Medical curriculums have historically been teaching healthcare professionals how dermatological conditions present on lighter skin phototypes whilst not exploring their presentation in skin of different pigmentations. This has meant that generations of doctors have been confident on diagnosing conditions in patients with lighter skin, but lacked confidence in diagnosing and managing patients with darker skin types.
Working as doctors in the NHS we have first-hand experience in how patients that do not fit the exact representation of pathology that we are taught at medical school can often be misdiagnosed. This is due to several reasons- patients presenting late, feeling embarrassed to discuss medical problems, language barriers, incorrect initial diagnoses, correct treatments not being prescribed (particularly in dermatology where often different potency topical steroids may be required in darker skin), poor concordance with treatment due to not being explained the rationale for them, and hence poor faith in the medical system with low rates of attendance to follow-up.
Skin, hair and nail disease also have unique cultural and social implications for such patients, which doctors may not always appreciate, and it is vital to prepare the next generation of doctors and medical students for treating conditions in an increasingly diverse population.
All Skin Tones is charitable initiative that aims to develop education materials and literature that will be distributed to both healthcare professionals and patients, as well as being available online and on social media.
Through our endeavours we hope to:
1. Improve time for diagnosis of dermatological disease in patients with darker skin phototype
2. Improve outcomes for patients through earlier diagnosis and management
3. Improve awareness of unique social and cultural implications of dermatological disease in patients of darker skin to allow more sensitive and holistic management by healthcare professionals and students
4. By improving education amongst patients of darker skin and south asian origin, we hope they may become more comfortable and empowered to present earlier to healthcare professionals
We are very grateful for support from the British Medical Association (BMA)
Specialty Registrar in Dermatology in Imperial College NHS Healthcare
Specialty Registrar in Gastroenterology in University College London Healthcare
Specialty Registrar in Obstetrics and Gynaecology in Imperial College NHS Healthcare