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Small L, Mellins C. Mental Health and Treatment Engagement among Low-Income Women of Color Living with HIV. Soc Work Public Health 2024; 39:393-404. [PMID: 38535437 DOI: 10.1080/19371918.2024.2323693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Low-income women of color are disproportionately more likely to contract HIV, struggle with treatment adherence, and have compromised health as a result of HIV infections in comparison to White and more affluent women. The current study is a secondary analysis aimed at examining the association between stress, symptoms of depression, trauma exposure, healthcare engagement, and adherence self-efficacy, among low-income women of color with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). Structural equation modeling is used to identify latent mental health symptoms that may influence one another, as well as outcomes involving treatment engagement. Participants contributing to this dataset (n = 134) were low income, women of color (primarily African American) living with HIV or AIDS, receiving care at a major medical center in the northeastern United States. Findings indicate significant indirect associations between perceived stress and the outcome of medical appointment attendance. Significant mediators of this indirect relationship include depressive symptoms, parenting stress, and adherence self-efficacy. Implications for health and behavioral health practice and policy interventions are drawn. Areas in need of future research are identified.
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Affiliation(s)
- Latoya Small
- UCLA Luskin School of Public Affairs, Department of Social Welfare, Los Angeles, California, USA
| | - Claude Mellins
- Medical Psychology (in Sociomedical Sciences and Psychiatry), Columbia University and New York State Psychiatric Institute, New York, USA
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2
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Juarez MC, Pulavarty A, Doudican N, Lee N, Stevenson ML, Carucci JA, Criscito MC. Tumor size associated with upstaged cutaneous squamous cell carcinoma in patients with skin of color. J Am Acad Dermatol 2024; 90:1048-1051. [PMID: 38215794 DOI: 10.1016/j.jaad.2023.12.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 12/03/2023] [Accepted: 12/22/2023] [Indexed: 01/14/2024]
Affiliation(s)
- Michelle C Juarez
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Akshay Pulavarty
- New York University Grossman School of Medicine, New York, New York
| | - Nicole Doudican
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Nayoung Lee
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Mary L Stevenson
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - John A Carucci
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Maressa C Criscito
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York.
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Hafez SY, Alraddadi EA, Ramadan M, Alsalamah F, Alghumuy R, Aljuhani FF. Assessment of prevalence of sunscreen use and related practices among people living in Saudi Arabia: A cross-sectional survey-based study. J Cosmet Dermatol 2024; 23:1718-1725. [PMID: 38234195 DOI: 10.1111/jocd.16191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND The use of sunscreen significantly reduces the risk of skin cancer and helps maintain skin health; however, improper use can decrease its effectiveness. This study aimed to investigate the prevalence and factors associated with sunscreen use in Saudi Arabia as well as identifying areas of weakness in sunscreen practices. METHODS A cross-sectional survey-based study was conducted with a diverse population sample in Saudi Arabia. Participants were asked about their sunscreen usage habits, motivations, and knowledge of proper application techniques. Demographic information, including age, gender, and skin type, were also collected. RESULTS A total of 2321 individuals participated in the study. More than two-thirds of the participants reported using sunscreen either always, regularly, or often, primarily to maintain a light skin color and prevent skin cancer. Factors associated with sunscreen use included younger age (18-40 years old), female gender, history of sunburn, and fair skin. Despite the majority reporting healthy sun exposure habits, several shortcomings were identified in sunscreen practices, including incorrect application and suboptimal reapplication frequency. CONCLUSION While sunscreen use is common among the study population, there is a need for improved education on proper application techniques. National awareness campaigns, especially those utilizing popular social media and digital platforms in Saudi Arabia, should focus on disseminating accurate sunscreen use guidelines to maximize sun protection and skin health.
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Affiliation(s)
- Salwa Y Hafez
- College of Nursing, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Ministry of National Guard - Health Affairs, Jeddah, Saudi Arabia
| | - Eman A Alraddadi
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Ministry of National Guard - Health Affairs, Jeddah, Saudi Arabia
- Department of Basic Sciences, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Majed Ramadan
- Ministry of National Guard - Health Affairs, Jeddah, Saudi Arabia
- Population Health Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Faris Alsalamah
- Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Raghad Alghumuy
- College of Nursing, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Faisal F Aljuhani
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Collage of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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Dermody SM, Kahng PW, Rao VM, Casper KA, Malloy KM, Rosko AJ, Stucken CL, Chinn SB, Spector ME, Feng AL. Color Match following Free Flap Surgery in Head and Neck Reconstruction: A Colorimetric and Aesthetic Analysis. Plast Reconstr Surg 2024; 153:1142-1150. [PMID: 37285194 DOI: 10.1097/prs.0000000000010807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Many options for free tissue transfer have been described for head and neck reconstruction. Although functional outcomes remain paramount, aesthetic considerations such as color match can be equally consequential for patient quality of life. It is important to understand differences in color match based on flap donor site for head and neck reconstruction. METHODS A retrospective review was performed of patients who underwent head and neck reconstruction with free tissue transfer at a tertiary care academic medical center between November of 2012 and November of 2020. Patients with documented photographs of their reconstruction and external skin paddles were considered. Patient demographics and surgery-specific factors were recorded. Objective differences in color match were obtained by calculating the International Commission on Illumination Delta E 2000 (dE2000) score. Standard univariate descriptive statistics and multivariable statistical analyses were performed. RESULTS Lateral arm, parascapular, and medial sural artery perforator free tissue transfer performed favorably compared with other donor sites, whereas anterolateral thigh flaps had the highest average dE2000 scores. Differences in dE2000 scores were mitigated by postoperative irradiation of the flap site and with increasing time beyond 6 months postoperatively. CONCLUSIONS The authors provide an objective assessment of external skin color match in patients undergoing free tissue transfer for head and neck cancer by donor site. Medial sural artery perforator, lateral arm, and parascapular free flaps performed well compared with traditional donor sites. These differences are more significant at the face and mandible when compared with the neck, but they diminish 6 months after surgery and with postoperative irradiation of the free flap skin paddle. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, III.
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Affiliation(s)
- Sarah M Dermody
- From the Department of Otolaryngology-Head and Neck Surgery, University of Michigan
| | - Peter W Kahng
- From the Department of Otolaryngology-Head and Neck Surgery, University of Michigan
| | - Vishwanatha M Rao
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear
| | - Keith A Casper
- From the Department of Otolaryngology-Head and Neck Surgery, University of Michigan
| | - Kelly M Malloy
- From the Department of Otolaryngology-Head and Neck Surgery, University of Michigan
| | - Andrew J Rosko
- From the Department of Otolaryngology-Head and Neck Surgery, University of Michigan
| | - Chaz L Stucken
- From the Department of Otolaryngology-Head and Neck Surgery, University of Michigan
| | - Steven B Chinn
- From the Department of Otolaryngology-Head and Neck Surgery, University of Michigan
| | - Matthew E Spector
- From the Department of Otolaryngology-Head and Neck Surgery, University of Michigan
| | - Allen L Feng
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School
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Maher PJ, Goel NN, Horowitz CR, Rea M, Figueiro MG, Richardson LD. Survey in emergency medicine of skin pigmentation bias in pulse oximeters. Am J Emerg Med 2024; 79:209-211. [PMID: 38461101 DOI: 10.1016/j.ajem.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 03/11/2024] Open
Affiliation(s)
- Patrick J Maher
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
| | - Neha N Goel
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
| | - Carol R Horowitz
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, New York NY, USA.
| | - Mark Rea
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Light and Health Research Center, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York NY, USA.
| | - Mariana G Figueiro
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Light and Health Research Center, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York NY, USA.
| | - Lynne D Richardson
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, New York NY, USA.
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Martin D, Johns C, Sorrell L, Healy E, Phull M, Olusanya S, Peters M, Fabes J. Effect of skin tone on the accuracy of the estimation of arterial oxygen saturation by pulse oximetry: a systematic review. Br J Anaesth 2024; 132:945-956. [PMID: 38368234 DOI: 10.1016/j.bja.2024.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/10/2024] [Accepted: 01/19/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND Pulse oximetry-derived oxygen saturation (SpO2) is an estimate of true arterial oxygen saturation (SaO2). The aim of this review was to evaluate available evidence determining the effect of skin tone on the ability of pulse oximeters to accurately estimate SaO2. METHODS Published literature was screened to identify clinical and non-clinical studies enrolling adults and children when SpO2 was compared with a paired co-oximetry SaO2 value. We searched literature databases from their inception to March 20, 2023. Risk of bias (RoB) was assessed using the QUADAS-2 tool. Certainty of assessment was evaluated using the GRADE tool. RESULTS Forty-four studies were selected reporting on at least 222 644 participants (6121 of whom were children) and 733 722 paired SpO2-SaO2 measurements. Methodologies included laboratory studies, prospective clinical, and retrospective clinical studies. A high RoB was detected in 64% of studies and there was considerable heterogeneity in study design, data analysis, and reporting metrics. Only 11 (25%) studies measured skin tone in 2353 (1.1%) participants; the remainder reported participant ethnicity: 68 930 (31.0%) participants were of non-White ethnicity or had non-light skin tones. The majority of studies reported overestimation of SaO2 by pulse oximetry in participants with darker skin tones or from ethnicities assumed to have darker skin tones. Several studies reported no inaccuracy related to skin tone. Meta-analysis of the data was not possible. CONCLUSIONS Pulse oximetry can overestimate true SaO2 in people with darker skin tones. The clinical relevance of this bias remains unclear, but its magnitude is likely to be greater when SaO2 is lower. SYSTEMATIC REVIEW PROTOCOL International Prospective Register of Systematic Reviews (PROSPERO): CRD42023390723.
