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Background Skin diseases in patients with skin of colour (Fitzpatrick skin types IV to VI) are underrepresented in dermatology training, which may lead to lower quality of care for these patients. To address this underrepresentation in medical education, a newly developed seminar on skin type diversity using an interactive teaching method was implemented in an undergraduate medical curriculum. This study examined the effects of a seminar on the self-assessed competence of medical students in managing skin conditions in patients with skin of colour. Methods A questionnaire survey was conducted among fourth-year undergraduate medical students at the University of Hamburg (Germany) between October 2023 and February 2024. Students’ self-assessed competence was compared before and after the obligatory seminar (pre- and post-design). Results In total, 158 students participated in the survey. After the seminar, knowledge of the presentation of skin diseases in patients with skin of colour and the associated psychological burden, differences in the incidence of skin diseases in different skin types, and the ability to diagnose skin diseases in darker skin types increased. Most participants stated that they wanted to attend more courses on this topic. Discussion Appropriate courses for medical students can improve their competence in managing different skin diseases in patients with skin of colour. In the future, more attention should be paid to teaching the diversity of skin types in dermatology education.

Objective: To compare the efficacy of microdermabrasion and glycolic acid peeling in the treatment of acne vulgaris in skin of color. Study Design: Quasi-experimental study.  Place and Duration of Study: Department of Dermatology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from May 2022 to Nov 2022. Methodology: A total of 150 patients of both gender with age 15-30 years and diagnosis of Acne Vulgaris (mild, moderate or severe) for more than 4 weeks were included. Patients who were already using oral/topical acne treatment including isotretinoin, other skin diseases and polycystic ovarian syndrome were excluded. Patients were divided into the glycolic acid peel Group (Group-A) and the micro-dermabrasion Group (Group-B). The procedure was repeated monthly for 3 months, in both Groups and assessment was done at the end of 3 months on a specially designed Performa. Results: The mean age of the patients was 21.2±3.3 years and 21.4±3.3 years in Group-A and B, respectively. The mean duration of complaints was 11.3±1.3 weeks in Group-A while 9.7±1.1 weeks in Group B. GAG score for acne assessment was used to see the response of treatment in each Group. The females had a better response as compared to males. Moreover, the efficacy of glycolic acid peel was slightly better in the younger age Group while the efficacy of microdermabrasion showed better results in the older age Group (21 years to 30 years). The microdermabrasion was found to be more efficacious as compared to glycolic acid peeling (p=0.005). Conclusion: The efficacy of microdermabrasion was statistically significant..

Related Article Comment on: http://www.jmir.org/2023/1/e48635/

Living Color is the first book to investigate the social history of skin color from prehistory to the present, showing how our body's most visible trait influences our social interactions in profound and complex ways. In a fascinating and wide-ranging discussion, Nina G. Jablonski begins with the biology and evolution of skin pigmentation, explaining how skin color changed as humans moved around the globe. She explores the relationship between melanin pigment and sunlight, and examines the consequences of rapid migrations, vacations, and other lifestyle choices that can create mismatches between our skin color and our environment. Richly illustrated, this book explains why skin color has come to be a biological trait with great social meaning— a product of evolution perceived by culture. It considers how we form impressions of others, how we create and use stereotypes, how negative stereotypes about dark skin developed and have played out through history—including being a basis for the transatlantic slave trade. Offering examples of how attitudes about skin color differ in the U.S., Brazil, India, and South Africa, Jablonski suggests that a knowledge of the evolution and social importance of skin color can help eliminate color-based discrimination and racism.

Doctors-in-training often receive an inadequate dermatology education. Furthermore, studies have highlighted the under-representation of skin of colour (SOC) in dermatological teaching, learning resources and research. Our image-based questionnaire, distributed to all internal medicine trainees in southwest England, highlighted knowledge gaps regarding SOC among training physicians. It is intrinsically more challenging for clinicians to confidently formulate dermatological diagnoses in SOC. In this review, we provide guidance for physicians to help make the diagnostic process more straightforward. First, we outline how skin colour is determined and classified. We discuss how inflammation presents in SOC, with the typical 'erythema’ that physicians often associate with inflammation being a less prominent feature in darker skin tones. We then summarise nine important conditions that we believe physicians working in all specialties should be able to identify in patients with SOC, covering both conditions encountered on the medical take and conditions disproportionately affecting individuals with SOC. The population of the UK is rapidly diversifying; thus, as physicians, we have a professional duty to educate ourselves on dermatological conditions in SOC to provide the best quality of care for all our patients, regardless of their skin type.

