BOSTON ― Among dermatology residents and attending dermatologists, rates of diagnostic accuracy and appropriate biopsy recommendations were significantly lower for patients with skin of color compared with White patients, new research shows.
Dr Loren Krueger
"Our findings suggest diagnostic biases based on skin color exist in dermatology practice," lead author Loren Krueger, MD, assistant professor in the Department of Dermatology, Emory University School of Medicine, Atlanta, said at the Annual Meeting of the Skin of Color Society Scientific Symposium (SOCS) 2022. "A lower likelihood of biopsy of malignancy in darker skin types could contribute to disparities in cutaneous malignancies," she added.
Disparities in dermatologic care among Black patients in comparison with White patients have been well documented. Recent evidence includes a 2020 study that showed significant shortcomings among medical students in correctly diagnosing squamous cell carcinoma, urticaria, and atopic dermatitis for patients with skin of color.
"It's no secret that our images do not accurately or in the right quantity include skin of color," Krueger said. "Yet few papers talk about how these biases actually impact our care. Importantly, this study demonstrates that diagnostic bias develops as early as the medical student level."
To further investigate the role of skin color in the assessment of neoplastic and inflammatory skin conditions and decisions to perform biopsy, Krueger and her colleagues surveyed 144 dermatology residents and attending dermatologists to evaluate their clinical decision-making skills in assessing skin conditions for patients with lighter skin and those with darker skin.