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Affiliation(s)
- Daniel Martin
- Peninsula Medical School, University of Plymouth, John Bull Building, Plymouth, UK; Intensive Care Unit, University Hospitals Plymouth, Plymouth, UK.
| | - Chris Johns
- Library & Digital Support, University of Plymouth, Drake Circus, Plymouth, UK
| | - Lexy Sorrell
- Peninsula Medical School, University of Plymouth, John Bull Building, Plymouth, UK
| | - Eugene Healy
- Dermatopharmacology, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Dermatology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mandeep Phull
- Barking, Havering and Redbridge University Trust, Romford, UK; William Harvey Research Institute, Queen Mary University London, London, UK
| | | | - Mark Peters
- Paediatric Intensive Care Unit, Great Ormond Street Hospital for Children NHS Foundation Trust and NIHR Biomedical Research Centre, London, UK; University College London Great Ormond St Institute of Child Health, London, UK
| | - Jeremy Fabes
- Peninsula Medical School, University of Plymouth, John Bull Building, Plymouth, UK; Anaesthetic Department, University Hospitals Plymouth, Plymouth, UK
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Downing NR, Scafide KN, Ali Z, Hayat MJ. Visibility of inflicted bruises by alternate light: Results of a randomized controlled trial. J Forensic Sci 2024; 69:880-887. [PMID: 38323488 DOI: 10.1111/1556-4029.15481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/08/2024]
Abstract
Difficulty visualizing bruises resulting from interpersonal violence, especially in individuals with dark skin, contributes to disparities in access to justice. The purpose of this analysis was to compare bruise visibility of detected injuries using white light versus alternate light sources (ALS). Visibility was assessed using the 5-point Bruise Visibility Scale (BVS) for white light and the ALS Visibility Scale (AVS) for ALS. Bruises were induced using controlled application of a paintball to the upper arm on 157 healthy adults across six skin color categories. Using a crossover design, the light source used first to assess the bruise (white light or ALS) was randomized. Each bruise was examined up to 21 times over 4 weeks using white light and 10 combinations of wavelengths (350 nanometer [nm] - 535 nm) and colored filters (yellow, orange, and red). Multilevel modeling was used to analyze the repeated measures data with a total 20,103 bruise assessments. Results revealed 415 nm with yellow filter resulted in an almost 0.5-point increase in BVS/AVS score across all skin colors (Estimate = 0.46; 95% CI: 0.43, 0.49; p < 0.001), a clinically significant improvement in ability to visualize bruises. Conversely, 515 nm (Estimate = -0.80; 95% CI: -0.84, -0.76; p < 0.001) and 535 nm (Estimate = -0.64, 95% CI: -0.67, -0.60; p < 0.001) with red filter resulted in more than 0.5-point decrease in BVS/AVS score. The use of ALS is supported by the data and results in improved bruise visibility during medical forensic examinations.
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Affiliation(s)
- Nancy R Downing
- School of Nursing, Texas A&M University Health Sciences Center, Bryan, Texas, USA
| | | | - Zahra Ali
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Matthew J Hayat
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
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Jean-Pierre P, Nouri K. Skin of color representation of skin cancer is minimal on the internet: a Google images search analysis. Arch Dermatol Res 2024; 316:132. [PMID: 38662048 DOI: 10.1007/s00403-024-02894-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 03/20/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Affiliation(s)
- Philippe Jean-Pierre
- Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, 1150 NW 14th Street, Suite 500, Miami, FL, 33136, USA.
| | - Keyvan Nouri
- Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, 1150 NW 14th Street, Suite 500, Miami, FL, 33136, USA
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Poondru S, Yang LJ, Kundu RV. Use of complementary and alternative medicine in vitiligo: a cross-sectional survey. Arch Dermatol Res 2024; 316:126. [PMID: 38652183 DOI: 10.1007/s00403-024-02872-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 02/20/2024] [Accepted: 04/07/2024] [Indexed: 04/25/2024]
Abstract
Vitiligo is characterized by skin depigmentation, which can lead to profound psychological effects and decreased quality of life, especially for those with skin of color. Individuals with vitiligo may utilize complementary and alternative medicine (CAM) due to limited treatment options with varying efficacy.An anonymous, multiple-choice, cross-sectional questionnaire was distributed to participants with vitiligo in the United States through online forums. Data on disease characteristics, use of prescription medications, use of topical therapies, supplements, and diets, and perceptions of CAM were collected.In total, 625 respondents completed the survey. Overall, 32.5% of participants (203/625) have tried CAM. Commonly reported CAM include supplements of vitamin D (57.7%, 116/203), vitamin B12 (46.3%, 93/203), vitamin C (27.4%, 55/203), topical Nigella sativa oil (26.4%, 53/203), oral omega-3 fatty acids (24.9%, 50/203), folic acid (22.9%, 46/203), and vitamin E (22.9%, 46/203). Frequently cited reasons for CAM use include desire to try "new" (40.4%, 82/203) or "more natural" (26.6%, 54/203) therapies, "frustration with conventional medicine" (24.6%, 50/203), and fear of "adverse side effects of conventional medicine" (23.6%, 48/203). Non-White participants were more likely than their White counterparts to report CAM use and have more positive perceptions of CAM therapies. Less than half (43.3%, 88/203) of CAM users reported that they disclosed their use of CAM with their physician.Dermatologists should be mindful of CAM and ask patients about their use. Further investigation of the role of CAM as adjuvant therapy for vitiligo is warranted to better advise patients.
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Affiliation(s)
- Sneha Poondru
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N St Clair Street, Suite 1600, Chicago, IL, 60611, USA
| | - Lynna J Yang
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N St Clair Street, Suite 1600, Chicago, IL, 60611, USA
| | - Roopal V Kundu
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N St Clair Street, Suite 1600, Chicago, IL, 60611, USA.
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Oyesiku L, Dlova N, Ahmed S, Owen DR, Ingram JR, Freeman E, Jablonski NG. Inclusive and equitable language for skin colour in the British Journal of Dermatology: acknowledging our past and laying the foundations to move forward. Br J Dermatol 2024; 190:605-607. [PMID: 38477822 DOI: 10.1093/bjd/ljae064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Indexed: 03/14/2024]
Affiliation(s)
- Linda Oyesiku
- Department of Dermatology, University of Washington School of Medicine, Seattle, WA, USA
| | - Ncoza Dlova
- Department of Dermatology, University of KwaZulu-Natal, Durban, South Africa
| | | | - David R Owen
- British Association of Dermatologists, London, UK
| | - John R Ingram
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Esther Freeman
- Department of Dermatology, Harvard Medical School, Boston, MA, USA
| | - Nina G Jablonski
- Department of Anthropology, Pennsylvania State University, University Park, PA, USA
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Krefting F, Moelleken M, Hölsken S, Placke JM, Eisenburger RT, Albrecht LJ, Tasdogan A, Schadendorf D, Ugurel S, Dissemond J, Sondermann W. Comparison of visual diagnostic accuracy of dermatologists practicing in Germany in patients with light skin and skin of color. Sci Rep 2024; 14:8740. [PMID: 38627499 PMCID: PMC11021442 DOI: 10.1038/s41598-024-59426-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 04/10/2024] [Indexed: 04/19/2024] Open
Abstract
Visual clinical diagnosis of dermatoses in people of color (PoC) is a considerable challenge in daily clinical practice and a potential cause of misdiagnosis in this patient cohort. The study aimed to determine the difference in visual diagnostic skills of dermatologists practicing in Germany in patients with light skin (Ls) and patients with skin of color (SoC) to identify a potential need for further education. From April to June 2023, German dermatologists were invited to complete an online survey with 24 patient photographs depicting 12 skin diseases on both Ls and SoC. The study's primary outcomes were the number of correctly rated photographs and the participants' self-assessed certainty about the suspected visual diagnosis in Ls compared to SoC. The final analysis included surveys from a total of 129 dermatologists (47.8% female, mean age: 39.5 years). Participants were significantly more likely to correctly identify skin diseases by visual diagnostics in patients with Ls than in patients with SoC (72.1% vs. 52.8%, p ≤ 0.001, OR 2.28). Additionally, they expressed higher confidence in their diagnoses for Ls than for SoC (73.9 vs. 61.7, p ≤ 0.001). Therefore, further specialized training seems necessary to improve clinical care of dermatologic patients with SoC.
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Affiliation(s)
- Frederik Krefting
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Maurice Moelleken
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Stefanie Hölsken
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, 45122, Essen, Germany
- Center of Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, 45122, Essen, Germany
| | - Jan-Malte Placke
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Robin Tamara Eisenburger
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Lea Jessica Albrecht
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Alpaslan Tasdogan
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Dirk Schadendorf
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
- German Cancer Consortium, Partner Site Essen, Essen, Germany
- Research Alliance Ruhr, Research Center One Health, University Duisburg-Essen, Essen, Germany
- National Center for Tumor Diseases (NCT-West), Campus Essen, Essen, Germany
| | - Selma Ugurel
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Joachim Dissemond
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Wiebke Sondermann
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany.
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12
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Parker JE, Enders CK, Fitzpatrick SL, Mahasin S M, Laraia BA, Epel ES, Tomiyama AJ. Longitudinal associations between adolescent skin color satisfaction and adult health outcomes in Black women. Health Psychol 2024; 43:289-297. [PMID: 38059930 PMCID: PMC10939857 DOI: 10.1037/hea0001336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
OBJECTIVE Although emerging studies examine the inverse relationship between body satisfaction and disordered eating for Black women, it has not been established how racially salient aspects of body satisfaction may have implications for eating behaviors and longitudinal health outcomes. METHOD In a longitudinal sample of 455 Black women, we examined whether skin color satisfaction across ages 10-15 was directly related to adult health outcomes at age 40 (e.g., disordered eating, self-esteem, self-reported health, depressive symptoms, and cardiovascular risk). We also investigated the indirect impact of skin color satisfaction on adult health, mediated by body satisfaction, and binge eating. RESULTS No significant direct or indirect effects of adolescent skin color satisfaction were observed for depressive symptoms or cardiovascular health outcomes. At ages 10 and 12, skin color satisfaction had negative and positive direct effects, respectively, on self-esteem. At age 15, greater skin color satisfaction was directly associated with greater self-reported health. Post hoc analyses revealed that when additionally accounting for adolescent body satisfaction, greater skin color satisfaction was indirectly associated with greater self-esteem and self-reported health, alongside lower cardiovascular risk. CONCLUSIONS Although previous research suggests that in adolescence, Black girls' skin color satisfaction affects both body satisfaction and disordered eating behaviors, this association does not hold into midlife. Rather, post hoc analyses suggest that the lasting effects of adolescent skin color satisfaction are mediated by the longitudinal stability of body satisfaction, which in turn, is associated with adult health outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Craig K. Enders
- University of California Los Angeles, Department of Psychology
| | | | - Mujahid Mahasin S
- University of California Berkeley, School of Public Health, Division of Epidemiology
| | - Barbara A. Laraia
- University of California Berkeley School of Public Health, Division of Public Health Nutrition
| | - Elissa S. Epel
- University of California San Francisco, Department of Psychiatry and Behavioral Sciences
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13
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Gosch ME, McMichael AJ, Niehaus AG, Sangüeza OP. Progressive Hyperpigmentation on the Face in a Skin of Color Woman: Challenge. Am J Dermatopathol 2024; 46:e25-e26. [PMID: 38488352 DOI: 10.1097/dad.0000000000002670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Affiliation(s)
- Marianne E Gosch
- Department of Dermatology, Hospital del Salvador, Providencia, Santiago, Chile
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC; and
| | - Amy J McMichael
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC; and
| | - Angela G Niehaus
- Department of Pathology, Wake Forest Baptist Health, Medical Center Boulevard, Winston-Salem, NC
| | - Omar P Sangüeza
- Department of Pathology, Wake Forest Baptist Health, Medical Center Boulevard, Winston-Salem, NC
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14
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Shahin MM, Quach HT, Marathe KS. Pediatric Dermatology for People of Color. Pediatr Ann 2024; 53:e146-e151. [PMID: 38574070 DOI: 10.3928/19382359-20240205-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
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.].
