1
|
Ricciardo BM, Kessaris HL, Nannup N, Tilbrook D, Rind N, Douglas R, Ingrey J, Walton J, Michie C, Farrant B, Delaney E, Kumarasinghe SP, Carapetis JR, Bowen AC. Skin health of Aboriginal children living in urban communities. Australas J Dermatol 2024. [PMID: 39205508 DOI: 10.1111/ajd.14363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/25/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Skin concerns are frequent among urban-living Aboriginal children, yet specialist dermatology consultations are limited with studies highlighting the need for improved cultural security. Through newly established paediatric dermatology clinics at two urban Aboriginal Community Controlled Health Organisations (ACCHOs), we aimed to describe clinic and patient data, including disease frequencies and associations, to inform dermatology service provision and advocacy. METHODS A prospective cohort study of Aboriginal children and young people (CYP, 0-18 years) attending Aboriginal Health Practitioner (AHP) co-ordinated paediatric dermatology clinics at two urban ACCHOs. RESULTS Data were collected from 32 clinics over 19 months, with 335 episodes of care and a mean attendance rate of 74%. From 78 new patients, 72 (92%) were recruited into the study, only one of whom had previously received dermatologist assessment. Eczema, tinea or acne accounted for 47% (34/72) of referrals, and 60% of patients received their first appointment within 4 weeks of referral. In 47/72 (65%) consultations, the GP referral and dermatologist diagnosis concurred. The most frequent diagnoses (primary or secondary) at first consultation were atopic dermatitis (26%, 19/72), dermatophyte infections (25%, 18/72), acne (21%, 15/72), bacterial skin infections (18%, 13/72) and post-inflammatory dyspigmentation (18%, 13/72). Three categories of the 2022 Australasian College of Dermatologists curriculum (infections, eczema/dermatitis, pigmentary disorders) accounted for 59% of all diagnoses. CONCLUSIONS This study highlights the specialist dermatology needs of urban-living Aboriginal CYP. ACCHO-embedded dermatology clinics co-ordinated by AHPs demonstrated benefits for Aboriginal CYP in accessing care. Opportunities to embed dermatology practice within ACCHOs should be prioritised.
Collapse
Affiliation(s)
- Bernadette M Ricciardo
- University of Western Australia, Crawley, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
- Perth Children's Hospital, Nedlands, Western Australia, Australia
- Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Heather-Lynn Kessaris
- Perth Children's Hospital, Nedlands, Western Australia, Australia
- Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Noel Nannup
- University of Western Australia, Crawley, Western Australia, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Dale Tilbrook
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- Maalingup Aboriginal Gallery, Caversham, Western Australia, Australia
| | - Nadia Rind
- Derbarl Yerrigan Health Service Aboriginal Corporation, East Perth, Western Australia, Australia
| | - Richelle Douglas
- Derbarl Yerrigan Health Service Aboriginal Corporation, East Perth, Western Australia, Australia
| | - Jodie Ingrey
- South West Aboriginal Medical Service, Bunbury, Western Australia, Australia
| | - Jacinta Walton
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Carol Michie
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Brad Farrant
- University of Western Australia, Crawley, Western Australia, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Eloise Delaney
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - S Prasad Kumarasinghe
- University of Western Australia, Crawley, Western Australia, Australia
- Western Dermatology, Nedlands, Western Australia, Australia
| | - Jonathan R Carapetis
- University of Western Australia, Crawley, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
- Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Asha C Bowen
- University of Western Australia, Crawley, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
- Perth Children's Hospital, Nedlands, Western Australia, Australia
| |
Collapse
|
2
|
Watters JJ, Bell MC, Slaven JE, Que SKT. Educational intervention targeting primary care residents improves skin cancer recognition in patients with skin of color. J Am Acad Dermatol 2024:S0190-9622(24)02715-4. [PMID: 39182682 DOI: 10.1016/j.jaad.2024.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 07/18/2024] [Accepted: 08/07/2024] [Indexed: 08/27/2024]
Affiliation(s)
- Jennifer J Watters
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, Indiana.
| | - Maria C Bell
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana
| | - James E Slaven
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, Indiana
| | - Syril Keena T Que
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana
| |
Collapse
|
3
|
Ahmed F, Maranga A, Lipoff JB. Underrepresentation of skin of color in dermatology grand rounds cases: A single-center retrospective study. J Am Acad Dermatol 2022; 87:e193-e194. [PMID: 35961422 DOI: 10.1016/j.jaad.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 10/31/2022]
Affiliation(s)
- Fahad Ahmed
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Abena Maranga
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jules B Lipoff
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania.
| |
Collapse
|