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Dermatologists Diagnose Psoriasis Less Frequently in Black Patients

A Perelman School of Medicine assessment of biopsy rates support previous findings showing that dermatologists are less confident making psoriasis diagnoses in patients with darker skin color.

Dermatologists have less confidence making a psoriasis diagnosis in Black patients than they do White patients, according to new late-breaking session findings presented at the American Academy of Dermatology (AAD) 2022 Annual Meeting in Boston this weekend.

An assessment of skin biopsy rates, stratified by patient-reported race, by a team of University of Pennsylvania Perelman School of Medicine investigators showed that psoriasis diagnostic uncertainty is more common among Black patients than White patients.

The findings complement previous survey-based assessments by Perelman investigators suggesting that dermatologists and specialists in dermatology express less confidence in diagnosing chronic skin disease in patients with darker skin color. What’s more, they highlight the significant disparities in treatment initiation and clinical outcomes among differing races of patients with psoriasis.

In a special episode of DocTalk during AAD 2022, study investigators Fahad Ahmed, a medical student at Perelman, and Junko Takeshita, MD, PhD, Assistant Professor of Dermatology and Epidemiology, joined to discuss their research and the history of interpreted disparities in chronic skin disease management.

“In short, there’s not a ton of literature on this topic, and it’s growing rapidly,” Takeshita said. “The motivation behind this study was that we had found that there are racial and ethnic disparities in burden of disease…and there are healthcare utilization disparities…and we found racial disparities in treatment for psoriasis.”

While acknowledging that patient-reported race may be an “imperfect proxy” of skin color, Takeshita noted that this assessment of real-world biopsy rates highlights how prevalent the issue of diagnostic uncertainty by race is in dermatology.

The team also discussed matters of improving baseline dermatology diagnosis education at the medical school level.

“There’s been this interest that’s been gained in representing skin of color in educational resources,” Ahmed said. “There’s been a focus on representing these conditions in various skin tones. It seems as though on these tests that we are taking…we feel that just by being exposed to this, we are making great headway on the issue.”

Listen to the full podcast episode above.