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15
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Zhang R, Pu W, Zhang X, Di Y, Xu J, Zhu M, Tan Y, Liu W, Krutmann J, Wang J, Ma Y. Blue light protection factor: a method to assess the protective efficacy of cosmetics against blue light-induced skin damage in the Chinese population. Photochem Photobiol Sci 2024; 23:711-718. [PMID: 38430370 DOI: 10.1007/s43630-024-00546-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 02/05/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Previous studies have shown that visible light (VL), especially blue light (BL), could cause significant skin damage. With the emergence of VL protection products, a harmonization of light protection methods has been proposed, but it has not been widely applied in the Chinese population. OBJECTIVE Based on this framework, we propose an accurate and simplified method to evaluate the efficacy of BL photoprotection for the Chinese population. METHODS All subjects (n = 30) were irradiated daily using a blue LED light for four consecutive days. Each irradiation dose was 3/4 MPPD (minimum persistent pigmentation darkening). The skin pigmentation parameters, including L*, M, and ITA°, were recorded. We proposed the blue light protection factor (BPF) metric based on the skin pigmentation parameters to evaluate the anti-blue light efficacies of different products. RESULTS We found that the level of pigmentation rose progressively and linearly as blue light exposure increased. We proposed a metric, BPF, to reflect the anti-blue light efficacy of products based on the linear changes in skin pigment characteristics following daily BL exposure. Moreover, we discovered that the BPF metric could clearly distinguish the anti-blue light efficacies between two products and the control group, suggesting that BPF is an efficient and simple-to-use metric for anti-blue light evaluation. CONCLUSION Our study proposed an accurate and simplified method with an easy-to-use metric, BPF, to accurately characterize the anti-blue light efficacies of cosmetic products, providing support for further development of anti-blue light cosmetics.
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Affiliation(s)
- Rui Zhang
- Human Phenome Institute, Fudan University, Shanghai, China
- Department of Skin and Cosmetic Research, Shanghai Skin Disease Hospital, Shanghai, China
| | - Weilin Pu
- Human Phenome Institute, Fudan University, Shanghai, China
- Greater Bay Area Institute of Precision Medicine (Guangzhou), School of Life Sciences, Fudan University, Guangzhou, 511458, China
| | - Xinyuan Zhang
- Shanghai Skinshield Clinical Testing and Technological Research Ltd., Shanghai, China
| | - Ye Di
- SHISEIDO China Co., Ltd, Shanghai, China
| | - Jing Xu
- SHISEIDO China Co., Ltd, Shanghai, China
| | - Meiyan Zhu
- SHISEIDO China Co., Ltd, Shanghai, China
| | - Yimei Tan
- Human Phenome Institute, Fudan University, Shanghai, China
- Department of Skin and Cosmetic Research, Shanghai Skin Disease Hospital, Shanghai, China
| | - Wei Liu
- Department of Dermatology, Air Force General Hospital, Beijing, China
| | - Jean Krutmann
- Human Phenome Institute, Fudan University, Shanghai, China
- IUF Leibniz Research Institute for Environmental Medicine, Dusseldorf, Germany
| | - Jiucun Wang
- Human Phenome Institute, Fudan University, Shanghai, China.
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.
- Research Unit of Dissecting the Population Genetics and Developing New Technologies for Treatment and Prevention of Skin Phenotypes and Dermatological Diseases (2019RU058), Chinese Academy of Medical Sciences, Beijing, China.
- Institute for Six-Sector Economy, Fudan University, Shanghai, 200433, China.
| | - Yanyun Ma
- Human Phenome Institute, Fudan University, Shanghai, China.
- Research Unit of Dissecting the Population Genetics and Developing New Technologies for Treatment and Prevention of Skin Phenotypes and Dermatological Diseases (2019RU058), Chinese Academy of Medical Sciences, Beijing, China.
- Institute for Six-Sector Economy, Fudan University, Shanghai, 200433, China.
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16
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Fliorent R, Fardman B, Podwojniak A, Javaid K, Tan IJ, Ghani H, Truong TM, Rao B, Heath C. Artificial intelligence in dermatology: advancements and challenges in skin of color. Int J Dermatol 2024; 63:455-461. [PMID: 38444331 DOI: 10.1111/ijd.17076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/13/2024] [Accepted: 01/30/2024] [Indexed: 03/07/2024]
Abstract
Artificial intelligence (AI) uses algorithms and large language models in computers to simulate human-like problem-solving and decision-making. AI programs have recently acquired widespread popularity in the field of dermatology through the application of online tools in the assessment, diagnosis, and treatment of skin conditions. A literature review was conducted using PubMed and Google Scholar analyzing recent literature (from the last 10 years through October 2023) to evaluate current AI programs in use for dermatologic purposes, identifying challenges in this technology when applied to skin of color (SOC), and proposing future steps to enhance the role of AI in dermatologic practice. Challenges surrounding AI and its application to SOC stem from the underrepresentation of SOC in datasets and issues with image quality and standardization. With these existing issues, current AI programs inevitably do worse at identifying lesions in SOC. Additionally, only 30% of the programs identified in this review had data reported on their use in dermatology, specifically in SOC. Significant development of these applications is required for the accurate depiction of darker skin tone images in datasets. More research is warranted in the future to better understand the efficacy of AI in aiding diagnosis and treatment options for SOC patients.
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Affiliation(s)
| | - Brian Fardman
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA
| | | | - Kiran Javaid
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA
| | - Isabella J Tan
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Hira Ghani
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Thu M Truong
- Center for Dermatology, Rutgers Robert Wood Johnson, Somerset, NJ, USA
| | - Babar Rao
- Center for Dermatology, Rutgers Robert Wood Johnson, Somerset, NJ, USA
| | - Candrice Heath
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
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17
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Leeb G, Auchus I, Law T, Bickler P, Feiner J, Hashi S, Monk E, Igaga E, Bernstein M, Chou YC, Hughes C, Schornack D, Lester J, Moore K, Okunlola O, Fernandez J, Shmuylovich L, Lipnick M. The performance of 11 fingertip pulse oximeters during hypoxemia in healthy human participants with varied, quantified skin pigment. EBioMedicine 2024; 102:105051. [PMID: 38458110 PMCID: PMC10943300 DOI: 10.1016/j.ebiom.2024.105051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/19/2024] [Accepted: 02/23/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Fingertip pulse oximeters are widely available, inexpensive, and commonly used to make clinical decisions in many settings. Device performance is largely unregulated and poorly characterised, especially in people with dark skin pigmentation. METHODS Eleven popular fingertip pulse oximeters were evaluated using the US Food and Drug Administration (FDA) Guidance (2013) and International Organization for Standardization Standards (ISO, 2017) in 34 healthy humans with diverse skin pigmentation utilising a controlled desaturation study with arterial oxygen saturation (SaO 2) plateaus between 70% and 100%. Skin pigmentation was assessed subjectively using a perceived Fitzpatrick Scale (pFP) and objectively using the individual typology angle (ITA) via spectrophotometry at nine anatomical sites. FINDINGS Five of 11 devices had a root mean square error (ARMS) > 3%, falling outside the acceptable FDA performance range. Nine devices demonstrated worse performance in participants in the darkest skin pigmentation category compared with those in the lightest category. A commonly used subjective skin colour scale frequently miscategorised participants as being darkly pigmented when compared to objective quantification of skin pigment by ITA. INTERPRETATION Fingertip pulse oximeters have variable performance, frequently not meeting regulatory requirements for clinical use, and occasionally contradicting claims made by manufacturers. Most devices showed a trend toward worse performance in participants with darker skin pigment. Regulatory standards do not adequately account for the impact of skin pigmentation on device performance. We recommend that the pFP and other non-standardised subjective skin colour scales should no longer be used for defining diversity of skin pigmentation. Reliable methods for characterising skin pigmentation to improve diversity and equitable performance of pulse oximeters are needed. FUNDING This study was conducted as part of the Open Oximetry Project funded by the Gordon and Betty Moore Foundation, Patrick J McGovern Foundation, and Robert Wood Johnson Foundation. The UCSF Hypoxia Research Laboratory receives funding from multiple industry sponsors to test the sponsors' devices for the purposes of product development and regulatory performance testing. Data in this paper do not include sponsor's study devices. All data were collected from devices procured by the Hypoxia Research Laboratory for the purposes of independent research. No company provided any direct funding for this study, participated in study design or analysis, or was involved in analysing data or writing the manuscript. None of the authors own stock or equity interests in any pulse oximeter companies. Dr Ellis Monk's time utilised for data analysis, reviewing and editing was funded by grant number: DP2MH132941.