Nottingham University medical students undergo a two-week rotation in dermatology which incorporates teaching sessions, including didactic lecture presentations, tutorial seminars on skin cancers and acute dermatological conditions and patient simulations. Many studies highlight the need to improve skin of colour teaching in medical school curricula globally, as low representation can negatively affect physician knowledge throughout their career. Using a pre-post intervention study design, Nottingham University Hospitals NHS Trust (NUH) teaching materials were adapted by adding clinical images of dermatological conditions in skin of colour to existing teaching sessions (obtained from DermNetNZ). Four new learning objectives were set relating to skin of colour in four common skin conditions in the curriculum: acne, eczema, psoriasis and skin cancer. Teaching materials were added to cover this content, and knowledge acquisition was assessed before and after the dermatology rotation using a pre/post-attachment questionnaire. Data were analysed using descriptive analysis. Ninety-nine medical students completed pre- and post-dermatology attachment questionnaires. Students' confidence in recognising skin conditions in patients with skin of colour improved, with 71% reporting confidence ≤5/10 pre-attachment and 74.7% reporting confidence >5/10 post-attachment. The post-attachment questionnaire showed that 97% of students identified increased risk of post-inflammatory hyperpigmentation and scarring in acne in skin of colour, 94.9% recognised psoriatic plaques differed in darker skin tones, 100% recognised erythema can be challenging to identify in eczema of darker skin tones, and 97% identified that melanoma is diagnosed later and is associated with poorer survival in patients with skin of colour. Adaptations to the NUH dermatology teaching materials demonstrate the feasibility and educational benefits of incorporating skin of colour content into existing undergraduate dermatology teaching. Data collection is ongoing to increase sample size and assess inclusivity. Results are preliminary and may be limited by methods used to assess knowledge gain and confidence.

Skin of colour, defined as Fitzpatrick skin types IV–VI, is especially susceptible to hyperpigmentation concerns such as melasma and postinflammatory hyperpigmentation (PIH). Treating hyperpigmentation in skin of colour is challenging due to increased risk of PIH, which can be induced by the treatments. Isobutylamido‐Thiazolyl‐Resorcinol (ITR), a tyrosinase inhibitor, has previously been identified as an effective and safe solution for hyperpigmentation, inhibiting melanin production without common side effects. This review evaluates available evidence on ITR's efficacy and safety for the management of hyperpigmentation in skin types IV–VI. Three publications reporting four studies were reviewed. Two randomised controlled trials assessed the efficacy and tolerability of ITR for the management of melasma in patients with skin of colour, whereas one randomised clinical trial and one observational real‐world study explored therapeutic benefits for patients with acne‐related PIH. A total of 234 participants completed the four reviewed studies, of which 232 were skin of colour. In a randomised vehicle‐controlled trial, ITR significantly improved Melasma Area and Severity Index scores and quality of life over 24 weeks of application compared to baseline and vehicle. A comparative clinical trial showed ITR, alone or with hyaluronic acid, effectively reduced melasma. A randomised vehicle‐controlled study in patients with acne‐related PIH showed ITR significantly reduced PIH visibility as compared to baseline and vehicle. An observational real‐world study confirmed effective PIH reduction by ITR in a real‐life setting. All studies showed good tolerability of the examined ITR‐containing formulations. The results collectively support ITR as a safe and effective cosmetic solution in skin of colour. ITR emerges as a reliable hyperpigmentation management option for this patients groups, backed by robust methodologies. Future research should include more patients with Fitzpatrick skin type VI and explore potential benefits of combining ITR and laser treatments in skin of colour to reduce PIH risk.