Misdiagnosis, decreased access to effective treatments, and underrepresentation in research studies are all issues that Black people with atopic dermatitis face.
Atopic Dermatitis in Black Patients
Atopic dermatitis (AD), also known as eczema, is a common condition that usually begins in childhood but can appear at any age. Inflammation, redness, and skin irritation are characteristics of AD. This chronic disease is more prevalent in non-Hispanic Black children, with females developing the disease slightly more often than males [1].
The Effects of Gene–Environment Interaction
Lower socioeconomic status, caregivers with lower educational attainment, limited access to green space, and living in segregated communities were given as examples of how systemic racism can have an adverse effect on Blacks suffering from AD. This gene-environment interaction is one possible explanation for the differences in AD severity in racial/ethnic groups [2].
Atopic Dermatitis and Misdiagnosis
Blacks risk being misdiagnosed with AD when it could be another disease. For example, due to its physical presentation on the body, mycosis fungoides (MF) is frequently misdiagnosed as AD in Black patients, according to a 2022 study published in Archives of Dermatological Research2. MF also has a higher incidence and poorer prognosis in Black patients, and misdiagnosis can lead to an incorrect course of treatment for patients with MF or AD.
Treatment Disparity in Patients with Atopic Dermatitis.
However, even with the correct diagnosis, Blacks may not receive access to effective medications. Although Black Americans suffer from AD at a higher rate, they are less likely to receive new recommended medications offered to White patients, according to a 2020 study published in the Journal of the National Medical Association [3].
Racial Disparities in Research
A review of research studies conducted July 2010–July 2015 involving AD and skin conditions found that overall, only 11.3% of international research studies and 59.8% of studies within the United States reported on the racial/ethnic demographics of their study participants [4]. Lack of transparency regarding the racial/ethnic makeup of the studies makes it difficult to determine if they were producing information that would provide an evidence-based course of treatment in the Black population.
References
1. National Institutes of Health. (2022, November ). Overview of Atopic Dermatitis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/atopic-dermatitis#:~:text=Atopic%20dermatitis%2C%20often%20referred%20to,the%20disease%20at%20any%20age
2. Narla, S., Heath, C. R., Alexis, A., & Silverberg, J. I. (2022). Racial disparities in dermatology. Archives for Dermatological Research. Archiv für Dermatologische Forschung, 1-9. https://doi.org/10.1007/s00403-022-02507-z
3. Bell, M. A., Whang, K. A., Thomas, J., Aguh, C., & Kwatra, S. G. (2020). Racial and Ethnic Disparities in Access to Emerging and Frontline Therapies in Common Dermatological Conditions: A Cross-Sectional Study. Journal of the National Medical Association, 112(6), 650-653. https://doi.org/10.1016/j.jnma.2020.06.009
4. Charrow, A., Xia, F. D., Joyce, C., & Mostaghimi, A. (2017). Diversity in Dermatology Clinical Trials: A Systematic Review. JAMA Dermatol, 153(2), 193-198. https://doi.org/10.1001/jamadermatol.2016.4129