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Affiliation(s)
- Gregory Leeb
- Department of Anesthesia, University of California, San Francisco, USA
| | - Isabella Auchus
- Department of Anesthesia, University of California, San Francisco, USA.
| | - Tyler Law
- Department of Anesthesia, University of California, San Francisco, USA
| | - Philip Bickler
- Department of Anesthesia, University of California, San Francisco, USA
| | - John Feiner
- Department of Anesthesia, University of California, San Francisco, USA
| | - Shamsudini Hashi
- Department of Anesthesia, University of California, San Francisco, USA
| | - Ellis Monk
- Department of Sociology, Harvard University, USA
| | - Elizabeth Igaga
- Department of Anesthesia, College of Health Sciences, Makerere University, Uganda
| | | | - Yu Celine Chou
- Department of Anesthesia, University of California, San Francisco, USA
| | - Caroline Hughes
- Department of Anesthesia, University of California, San Francisco, USA
| | - Deleree Schornack
- Department of Anesthesia, University of California, San Francisco, USA
| | - Jenna Lester
- Department of Dermatology, University of California, San Francisco, USA
| | - Kelvin Moore
- University of California, San Francisco School of Medicine, USA
| | - Olubunmi Okunlola
- Department of Anesthesia, New York University Langone Hospital Brooklyn, USA
| | - Jana Fernandez
- Department of Anesthesia, University of California, San Francisco, USA
| | | | - Michael Lipnick
- Department of Anesthesia, University of California, San Francisco, USA; University of California, San Francisco Institute for Global Health Sciences, USA
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18
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Nguyen AW, Taylor HO, Keith VM, Qin W, Mitchell UA. Discrimination and social isolation among African Americans: The moderating role of skin tone. Cultur Divers Ethnic Minor Psychol 2024; 30:374-384. [PMID: 36441993 PMCID: PMC10225012 DOI: 10.1037/cdp0000569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES Discrimination is an urgent public health problem. A number of major cities and counties across the United States has declared racism a public health crisis. While there is a growing body of research on the discrimination-health connection, less is known regarding the social relational consequences of discrimination. The present study addresses this knowledge gap by investigating the relationship between discrimination, skin tone, and objective and subjective social isolation using a nationally representative sample of African Americans. METHOD This analysis was based upon the African American subsample (N = 3,570) of the National Survey of American Life. Discrimination was assessed with the Everyday Discrimination Scale. Objective and subjective isolation differentiated between respondents who were (a) socially isolated from both family and friends, (b) socially isolated from friends only, (c) socially isolated from family only, and (d) not socially isolated. Skin tone was self-reported. Multinomial logistic regression analyses were used to test the study hypotheses. RESULTS The analyses indicated that more frequent discriminatory experiences were associated with increased risk for subjective and objective social isolation. Skin tone moderated the association between discrimination and subjective isolation; the discrimination-isolation relationship was stronger among participants with darker skin tones. CONCLUSIONS These findings shed light on African Americans' nuanced experiences with discrimination and colorism. Further, the data demonstrate heterogeneity in the vulnerability to the adverse effects of discrimination within the African American population; the relationship between discrimination and subjective isolation was stratified by skin tone. This underscores the well-documented and persistent racialized social stratification system in the United States (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Ann W. Nguyen
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University
| | | | - Verna M. Keith
- Department of Sociology, University of Alabama at Birmingham
| | - Weidi Qin
- Populations Studies Center, University of Michigan
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19
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Gosch ME, McMichael AJ, Niehaus AG, Sangüeza OP. Progressive Hyperpigmentation on the Face in a Skin of Color Woman: Answer. Am J Dermatopathol 2024; 46:255-256. [PMID: 38488349 DOI: 10.1097/dad.0000000000002671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Affiliation(s)
- Marianne E Gosch
- Department of Dermatology, Hospital del Salvador, Providencia, Santiago, Chile
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC; and
| | - Amy J McMichael
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC; and
| | - Angela G Niehaus
- Department of Pathology, Wake Forest Baptist Health, Winston-Salem, NC
| | - Omar P Sangüeza
- Department of Pathology, Wake Forest Baptist Health, Winston-Salem, NC
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20
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Bui IT, Silfvast-Kaiser AS, Hudson A, Saad SS, Albahra SM. Hemorrhagic bullous IgA vasculitis in pediatric skin of color: an mpox mimicker. Int J Dermatol 2024; 63:541-542. [PMID: 38308487 DOI: 10.1111/ijd.17051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 01/03/2024] [Accepted: 01/12/2024] [Indexed: 02/04/2024]
Affiliation(s)
- Ian T Bui
- Texas A&M Health Science Center School of Medicine, Dallas, TX, USA
| | | | - Andrew Hudson
- Department of Dermatology, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Saadeddine S Saad
- Department of Dermatology, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Said M Albahra
- Department of Pathology, Baylor Scott & White Healthcare, Temple, TX, USA
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21
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Johnson J, Johnson AR, Andersen CA, Kelso MR, Oropallo AR, Serena TE. Skin Pigmentation Impacts the Clinical Diagnosis of Wound Infection: Imaging of Bacterial Burden to Overcome Diagnostic Limitations. J Racial Ethn Health Disparities 2024; 11:1045-1055. [PMID: 37039975 PMCID: PMC10933203 DOI: 10.1007/s40615-023-01584-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/22/2023] [Accepted: 03/31/2023] [Indexed: 04/12/2023]
Abstract
Underrepresentation of diverse skin tones in medical education and providers' implicit racial bias drives inequities in wound care, such as disproportionally poor outcomes for Black patients. Diagnostic indicators (e.g., erythema) can present differently depending on skin pigmentation. This post hoc analysis of 350 chronic wounds from a prospective 14-site clinical trial aimed to determine how the perception of clinical signs and symptoms of infection (CSS) differs by patient skin tone and if fluorescence-imaging can offer a more objective diagnostic solution. Participants were grouped by skin tone (low, medium, high) as measured by the Fitzpatrick Skin Phototype Classification (FSPC) scale. CSS and total bacterial load (TBL) were compared across FSPC groups, along with sensitivity to detect TBL >104 CFU/g using CSS alone and combined with fluorescence-imaging. Erythema was reported less often with increasing FSPC score (p = 0.05), from 13.4% (low), to 7.2% (medium), to 2.3% (high), despite comparable bacterial loads (median = 1.8 × 106 CFU/g). CSS sensitivity in the high group (2.9%) was 4.8-fold to 8.4-fold lower than the low (p = 0.003) and medium groups (p = 0.04). Fluorescence-imaging significantly improved the detection of high bacterial load in each group, peaking in the high group at 12-fold over CSS alone. These findings underscore the threat of pervasive racialized health inequities in wound care, where missed diagnosis of pathogenic bacteria and infection could delay treatment, increasing the risk of complications and poor outcomes. Fluorescence-imaging is poised to fill this gap, at least in part, serving as a more objective and equitable indicator of wound bacteria. Clinicaltrials.gov #NCT03540004 registered 16-05-2018.
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Affiliation(s)
- Jonathan Johnson
- Comprehensive Wound Care Services and Capital Aesthetic & Laser Center, Washington, DC, USA
| | - Alton R Johnson
- University of Michigan School of Medicine in the Division of Metabolism, Endocrinology and Diabetes-Podiatry, Ann Arbor, MI, USA
| | | | | | - Alisha R Oropallo
- Comprehensive Wound Healing Center and Hyperbarics, Northwell Health and Department of Vascular Surgery, Zucker School of Medicine Hofstra/Northwell, Hempstead, NY, USA
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22
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Goldust M. Progress and challenges of artificial intelligence in skin of color. Int J Dermatol 2024; 63:409-410. [PMID: 38345669 DOI: 10.1111/ijd.17071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 01/22/2024] [Indexed: 03/22/2024]
Affiliation(s)
- Mohamad Goldust
- Department of Dermatology, Yale University School of Medicine, New Haven, USA
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23
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Salmen NL, Menage K, Baumann AN, Curtis DP, Brodell RT. Skin color reporting in squamous cell carcinoma-related randomized controlled trials in top dermatology journals: a systematic review. Arch Dermatol Res 2024; 316:115. [PMID: 38554241 PMCID: PMC10981586 DOI: 10.1007/s00403-024-02843-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 01/27/2024] [Accepted: 02/09/2024] [Indexed: 04/01/2024]
Abstract
The objectives are to determine the frequency that skin color is reported in randomized controlled trials (RCTs) involving squamous cell carcinoma (SCC) detection and treatment in leading dermatology journals. A systematic review of RCTs involving SCC was conducted among the top ten most impactful dermatology journals from inception to July 10th, 2023. Studies were included if they reviewed the treatment, prevention, or detection of SCC, involved patients directly and were classified as traditional RCTs. Studies were considered positive for reporting SOC if there was any demographic data in the methods or results of the following terms: Fitzpatrick scale, race, ethnicity, sunburn tendency, or skin of color. Of the 39 studies which were identified, 23 reported data related to skin color data (59.0%). White individuals were the most reported in these studies (56.5%). Subgroup analysis was conducted, and no statistical significance was found for study location, year of publication, or funding source. Skin color impacts skin cancer detection, predominant location of tumors, and recurrence. Less than 60% of high-quality RCTs related to SCC in top global dermatology journals included skin color among the demographic traits of study participants. Subgroup analysis demonstrated no improvement in reporting over the past 2 decades. Further research is needed to understand the reason for low skin color reporting rates among SCC-related RCTs and the impact this has on society.
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Affiliation(s)
- Natasha L Salmen
- Northeast Ohio Medical University, Rootstown, OH, United States.
| | - Klarens Menage
- Northeast Ohio Medical University, Rootstown, OH, United States
| | | | - Deven P Curtis
- Northeast Ohio Medical University, Rootstown, OH, United States
| | - Robert T Brodell
- Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA
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24
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Liu L, Wang X, Zhang R, Li H, Zhu H. Correlation of skin color and plasma carotenoid-related metabolites of ornamental koi carp under temperature fluctuations. Ecotoxicol Environ Saf 2024; 273:116165. [PMID: 38458068 DOI: 10.1016/j.ecoenv.2024.116165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/13/2024] [Accepted: 02/27/2024] [Indexed: 03/10/2024]
Abstract
The skin color of koi carp (Cyprinus carpio L.) is one of the traits that most influence their ornamental and economic values. The present study suggested the effects of temperature fluctuation on koi carp in terms of skin color and plasma carotenoids and related-metabolites. The main results were as follows. (1) The vulnerability of koi skin color to acute temperature stress was in the order of white koi> black koi> yellow koi. Both high- (25°C-30°C-25°C) and low-temperature (25°C-20°C-25°C) fluctuations tended to decrease the saturation of white koi. The temperature fluctuation had little effects on the skin color of black and yellow koi. (2) Targeted metabolomics analysis indicated that the effects of cooling stress on oxycarotenoids of all five koi varieties were reversible. The plasma oxycarotenoids in mirror koi with all colors were insensitive to acute heat stress. However, the cooling process from a high temperature (30°C-25°C) still made contributions to the increase of oxycarotenoids. (3) The principal component analysis confirmed the deviation of carotenoid-related metabolites after high temperature fluctuation and the reversibility after low temperature fluctuation. Finally, the correlation analysis revealed that koi skin brightness was negatively correlated with the plasma guanine content and that temperature fluctuations might change koi skin brightness via the L(-)-epinephrine-guanine pathway. The red hue and yellow hue were negatively correlated with the oxycarotenoids in plasma, suggesting that oxycarotenoids were favorable for enhancing koi skin color saturation. Overall, this study revealed the direct action of temperature fluctuations on the skin color and carotenoid-related metabolites of koi.
