Skin of Colour Resource
Introduction by Dr Sharon Belmo, Clinical Lead for the Skin of Colour Resource
Ethnic dermatology or dermatology for skin of color, is a relatively new facet of dermatology that has expanded in recent years. The field encompasses skin and hair disorders amongst non-white populations, i.e., those of African, Asian, Middle-Eastern or Hispanic/Latino descent, also taking inter-racial mixing into account.
"Conventional"' dermatology taught and practised in the Western world has largely focused on lightly pigmented, Eurocentric skin types with little emphasis on variation amongst ethnic groups. The demographics of the Western world however, are rapidly diversifying.
The US Census Bureau’s 2014 National Projections suggest that by 2060, the proportion of the white population will decrease from 62% to 44% of the total US population, while the non-white "minority" population will increase from 38% to 56%. The mixed population is projected to be the fastest growing non-white group, with a predicted 226% increase in numbers over the next 46 years. The second fastest growing non-white group, the Asian group, is predicted to increase by 128%. It is believed that the USA will become a "majority minority" nation.
Likewise, for the UK the TREND-EF projection predicts that by 2051 the proportion of the white population will have decreased from 92% to 79%, while the black and ethnic minority population will have increased from 8% to 21%. The mixed group is expected to grow by between 148 and 249%, and the Asian group by between 95% and 153%.
Dermatological conditions often differ in those with pigmented skin with regards to clinical presentation, predisposing factors and prognosis. Additionally, there are some disorders that are more common and/or unique in specific ethnic groups.
As global demographics continue to diversify, western dermatologists will increasingly encounter a plethora of skin and hair disorders in the non-white population. Many of these disorders may vary clinically, and good quality information on them might be missing or limited in contemporary general dermatology textbooks. Dermatologists are subsequently faced with a multitude of diagnostic challenges and with a lack of evidence based reference guides, there is potential for substandard patient care.
In the interests of quality and professionalism, it is important that all dermatologists recognise the increasing need for ethnic dermatology and further research in this field to fill the many knowledge gaps that exist.
To help fill this gap, we at the Centre of Evidence Based Dermatology present to you the Skin of Colour Resource: an extension of our Centre’s work that is solely focused on skin of colour. The purpose of this resource is to provide health care professionals with regularly updated, comprehensive evidence based information in the form of systematic reviews, review articles, guidelines and patient information leaflets, complemented where possible by good quality clinical images kindly supplied by DermNet NZ. Our recommendations for relevant textbooks and websites are also listed.
In this resource you will find a wide-ranging list of disorders that are unique, prevalent or clinically variable in pigmented skin. For vitiligo, please see our separate mapping of systematic reviews on vitiligo by topic.
To the best of our knowledge, this is the first comprehensive online resource of this type. It is our hope that it will serve as an invaluable tool to health care professionals, stimulating interest, good patient care and research. Our demographics are changing. It is time for dermatology to catch up!
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