part of the solution when it comes to health inequities by providing knowledge-based representative care. Just as continuing medical education is a lifelong pursuit, taking the time to understand the biology of diverse skin and issues affecting those of different backgrounds is crucial to our development,” Dr. McCuaig said in a CDA press release about the learning series. Watch: Video: Three questions about being a minority doctor in a rural area Dr. Shakira Braithwaite, who graduated from Queen’s University this year, said that she felt frustrated and disappointed with the lack of diversity shown in teaching resources. She said when at a dermatology placement she felt underprepared to manage patients with skin of colour because she had not learned to recognize certain conditions in skin of colour. She and a fellow group of Queen’s University medical students reviewed learning materials and found that out of 168 learning events, 131 showed only white skin presentations, according to a February 2021 press release from the school. Dr. Braithwaite and fellow students are currently creating an interactive teaching module with information about skin conditions in skin of colour. The students’ work prompted the Queen’s University health sciences library to purchase VisualDX, a more diverse medical image database, according to the press release. University of Ottawa medical students also developed a learning module for the undergraduate medical curriculum that addresses skin colour diversity. Selam Ogbalidet, a third-year medical student, said that her interest was piqued when she attended the 2019 Canadian Conference on Ethnodermatology. Ogbalidet, a member of the university’s dermatology interest group, reached out to classmates, including Mina Boshra, to advocate for a learning module. “The biggest challenge for people of colour is that their skin manifestations for certain diseases are not widely studied and shown,” Boshra said in a University of Ottawa press release about the initiative. She cited the case of melanoma in people with skin of colour. Recent studies have shown that there is a delay in diagnosis for people with skin of colour compared to people with lighter skin, leading to poorer outcomes. The module was developed with guidance from university faculty members. The University of Ottawa’s dermatology interest group has reached out to medical learners in other universities about improving skin colour representation in medical education. Read: Evidence for cannabis products in dermatology only skin deep Other educational opportunities about dermatology in skin of colour are available to Canadian physicians. The Canadian Conference on Ethnodermatology, or Skin Spectrum Summit, will be held virtually on November 4 and 6, 2021. According to the conference website, the conference provides education on treating patients across all skin types, with a focus on the care of people with skin of colour. An Indigenous skin spectrum summit was held in March 2021. Academic settings are starting to provide learning events that discuss skin of colour. For example, Dr. Boluwaji Ogunyemi, assistant dean of social accountability and dermatologist at Memorial University of Newfoundland, will present a lecture on common dermatoses in children and adolescent newcomers across the skin spectrum. The lecture is part of MUN’s virtual Refugee Health Symposium on October 15 and 16, 2021. Patient groups are also offering education on skin of colour. The Eczema Society of Canada is hosting a webinar on Ezcema in Skin of Colour with Dr. Marissa Joseph in October. Read: Be alert for dermatologic conditions related to COVID-19 On social media, Canadian physicians and the general public can go to @BrwnSkinMatters on Twitter or @brownskinmatters on Instagram, which posts images of dermatological conditions in people with skin of colour, often beside photos of the same condition in a person with lighter skin. McMaster University posted a patient-focused video on skin cancer and black skin in August 2021. The video is part of their Demystifying Medicine series. The volume of peer-reviewed scientific literature about skin of colour has blossomed in recent years. A review of publications about skin of colour showed that there has been 7.8-fold increase in the number of papers pertaining to skin of colour published in the past 13 years (2007 to 2021) compared to the previous 13 years (1993 to 2006). Citations, page views and impact factor of the papers also rose. The increase has been even greater in the past five years, with 57% more papers published between 2016 to 2020 compared to between 2011 to 2015. The review paper was published on September 20 in the Journal of Cutaneous Medicine and Surgery. The new resources may be welcomed by not only physicians, but also their patients. An online survey of 1,529 Canadians with a variety of skin types showed 72% approved the CDA learning program, with 77% of Black Canadians surveyed said they would prefer to visit a dermatologist with training in skin diversity. The survey was conducted in June 2021. Read: Combination shown effective for patients with advanced melanoma

Skin across the spectrum: Dermatology education resources turn attention to caring for people with skin of colour

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