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Affiliation(s)
- Lili Liu
- Fisheries Research Institute, Beijing Academy of Agriculture and Forestry Sciences, Beijing 100068, China; Beijing Key Laboratory of Fisheries Biotechnology, Beijing 100068, China
| | - Xiaowen Wang
- Fisheries Research Institute, Beijing Academy of Agriculture and Forestry Sciences, Beijing 100068, China; Beijing Key Laboratory of Fisheries Biotechnology, Beijing 100068, China
| | - Rong Zhang
- Fisheries Research Institute, Beijing Academy of Agriculture and Forestry Sciences, Beijing 100068, China; Beijing Key Laboratory of Fisheries Biotechnology, Beijing 100068, China
| | - Huijuan Li
- Fisheries Research Institute, Beijing Academy of Agriculture and Forestry Sciences, Beijing 100068, China; Beijing Key Laboratory of Fisheries Biotechnology, Beijing 100068, China
| | - Hua Zhu
- Fisheries Research Institute, Beijing Academy of Agriculture and Forestry Sciences, Beijing 100068, China; Beijing Key Laboratory of Fisheries Biotechnology, Beijing 100068, China.
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25
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Taylor S, Weinkle S, Kaufman-Janette J, Gallagher CJ, Kooken K, Brown J. Effectiveness and Safety of Resilient Hyaluronic Acid (RHA) Dermal Fillers for the Correction of Moderate-to-Severe Nasolabial Folds in People of Color: Post Hoc Subgroup Analyses of US Pivotal Clinical Data. Aesthet Surg J 2024; 44:412-420. [PMID: 37556827 PMCID: PMC10942799 DOI: 10.1093/asj/sjad251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 07/21/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND People of color (POC) are often underrepresented in clinical studies evaluating the safety and effectiveness of aesthetic products, including hyaluronic acid (HA) fillers, for which there is to date limited clinical data in POC. OBJECTIVES The aim of this study was to assess the safety and effectiveness of a new line of dynamic resilient HA fillers (RHA; Revance, Nashville, TN) for treating moderate-to-severe nasolabial folds (NLFs) in POC vs non-POC. METHODS Post hoc subgroup analyses compared the efficacy and safety of POC vs non-POC subjects treated with RHA2, RHA3, or RHA4 for correction of moderate-to-severe NLFs in the pooled per-protocol population (N = 217) in 2 clinical trials. Evaluated population cohorts were classified by Fitzpatrick skin type (FST) (high FST [IV-VI] vs low FST [I-III]) and by subject-reported race (non-White vs White) relative to baseline at 6, 9, 12, and 15 months. RESULTS POC consistently showed greater improvement in wrinkle severity and higher responder rates compared with non-POC, which reached statistical significance at several measured time points. Global Aesthetic Improvement Scale scores and subject satisfaction ratings were similar for POC and non-POC and remained high throughout the course of the study. Treatment-related adverse event rates were generally lower for high FSTs vs low FSTs, with no reported cases of keloidal scarring. CONCLUSION The RHA line of dynamic fillers is well tolerated and effective for the correction of moderate-to-severe NLFs in POC and can be confidently used in this important and growing patient population.See the abstract translated into Hindi, Portuguese, Korean, German, Italian, Arabic, Chinese, and Taiwanese online here: https://doi.org/10.1093/asj/sjad251. LEVEL OF EVIDENCE: 2
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Affiliation(s)
- Susan Taylor
- Corresponding Author: Dr Susan Taylor, 3400 Civic Center Blvd, South Tower 7-768, Philadelphia, PA 19104, USA. E-mail:
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Paul D, Todd A, Baum C. Squamous cell carcinoma incidence, demographics, and outcomes in skin of color patients. J Am Acad Dermatol 2024; 90:665-666. [PMID: 38008406 DOI: 10.1016/j.jaad.2023.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 11/28/2023]
Affiliation(s)
- Deborah Paul
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
| | - Austin Todd
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Christian Baum
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
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Benčević M, Habijan M, Galić I, Babin D, Pižurica A. Understanding skin color bias in deep learning-based skin lesion segmentation. Comput Methods Programs Biomed 2024; 245:108044. [PMID: 38290289 DOI: 10.1016/j.cmpb.2024.108044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND The field of dermatological image analysis using deep neural networks includes the semantic segmentation of skin lesions, pivotal for lesion analysis, pathology inference, and diagnoses. While biases in neural network-based dermatoscopic image classification against darker skin tones due to dataset imbalance and contrast disparities are acknowledged, a comprehensive exploration of skin color bias in lesion segmentation models is lacking. It is imperative to address and understand the biases in these models. METHODS Our study comprehensively evaluates skin tone bias within prevalent neural networks for skin lesion segmentation. Since no information about skin color exists in widely used datasets, to quantify the bias we use three distinct skin color estimation methods: Fitzpatrick skin type estimation, Individual Typology Angle estimation as well as manual grouping of images by skin color. We assess bias across common models by training a variety of U-Net-based models on three widely-used datasets with 1758 different dermoscopic and clinical images. We also evaluate commonly suggested methods to mitigate bias. RESULTS Our findings expose a significant and large correlation between segmentation performance and skin color, revealing consistent challenges in segmenting lesions for darker skin tones across diverse datasets. Using various methods of skin color quantification, we have found significant bias in skin lesion segmentation against darker-skinned individuals when evaluated both in and out-of-sample. We also find that commonly used methods for bias mitigation do not result in any significant reduction in bias. CONCLUSIONS Our findings suggest a pervasive bias in most published lesion segmentation methods, given our use of commonly employed neural network architectures and publicly available datasets. In light of our findings, we propose recommendations for unbiased dataset collection, labeling, and model development. This presents the first comprehensive evaluation of fairness in skin lesion segmentation.
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Affiliation(s)
- Marin Benčević
- J. J. Strossmayer University of Osijek, Faculty of Electrical Engineering, Computer Science and Information Technology Osijek, Kneza Trpimira 2B, Osijek, 31000, Croatia; Ghent University, Department of Telecommunications and Information Processing, TELIN-GAIM, St-Pietersnieuwstraat 41, Ghent, 9000, Belgium.
| | - Marija Habijan
- J. J. Strossmayer University of Osijek, Faculty of Electrical Engineering, Computer Science and Information Technology Osijek, Kneza Trpimira 2B, Osijek, 31000, Croatia
| | - Irena Galić
- J. J. Strossmayer University of Osijek, Faculty of Electrical Engineering, Computer Science and Information Technology Osijek, Kneza Trpimira 2B, Osijek, 31000, Croatia
| | - Danilo Babin
- Ghent University, Department of Telecommunications and Information Processing, imec-TELIN-IPI, St-Pietersnieuwstraat 41, Ghent, 9000, Belgium
| | - Aleksandra Pižurica
- Ghent University, Department of Telecommunications and Information Processing, TELIN-GAIM, St-Pietersnieuwstraat 41, Ghent, 9000, Belgium
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King WM, Fleischer NL, Operario D, Chatters LM, Gamarel KE. Inequities in the distribution of adverse childhood experiences and their association with health among transgender people of color. Child Abuse Negl 2024; 149:106654. [PMID: 38350400 DOI: 10.1016/j.chiabu.2024.106654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/18/2023] [Accepted: 01/10/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Racism and cisgenderism expose transgender people of color to adversity across the life course. However, little is known about the prevalence of adverse childhood experiences (ACEs) in this population or their association with health in comparison to other groups. OBJECTIVE Guided by the structural trauma framework, we examined race/ethnicity/gender group differences in the prevalence of ACEs and their association with adult mental and physical health. PARTICIPANTS AND SETTING 2019-2021 Behavioral Risk Factor Surveillance Survey. METHODS Transgender participants (n = 551) were matched with two cisgender men (n = 1102) and two cisgender women (n = 1102) on key covariates. We compared age-adjusted predicted probabilities of nine ACEs by race/ethnicity/gender group. We then fit adjusted logistic regression models predicting poor mental and physical health by each ACE and compared marginal effects between groups. RESULTS Transgender people of color had higher age-adjusted probabilities of six ACEs than at least one other group; for example, household incarceration was 0.16 (95 % CI: 0.11-0.22) compared to 0.09 (95 % CI: 0.06-0.13) for cisgender men of color (p = 0.032). The relationship between five ACEs and poor mental health was greater for transgender people of color than at least one other group. For instance, the marginal effect of household alcoholism on poor mental health was 0.28 (95 % CI: 0.11-0.45) compared to 0.07 (0.01-0.14) for White cisgender men (p = 0.031). There were no statistically significant differences regarding effects on poor physical health. CONCLUSIONS ACEs inequitably impact transgender people of color, reflecting the need to restructure the interlocking systems that drive adversity among transgender children of color and exacerbate ACEs' health effects among adults.
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Affiliation(s)
- Wesley M King
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America.
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America.
| | - Don Operario
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1525 Clifton Road, Atlanta, GA 30329, United States of America.
| | - Linda M Chatters
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America; University of Michigan School of Social Work, 1080 South University Avenue, Ann Arbor, MI 48109, United States of America.
| | - Kristi E Gamarel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America.
