Racism in Dermatology

Recently, Laxmi Thapa was arrested as her son’s birthmarks were mistaken as bruises.

She had taken her child to the GP due to a concern about her son’s birthmark which had been noted in medical records as it was present on several parts of his body. Unfortunately, she was sent to the hospital where she was arrested by police due to suspected neglect and assault of her child. She spent 20 hours in a cell at Basingstoke Police Station until being released pending a medical report. From the BBC report, it can be seen that Miss Thapa felt like a criminal and although it was eventually confirmed that no assault had taken place, the misinterpretation of birthmarks or other skin conditions still remain prevalent within dermatology. Whilst it was found necessary to carry out safeguarding in Miss Thapa’s case, the issue of the lack of representation and diversity is prevalent within the medical curriculum. This is demonstrated through the lack of representation of darker skin in medical textbooks and journals, which would offer a well-needed wider education on how different skin conditions look on different skin types.

The absence of inclusion can lead to harm in patient outcomes - like what Miss Thapa had experienced. It is important to ensure dermatology education includes black, indigenous, people of colour (BIPOC) as healthcare education ultimately needs to be inclusive.

This was also particularly an issue during the COVID-19 pandemic, as it was learnt that rashes on the skin and toes were a symptom, although there was no presence of what these rashes would like on black skin. As a result, Jenna Lester (a dermatologist) was not able to identify these rashes on her patients. An analysis of textbooks at the University of Pennsylvania demonstrated that the percentage of images of dark skin ranged from 4% to 18%.


It may seem interesting how the field that deals with skin and its diseases has not yet evolved into becoming fully applicable for all regardless of race and skin colour, so it is important to remember that these fundamental inequalities within healthcare still exist and will continue to exist if drastic changes to the medical curriculum are not made. BIPOCs should not be subject to any disparities within healthcare due to the medical curriculum being faulty. However, there are efforts arising to ensure that dermatology becomes more inclusive to avoid these unfortunate events from continuing. For example, ‘Mind the Gap’ is a clinical handbook that shows skin conditions in black and brown skin created by a medical student who noticed a lack of teaching about darker skin.


Written by Aaliyah

Moderated by Adelene


References:

Yousuf, Y. and Yu, J.C. (2021). Improving Representation of Skin of Color in a Medical School Preclerkship Dermatology Curriculum. Medical Science Educator, 32. doi:https://doi.org/10.1007/s40670-021-01473-x.
McFarling, U.L. (2020). Lack of darker skin in textbooks, journals harms patients of color. [online] STAT. Available at: https://www.statnews.com/2020/07/21/dermatology-faces-reckoning-lack-of-darker-skin-in-textbooks-journals-harms-patients-of-color/.
BBC News. (2024). Blue spot: Mum held in police cell after birthmark mistake. [online] Available at: https://www.bbc.co.uk/news/articles/cy08elppe83o [Accessed 15 July 2024].
Rimmer, A. (2020). Presenting clinical features on darker skin: five minutes with . . . Malone Mukwende. BMJ, p.m2578. doi:https://doi.org/10.1136/bmj.m2578..