Pediatric Dermatology for People of Color

When evaluating pediatric patients of color, it is essential to consider the unique diagnostic and treatment factors that apply to this population. Certain dermatologic conditions are more common in these patients, including postinflammatory hyperpigmentation, pityriasis alba, progressive macular hypomelanosis, tinea capitis, traction alopecia, keloids, hypertrophic scars, pseudofolliculitis barbae, acne keloidalis nuchae, and hidradenitis suppurativa. Furthermore, conditions such as vitiligo are more noticeable in people of color. This can lead to a significantly diminished quality of life, so these conditions should be quickly recognized and treated. Notably, inflammation can be difficult to recognize on the skin of people of color, which can lead to the underestimation of severity as well as inappropriate treatment. Treatment recommendations can also differ based on lifestyle or cultural norms, such as the use of tinted sunscreens and the consideration of hair care practices. Pediatricians should be aware of these conditions and treatment considerations to best treat pediatric patients of color. [Pediatr Ann. 2024;53(4):e146-e151.].

Representation Matters

In the world of pediatrics, studies have shown that the majority of dermatology textbooks display pictures primarily of White skin.1 This lack of representation has led to pediatricians and dermatologists having less exposure to dermatologic conditions such as eczema in Black and Brown skin, even though studies show that it can be more prevalent in these populations.2 As such, trainees and others have advocated for and created more diverse picture libraries to better represent dermatologic presentations in various skin colors.3.

Gaps in medical education curricula on skin of color in medical school, residency, and beyond: Part 1

Various studies have revealed a disproportionately low representation of skin of color (SOC) dermatology in the medical education system of the United States. This disparity contributes to adverse experiences, missed and/or delayed diagnoses, and overall health inequities for individuals of color. The lack of sufficient SOC education begins at the medical school level and continues throughout residency, fellowship, and beyond formal training. This lack of education can be seen in the dearth of images of common and uncommon skin conditions in darker skin in widely used textbooks and educational resources as well as in the lack of formal training in SOC in many residency programs. Thus far, there have been valuable strides to make dermatologic education more inclusive of all skin colors, but there remains significant work to be done. With the population of the United States expected to continue to diversify and with the expectation that SOC will be a trait of over half of the population of the United States by 2050, it is important to strive for health equity by ensuring that comprehensive and inclusive medical training incorporates SOC. This paper will explore the issue of gaps in medical education in SOC dermatology at all levels and offer a strategic call to action to aid in rectifying this situation.

Effectiveness and Safety Analysis of Plasma Beam in the Treatment of Facial Depressed Scars

Objective

The study aimed to analyze the effectiveness and safety of microplasma beam in the treatment of facial depression scars.

Methods

106 patients with facial depression scars treated in the hospital between January 2017 and September 2021 were selected as the observation subjects. According to different treatment methods, the patients were divided into the control group (receiving ultrapulsed carbon dioxide lattice laser treatment, n = 51) and the observation group (undergoing plasma beam treatment, n = 55). The two groups were treated for 6 months, and the treatment effects were compared between the two groups. The Visual Analogue Scale (VAS) was used to compare the pain between the two groups, and the duration of pain and the time of scab shedding were recorded. The improvement of scars was compared between the two groups according to the Evaluation Clinique des Cicatrices d' Acne (ECCA), and the adverse reactions during treatment were compared between the two groups.

Results

A clinical effective rate of 94.55% in the observation group was higher than a clinical effective rate of 82.35% in the control group (P < 0.05). The VAS score in the observation group was lower than that in the control group, and the pain duration and the scab shedding time were shorter than those in the control group (P < 0.05). ECCA scores in the observation group after twice and 3 times of treatments were lower than those in the control group (P < 0.05). The total incidence rate of adverse reactions of 10.91% in the observation group was lower, whereas it was 25.49% in the control group (P > 0.05).

Conclusion

Plasma beam has a significant efficacy in the treatment of facial depressed scars, and it has mild pain, quick recovery, and high safety. Clinical Trial Registration Number. The clinical trial registration number is T2017081.

Recognizing Drug Hypersensitivity in Pigmented Skin

The imagery of pigmented skin is underrepresented in teaching materials such as textbooks, journals, and online references, and this has resulted in poorer diagnostic and management outcomes of skin pathology, including delayed cutaneous drug hypersensitivity reactions. In this review, we use clinical images to highlight factors that impact clinical presentations and sequelae of drug hypersensitivity reactions in pigmented skin compared with nonpigmented skin. We describe clinical features in some anatomic sites that aid diagnosis or are associated with more severe sequelae. Finally, we discuss strategies that may aid the diagnosis and management of these reactions in pigmented skin.

Skin of color images in pediatric dermatology textbooks

Due to globalization, dermatologists routinely see patients of different ethnicities and skin tones. Surveys from the US have shown that dermatologists felt that their training was lacking in diagnosing dermatoses in skin-of-color patients. Underrepresentation of skin of color in dermatology textbooks has been reported. We evaluated clinical images in selected pediatric dermatology textbooks with regard to skin color.