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Kim SH, Kim JH, Choi YM, Seo SM, Jang EY, Lee SJ, Cho S, Jeong DH, Lee KH. Microneedles: A novel clinical technology for evaluating skin characteristics. Skin Res Technol 2024; 30:e13647. [PMID: 38465749 PMCID: PMC10926177 DOI: 10.1111/srt.13647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/19/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Current methods for evaluating efficacy of cosmetics have limitations because they cannot accurately measure changes in the dermis. Skin sampling using microneedles allows identification of skin-type biomarkers, monitoring treatment for skin inflammatory diseases, and evaluating efficacy of anti-aging and anti-pigmentation products. MATERIALS AND METHODS Two studies were conducted: First, 20 participants received anti-aging treatment; second, 20 participants received anti-pigmentation treatment. Non-invasive devices measured skin aging (using high-resolution 3D-imaging in the anti-aging study) or pigmentation (using spectrophotometry in the anti-pigmentation study) at weeks 0 and 4, and adverse skin reactions were monitored. Skin samples were collected with biocompatible microneedle patches. Changes in expression of biomarkers for skin aging and pigmentation were analyzed using qRT-PCR. RESULTS No adverse events were reported. In the anti-aging study, after 4 weeks, skin roughness significantly improved in 17 out of 20 participants. qRT-PCR showed significantly increased expression of skin-aging related biomarkers: PINK1 in 16/20 participants, COL1A1 in 17/20 participants, and MSN in 16/20 participants. In the anti-pigmentation study, after 4 weeks, skin lightness significantly improved in 16/20 participants. qRT-PCR showed significantly increased expression of skin-pigmentation-related biomarkers: SOD1 in 15/20 participants and Vitamin D Receptor (VDR) in 15/20 participants. No significant change in TFAP2A was observed. CONCLUSION Skin sampling and mRNA analysis for biomarkers provides a novel, objective, quantitative method for measuring changes in the dermis and evaluating the efficacy of cosmetics. This approach complements existing evaluation methods and has potential application in assessing the effectiveness of medical devices, medications, cosmeceuticals, healthy foods, and beauty devices.
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Affiliation(s)
- Seo Hyeong Kim
- Cutis Biomedical Research Center Co. Ltd.SeoulRepublic of Korea
| | - Ji Hye Kim
- Cutis Biomedical Research Center Co. Ltd.SeoulRepublic of Korea
| | - Yoon Mi Choi
- Cutis Biomedical Research Center Co. Ltd.SeoulRepublic of Korea
| | - Su Min Seo
- Cutis Biomedical Research Center Co. Ltd.SeoulRepublic of Korea
| | - Eun Young Jang
- Cutis Biomedical Research Center Co. Ltd.SeoulRepublic of Korea
| | - Sung Jae Lee
- Cutis Biomedical Research Center Co. Ltd.SeoulRepublic of Korea
| | - Suhyun Cho
- Yonsei BB Skin ClinicSeoulRepublic of Korea
| | | | - Kwang Hoon Lee
- Cutis Biomedical Research Center Co. Ltd.SeoulRepublic of Korea
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Pourghadiri A, Mukovozov I, Joseph M, Liu C. A 10-Year Evaluation of Skin Tone Diversity in the Journal of Cutaneous Medicine and Surgery. J Cutan Med Surg 2024; 28:202-203. [PMID: 38303652 DOI: 10.1177/12034754241229632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Affiliation(s)
- Amir Pourghadiri
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Marissa Joseph
- Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Section of Dermatology, Division of Pediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Chaocheng Liu
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
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Goh AH, Altman MR, Canty L, Edmonds JK. Communication Between Pregnant People of Color and Prenatal Care Providers in the United States: An Integrative Review. J Midwifery Womens Health 2024; 69:202-223. [PMID: 37961941 DOI: 10.1111/jmwh.13580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/16/2023] [Indexed: 11/15/2023]
Abstract
INTRODUCTION Racism and discrimination negatively affect patient-provider communication. Yet, pregnant people of color consistently report being discriminated against, disrespected, and ignored. The purpose of this integrated review was to identify studies that examined communication between pregnant people of color and their prenatal care providers and evaluate the factors and outcomes arising from communication. METHODS We searched the PubMed, Embase, CINAHL, and PsychINFO databases for studies published between 2001 and 2023. Articles were eligible for inclusion if they reported on primary research conducted in the United States, were written in English, and focused on patient-provider communication with a sample that included pregnant people of color, defined as those who self-identified as Black, African American, Hispanic, Latina/x/e, Indigenous, American Indian, Asian, Asian American, Native Hawaiian, and/or Pacific Islander American. Twenty-six articles were included in the review. Relevant data were extracted and compiled into an evidence table. We then applied the rating scale of the Johns Hopkins Evidence-Based Practice model to assess the level of evidence and quality of the studies. Themes were identified using a memoing technique and organized into 3 a priori categories: factors, outcomes, and recommendations. RESULTS Two overarching themes emerged from our analysis: racism/discrimination and unmet information needs. Subthemes were then identified as factors, outcomes, or recommendations. Factors included provider behaviors, language barriers, structural barriers, provider type, continuity of care, and fear. Outcome themes were disrespect, trust, decision-making power, missed appointments, and satisfaction with care. Lastly, culturally congruent care, provider training, and workforce development were categorized as recommendations. DISCUSSION Inadequate communication between prenatal care providers and pregnant people of color continues to exist. Improving access to midwifery education for people of color can contribute to delivering perinatal care that is culturally and linguistically aligned. Further research about digital prenatal health communication is necessary to ensure equitable prenatal care.
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Affiliation(s)
- Amy H Goh
- Boston College Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts
| | - Molly R Altman
- School of Nursing, University of Washington, Seattle, Washington
| | - Lucinda Canty
- College of Nursing, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Joyce K Edmonds
- Boston College Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
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Schmalwieser AW, Götzinger S, Schwabel F. Exploratory study on the body distribution of skin color, pigmentation and, degree of tan in Central European Caucasian Women. Photochem Photobiol Sci 2024; 23:493-502. [PMID: 38351275 DOI: 10.1007/s43630-024-00533-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/02/2024] [Indexed: 04/04/2024]
Abstract
It is well known that skin color varies by body site and with season. However, little quantitative data on the topography of skin color and pigmentation are available. Therefore, exploratory cutaneous colorimetric measurements in 20 in central European Caucasian women aged 20 to 60 years have been made at 18 body sites. Tri-stimulus L*a*b*-values, hue, and chroma are considered to describe skin color. Based on the "Individual Typology Angle", the "Degree of Tan" was introduced to quantify the difference between constitutive and facultative pigmentation. Measurements were done in late winter and early summer to estimate potential changes by solar ultraviolet radiation. These measurements made evident that skin color obviously differs across the body in late winter. Even nearby body sites can be recognized as differently colored. A remaining degree of tan was found at permanent and intermittent exposed body sites. The remaining tan was not most pronounced at the permanently exposed sites but on the intermediate ones like the shoulder. In early summer, the degree of tan has most developed at the hands, arms, and instep, followed by the face. This study showed that besides basic differences between body sites in winter, accumulation, and degradation of tan also vary between body sites.
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Affiliation(s)
- Alois W Schmalwieser
- Unit of Physiology and Biophysics, University of Veterinary Medicine, Veterinaerplatz 1, 1210, Vienna, Austria.
| | - Sabine Götzinger
- Unit of Physiology and Biophysics, University of Veterinary Medicine, Veterinaerplatz 1, 1210, Vienna, Austria
| | - Florian Schwabel
- Unit of Physiology and Biophysics, University of Veterinary Medicine, Veterinaerplatz 1, 1210, Vienna, Austria
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Bajrami D, Zubiaga A, Renggli T, Kirsch C, Spano F, Fehr D, von Schulthess P, Lindhorst‐Peters A, Huber S, Roider E, Rossi RM, Navarini AA, Bonmarin M. Variations of skin thermal diffusivity on different skin regions. Skin Res Technol 2024; 30:e13622. [PMID: 38500350 PMCID: PMC10948952 DOI: 10.1111/srt.13622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 02/23/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND AND OBJECTIVE Skin thermal diffusivity plays a crucial role in various applications, including laser therapy and cryogenic skin cooling.This study investigates the correlation between skin thermal diffusivity and two important skin parameters, melanin content and erythema, in a cohort of 102 participants. METHODS An in-house developed device based on transient temperature measurement was used to assess thermal diffusivity at different body locations. Melanin content and erythema were measured using a colorimeter. Statistical analysis was performed to examine potential correlations. RESULTS The results showed that the measured thermal diffusivity values were consistent with previous reports, with variations observed among subjects. No significant correlation was found between thermal diffusivity and melanin content or erythema. This suggests that other factors, such as skin hydration or epidermis thickness, may have a more dominant influence on skin thermal properties. CONLCUSION This research provides valuable insights into the complex interplay between skin thermal properties and physiological parameters, with potential implications for cosmetic and clinical dermatology applications.
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Affiliation(s)
- Dardan Bajrami
- School of EngineeringZurich University of Applied Sciences (ZHAW)WinterthurSwitzerland
- Dermatology ClinicUniversity Hospital BaselUniversitäre Altersmedizin Felix PlatterBaselSwitzerland
| | - Asier Zubiaga
- School of EngineeringZurich University of Applied Sciences (ZHAW)WinterthurSwitzerland
| | - Timon Renggli
- Dermatology ClinicUniversity Hospital BaselUniversitäre Altersmedizin Felix PlatterBaselSwitzerland
| | - Christoph Kirsch
- School of EngineeringZurich University of Applied Sciences (ZHAW)WinterthurSwitzerland
| | - Fabrizio Spano
- School of EngineeringZurich University of Applied Sciences (ZHAW)WinterthurSwitzerland
| | - Daniel Fehr
- School of EngineeringZurich University of Applied Sciences (ZHAW)WinterthurSwitzerland
| | | | - Alisa Lindhorst‐Peters
- Dermatology ClinicUniversity Hospital BaselUniversitäre Altersmedizin Felix PlatterBaselSwitzerland
| | - Stephanie Huber
- Dermatology ClinicUniversity Hospital BaselUniversitäre Altersmedizin Felix PlatterBaselSwitzerland
| | - Elisabeth Roider
- Dermatology ClinicUniversity Hospital BaselUniversitäre Altersmedizin Felix PlatterBaselSwitzerland
| | - René M. Rossi
- Empa, Swiss Federal Laboratories for Materials Science and TechnologyLaboratory for Biomimetic Membranes and TextilesSt. GallenSwitzerland
| | - Alexander A. Navarini
- Dermatology ClinicUniversity Hospital BaselUniversitäre Altersmedizin Felix PlatterBaselSwitzerland
| | - Mathias Bonmarin
- School of EngineeringZurich University of Applied Sciences (ZHAW)WinterthurSwitzerland
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Zhou C, Lee C, Salas J, Luke J. Guide to tinted sunscreens in skin of color. Int J Dermatol 2024; 63:272-276. [PMID: 38073075 DOI: 10.1111/ijd.16954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/21/2023] [Indexed: 02/17/2024]
Abstract
Disorders of hyperpigmentation, such as melasma and post-inflammatory hyperpigmentation, disproportionately affect skin of color and have a profound impact on quality of life. Exposure to ultraviolet light (UVL) is a well-documented factor in these disorders. However, recent studies show that visible light (VL) is a significant and underrecognized contributor to hyperpigmentation, especially in skin of color. Our objective is to review the role of VL in disorders of hyperpigmentation and that of tinted sunscreens in protecting against VL. Tinted sunscreens containing iron oxides should be recommended over nontinted sunscreens for patients prone to disorders of hyperpigmentation, as iron oxides protect against VL in addition to UVL. Tinted sunscreens are more effective than nontinted sunscreens in preventing melasma relapses and reducing hyperpigmentation, and they may also enhance the depigmenting efficacy of topical hydroquinone. In the search for an ideal tinted sunscreen for a particular patient, several factors must be considered, including a broad spectrum with adequate coverage of both UVL and VL, tint, formulation texture, active ingredients, and cost. VL is increasingly recognized as a major contributor of hyperpigmentation, and adequate treatment for disorders of hyperpigmentation should include protection against VL. Tinted sunscreens are ideal but require consideration of cosmesis, efficacy, and affordability.
