PURPOSE: To critically examine the roots and manifestations of dermatologic health disparities in Black, Indigenous, and People of Color (BIPOC).

SUMMARY: The aftermath of George Floyd’s murder in May 2020 and the critical contemplation of race and systemic racism that followed is considered a watershed moment in American history. Unfortunately, this deep-seated racism is a recurring theme in the long-silenced narrative of BIPOC communities in this country. A manifestation of this systemic racism within healthcare is the differential rates of morbidity and mortality for melanoma and non-melanoma skin cancer (NMSC) between White and BIPOC individuals. While dermatologic disparities in BIPOC communities are not limited to skin cancers, their disproportionate rates of morbidity and mortality calls for a critical reflection of (1) patient access to dermatologic care (2) inclusion of skin of color (SoC) in dermatologic medical education, as well as (3) the lack of pigmented skin in dermatologic research. 

CONCLUSION: Dermatologic health disparities between White individuals and BIPOC are indeed multifactorial. While the detection of melanotic lesions on SoC poses a challenge to diagnosis, it is far from adequately explaining the current disparity in dermatologic care that exists in communities of color. BIPOC patient access to dermatologic care is stifled by a shortage of dermatologists of color and a narrow Medi-Cal acceptance rate by dermatologists. Examination of dermatologic medical education textbooks reveals a paucity of dermatologic conditions represented on pigmented skin, with a problematic overrepresentation of pigmented skin for venereal diseases. Additionally, dermatologic research still lags in adequately recruiting and representing BIPOC. It is the responsibility of medical education institutions to recognize and rectify these disparities by: emphasizing dermatologic disparities, incorporating pigmented skin into the medical education curriculum, and on a systems level, increasing training of BIPOC dermatologists and the acceptance of under-insured patients.    

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