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Affiliation(s)
- Cici Zhou
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
| | - Claudia Lee
- University of California, Riverside, School of Medicine, Riverside, CA, USA
| | - Jesse Salas
- University of California, Riverside, School of Medicine, Riverside, CA, USA
| | - Janiene Luke
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
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Garcia Neves R, Goulart Peres T, Nogueira Gonzalez T, Nascimento da Silva C, Goulart I, Pereira Machado K, de Oliveira Saes M. A National Study on Psychological Violence in Brazil: Differences by Sex and Skin Color. J Interpers Violence 2024; 39:1291-1307. [PMID: 37864418 DOI: 10.1177/08862605231204585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
Violence is a global public health problem that affects especially the most vulnerable people. The aim was to analyze the prevalence of psychological violence in the Brazilian population and inequalities according to sex and skin color. This was a cross-sectional study in which the database of the National Health Survey 2019 was used. Psychological violence was considered present when an individual answered yes to at least one of the five variables investigated: In the last 12 months, has anyone (a) offended you, humiliated you, or ridiculed you in front of other people?; (b) yelled at you or called you names?; (c) used social media or cell phones to threaten, offend, curse, or expose your images without your consent?; (d) threatened to hurt you or hurt someone important to you?; and (e) destroyed something of yours on purpose? The independent variable was skin color. The crude prevalence ratio (PR) was determined by Poisson regression. All analyses were stratified by sex. Of the 88,531 respondents, 41,662 were males and 46,869 were females. The prevalence of the presence of psychological violence was 19% in women and 15.6% in men. Men and women with black/brown/yellow/indigenous skin color were 20% and 15% more likely to suffer one or more items of psychological violence, respectively, than men and women with white skin color (PR = 1.20; 95% CI [1.11, 1.30] and PR = 1.15; 95% CI [1.08, 1.23]). Psychological violence occurred predominantly against females and individuals with black/brown/yellow/indigenous skin color. There were notable inequalities in the exposure to this type of violence that need to be considered when making plans to address this problem. The findings emphasize the relevance of constantly reviewing political and social constructions to promote a reduction of inequalities.
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Affiliation(s)
| | | | | | | | - Ivana Goulart
- Federal University of Rio Grande, Rio Grande do Sul, Brazil
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Silverberg JI, Horeczko J, Alexis A. Development of an Eczema Area and Severity Index Atlas for Diverse Skin Types. Dermatitis 2024; 35:173-177. [PMID: 37279030 DOI: 10.1089/derm.2023.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Background: Current guidance for using Eczema Area and Severity Index (EASI) implementation is limited to lighter skin phototypes. We developed an EASI lesion severity atlas and refined guidance for investigators and clinicians to use across diverse patient populations. Methods: A review was performed of clinical images from internal atopic dermatitis (AD) photorepositories. Representative images of the 4 AD signs included in EASI were selected for different physician-assessed skin phototypes. Images were excluded if they had low resolution, poor focus, or lighting. Discrepancies regarding skin pigmentation and AD severity were resolved by consensus between authors. Results: Over 3000 clinical photographs were reviewed. Final images were selected using an iterative review process and consensus. Two different versions of the atlas were created across 6 physician-assessed phototypes (I-VI) and 3 skin complexions (light, medium, and dark). We propose guidance language for erythema to reflect the range of colors encountered across different skin complexions (shades of red, purple, and brown). Conclusion: We created a photographic atlas and updated guidance language for implementing EASI in diverse populations, including those with higher skin phototypes.
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Affiliation(s)
- Jonathan I Silverberg
- From the Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Joshua Horeczko
- Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Andrew Alexis
- Department of Dermatology, Weill Cornell Medical College, New York, New York, USA
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Suarez-Balcazar Y, Buckingham S, Rusch DB, Charvonia A, Young RI, Lewis RK, Ford-Paz RE, Mehta TG, Perez CM. Reproductive justice for Black, Indigenous, Women of Color: Uprooting race and colonialism. Am J Community Psychol 2024; 73:159-169. [PMID: 36912117 DOI: 10.1002/ajcp.12650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 07/01/2022] [Accepted: 11/25/2022] [Indexed: 06/18/2023]
Abstract
Historically, atrocities against Black, Indigenous, and Women of Color's (BIWoC) reproductive rights have been committed and continue to take place in contemporary society. The atrocities against BIWoC have been fueled by White supremacy ideology of the "desirable race" and colonial views toward controlling poverty and population growth, particularly that of "undesirable" races and ethnicities. Grounded in Critical Race Theory, this paper aims to provide a critical analysis of historical and contemporary violations of BIWoC reproductive rights; discuss interventions based on empowerment and advocacy principles designed to promote women's reproductive justice; and discuss implications for future research, action, and policy from the lenses of Critical Race Theory and Community Psychology. This paper contributes to the special issue by critically analyzing historical and contemporary racism and colonialism against BIWoC, discussing implications for future research and practice, and making policy recommendations.
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Affiliation(s)
| | - Sara Buckingham
- Department of Psychology, University of Alaska Anchorage, Anchorage, Alaska, USA
| | - Dana B Rusch
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois Chicago, Chicago, Illinois, USA
| | - Alissa Charvonia
- Department of Psychology, Howard University, Washington, District of Columbia, USA
| | | | - Rhonda K Lewis
- Department of Psychology, Wichita State University, Wichita, Kansas, USA
| | - Rebecca E Ford-Paz
- Pritzker Department of Psychiatry and Behavioral Health; Ann & Robert H. Lurie Children's Hospital of Chicago; Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Tara G Mehta
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois Chicago, Chicago, Illinois, USA
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Barber K. Skin Tone Diversity- JCMS. J Cutan Med Surg 2024; 28:132. [PMID: 38613133 DOI: 10.1177/12034754241239726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
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Ramprasad A, Ezekwe A, Lee BR, Balasubramanian S, Jones BL. The impact of skin color and tone on histamine iontophoresis and Doppler flowmetry measurements as a pharmacodynamic biomarker. Clin Transl Sci 2024; 17:e13777. [PMID: 38511581 PMCID: PMC10955605 DOI: 10.1111/cts.13777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/29/2024] [Accepted: 03/07/2024] [Indexed: 03/22/2024] Open
Abstract
The phenotypical manifestations of asthma among children are diverse and exhibit varying responses to therapeutic interventions. There is a need to develop objective biomarkers to improve the characterization of allergic and inflammatory responses relevant to asthma to predict therapeutic treatment responses. We have previously investigated histamine iontophoresis with laser Doppler flowmetry (HILD) as a potential surrogate biomarker that characterizes histamine response and may be utilized to guide the treatment of allergic and inflammatory disease. We have identified intra-individual variability of HILD response type among children and adults with asthma and that HILD response type varied in association with racial classification. As laser Doppler flowimetry may be impacted by skin color, we aimed to further validate the HILD method by determining if skin color or tone is associated with observed HILD response type differences. We conducted an observational study utilizing quantification of skin color and tone obtained from photographs of the skin among participants during HILD assessments via the RGB color model. We compared RGB values across racial, ethnic, and HILD response type via the Kruskal-Wallis test and calculated Kendall rank correlation coefficient to evaluate the relationship between RGB composite scores and HILD pharmacodynamic measures. We observed that RGB scores differed among racial groups and histamine response phenotypes (p < 0.05). However, there was a lack of correlation between the RGB composite score and HILD pharmacodynamic measures (r values 0.1, p > 0.05). These findings suggest that skin color may not impact HILD response variations, necessitating further research to understand previously observed differences across identified racial groups.
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Affiliation(s)
- Aarya Ramprasad
- University of Missouri‐Kansas City School of MedicineKansas CityMissouriUSA
| | - Adara Ezekwe
- Division of Pediatric Clinical Pharmacology and Therapeutic Innovation and Section of Allergy/Asthma/ImmunologyChildren's Mercy HospitalKansas CityMissouriUSA
| | - Brian R. Lee
- University of Missouri‐Kansas City School of MedicineKansas CityMissouriUSA
- Division of Health Services and Outcomes ResearchChildren's Mercy HospitalKansas CityMissouriUSA
| | | | - Bridgette L. Jones
- University of Missouri‐Kansas City School of MedicineKansas CityMissouriUSA
- Division of Pediatric Clinical Pharmacology and Therapeutic Innovation and Section of Allergy/Asthma/ImmunologyChildren's Mercy HospitalKansas CityMissouriUSA
- Department of PediatricsUniversity of Missouri‐Kansas City School of MedicineKansas CityMissouriUSA
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Clemett V, Gunowa NO, Geraghty J, Woodward S. What influences the inclusion of skin tone diversity when teaching skin assessment? Findings from a survey. Br J Nurs 2024; 33:176-186. [PMID: 38386525 DOI: 10.12968/bjon.2024.33.4.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
BACKGROUND Understanding the variances in visual skin changes across all skin tones is important in clinical care. However, the experiences of those teaching skin assessment to pre- and post-registrant nurses are unknown. AIMS To determine the barriers and facilitators experienced in teaching skin assessment across a range of skin tones to pre- and post-registrant nurses. METHODS A cross-sectional, mixed-methods online survey was undertaken throughout February and March 2023 based on the Theoretical Domains Framework of behaviour change. FINDINGS In this self-selecting sample, most participants were aware of why it was important to include all skin tones when teaching skin assessment and were professionally motivated to include this in their practice. However, resources and support are needed to overcome an unconscious bias in teaching skin tone diversity, resulting in a lack of availability of good quality photographs and educator confidence in their own skills. Educators not considering skin tone when selecting patient cases and relying on people with dark skin tones to highlight where practice is not inclusive may also lead to insufficient exposure for students. CONCLUSION There is some awareness of the importance of including diverse skin tones in teaching, but further education and resources are needed.
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Affiliation(s)
- Victoria Clemett
- Lecturer in Adult Nursing, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
| | - Neesha Oozageer Gunowa
- Senior Lecturer and Community Pathway Lead, School of Health Sciences, Faculty of Health & Medical Sciences, University of Surrey
| | - Jemell Geraghty
- Lecturer in Adult Nursing, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
| | - Sue Woodward
- Senior Lecturer, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
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Mohr C, Li Y, Navsaria LJ, Hinkston CL, Margolis DJ, Wehner MR. Melanoma risk in skin of colour patients with a history of a keratinocyte carcinoma. Br J Dermatol 2024; 190:449-451. [PMID: 38036490 PMCID: PMC10873563 DOI: 10.1093/bjd/ljad474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 12/02/2023]
Abstract
This manuscript uses individual-level data from 5 million Medicare beneficiaries to investigate the risks of melanoma in skin of color patients with a history of keratinocyte carcinoma. Despite worse melanoma outcomes, skin of color patients are often excluded from skin cancer literature. We found that skin of color patients with a history of keratinocyte carcinoma are at a significantly increased risk of melanoma, though their absolute risk is low.
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Affiliation(s)
- Cassandra Mohr
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Yao Li
- Departments of Health Services Research
| | | | | | - David J Margolis
- Departments of Dermatology
- Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Mackenzie R Wehner
- Departments of Health Services Research
- Dermatology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Hill RC, Axler E, Curtis KL, Katsiaunis A, Lipner SR. Representation for all: Educational handouts inclusive of patient skin color in a nail specialty clinic. J Am Acad Dermatol 2024; 90:e57. [PMID: 37844689 DOI: 10.1016/j.jaad.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 10/18/2023]
Affiliation(s)
| | - Eden Axler
- Department of Dermatology, Weill Cornell Medicine, New York, New York
| | | | | | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York.
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Jagannathan D, MacFarlane IM, Zierhut H. Exploration of support for Black, Indigenous, and people of color students in genetic counseling programs. J Genet Couns 2024; 33:54-70. [PMID: 38247379 DOI: 10.1002/jgc4.1849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 10/17/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024]
Abstract
Students in higher education who identify as Black, Indigenous, and people of color (BIPOC) experience racism, discrimination, and microaggressions through tokenization, hypervisibility, invisibility, and marginalization. The experiences of BIPOC genetic counseling students with curriculum, clinical training, and sense of belonging also differ. Therefore, there is a large need for understanding how support is defined by BIPOC genetic counseling students, and then how to integrate specific aspects of training into a practical framework for programs to address racism and the resulting emotional implications. This study aimed to define current practices of support and identify gaps in genetic counseling programs as described by BIPOC students. BIPOC genetic counseling students (N = 40) were recruited through Listserv, social media, and Slack channels to complete an online survey eliciting demographic data, perspectives on support, and available support resources. The online survey consisted of 22 open- and closed-ended questions. Data were collected over a 5-week period. Open-ended responses were coded by thematic analysis and audited. The top three supports were as follows: (1) presence of other BIPOC students; (2) presence of BIPOC faculty; and (3) financial funding. Participants' individual definitions of support indicated that each student defined support in a unique way. Most participants defined understanding and empathy stemming from peers, supervisors, and faculty within the program setting as important aspects of overall support. The majority of participants felt somewhat or strongly supported in areas of training. The area with the least support was within rotation/fieldwork experiences. Programs should consider social- and program-level support combined with emotional support. Individualized support for every student is needed while avoiding assumptions about their identity and support needs. Training programs may consider a balance of efforts to prioritize recruiting more BIPOC faculty and students and providing the outlined support and funding resources for their students.
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Affiliation(s)
- Dhriti Jagannathan
- University of Minnesota - Twin Cities, Minneapolis, Minnesota, USA
- Columbia University Irving Medical Center, New York City, New York, USA
| | - Ian M MacFarlane
- University of Minnesota - Twin Cities, Minneapolis, Minnesota, USA
| | - Heather Zierhut
- University of Minnesota - Twin Cities, Minneapolis, Minnesota, USA
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Desai SR, Alexis AF, Elbuluk N, Grimes PE, Weiss J, Hamzavi IH, Taylor SC. Best practices in the treatment of melasma with a focus on patients with skin of color. J Am Acad Dermatol 2024; 90:269-279. [PMID: 37748556 DOI: 10.1016/j.jaad.2023.07.1045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/16/2023] [Accepted: 07/22/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Melasma is a chronic hypermelanosis of the skin that affects approximately 1% of the global population, predominantly affects women, and is more prevalent in skin of color. Melasma is a common driver for patients with skin of color to seek out a dermatologist for treatment, and ensuring the right approach for these patients is important because some treatments may be associated with adverse side effects. Because of the chronicity of the disease and established psychosocial and emotional impacts, there is a large need to ensure care follows the best available evidence on the treatment of patients with melasma. OBJECTIVE Here, we summarized current available topical treatments for melasma with considerations dermatologists should have for their patients with skin of color. METHODS Steering committee consensus on clinical best practices. RESULTS We describe a flexible and focused treatment algorithm that reflects both treatment and maintenance periods that is a consensus of our extensive clinical experience. LIMITATIONS Use of real-world evidence and potential for individual practice bias. CONCLUSION Melasma can be challenging to treat, particularly in patients with skin of color, and our recommendations for best practices for patients in the United States are an important step toward standardizing care.
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Affiliation(s)
- Seemal R Desai
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas; Innovative Dermatology, Plano, Texas.
| | - Andrew F Alexis
- Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Nada Elbuluk
- Department of Dermatology, Keck School of Medicine Dermatology, University of South California, Los Angeles, California
| | - Pearl E Grimes
- Division of Dermatology, Vitiligo & Pigmentation Institute of Southern California, David Geffen School of Medicine, University of California, Los Angeles, California
| | | | - Iltefat H Hamzavi
- Department of Dermatology, Henry Ford Hospital; Hamzavi Dermatology/Dermatology Specialists, Detroit, Michigan
| | - Susan C Taylor
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Khanna AK, Beard J, Lamminmäki S, Närväinen J, Antaki N, Yapici HO. Assessment of skin pigmentation-related bias in pulse oximetry readings among adults. J Clin Monit Comput 2024; 38:113-120. [PMID: 37882880 PMCID: PMC10879215 DOI: 10.1007/s10877-023-01095-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 10/09/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE Recent reports that pulse oximeters may overestimate oxygen saturation in individuals with darker skin pigmentation have prompted concerns from regulatory authorities regarding racial bias. We investigated the performance of TruSignal SpO2 sensors (GE Healthcare, Helsinki, Finland) in adults with varying skin pigmentation. METHODS A retrospective study was conducted using a set of pooled assessments of SpO2/SaO2 measurements from nine studies to assess bias, accuracy (Arms), and precision of TruSignal sensors in healthy adults under induced hypoxia. Subgroup analyses were performed based on oxygen saturation levels (band 1, ≥ 70 and ≤ 80%; band 2, > 80 and ≤ 90%; band 3, > 90 and ≤ 100%). RESULTS Of the 10,800 data points from 131 individuals, 8,202 (75.9%) and 2,598 (24.1%) were assigned to the light and dark pigment groups, respectively. Bias was 0.14% overall and less than 1% across oxygenation bands. The difference in bias between dark and light pigment groups was statistically significant at the low oxygenation band with SpO2 ≥ 70 and ≤ 80% (+ 0.58% and + 0.30% respectively; p = 0.0035). Throughout the saturation range, Arms was 1.64% in the light and 1.71% in the dark pigment group, within device specifications and regulatory requirements. Oxygenation was the dominating factor in stepwise ANOVA modeling. The mixed model also showed that bias was strongly affected by the oxygenation range. CONCLUSION TruSignal sensors demonstrated higher bias at lower oxygen saturation, with less than 0.5% difference between pigment groups. These findings raise new questions, such as ways to improve pulse oximetry measurements during challenging clinical conditions, including low perfusion.
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Affiliation(s)
- Ashish K Khanna
- Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.
- Outcomes Research Consortium, Cleveland, OH, USA.
- Perioperative Outcomes and Informatics Collaborative (POIC), Winston-Salem, NC, USA.
| | - John Beard
- GE HealthCare - Patient Care Solutions, Milwaukee, WI, USA
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46
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King J. Why the mental cost of a STEM career can be too high for women and people of colour. Nature 2024; 626:235. [PMID: 38321140 DOI: 10.1038/d41586-024-00324-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
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Kontzias C, Pixley JN, Zaino M, Feldman SR. Validation of a new facial skin analysis device across Fitzpatrick skin types. J Cosmet Dermatol 2024; 23:720-721. [PMID: 37792416 DOI: 10.1111/jocd.16024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 09/25/2023] [Indexed: 10/05/2023]
Affiliation(s)
- Christina Kontzias
- Department of Dermatology, Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Jessica N Pixley
- Department of Dermatology, Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Mallory Zaino
- Department of Dermatology, Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Steven R Feldman
- Department of Dermatology, Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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Herzum A, Occella C, Gariazzo L, Ciccarese G, Pastorino C, Matarese S, Marasini L, Viglizzo G. Clinical features of atopic dermatitis in pediatric patients with skin of color and comparison with different phototypes. Skin Res Technol 2024; 30:e13614. [PMID: 38348720 PMCID: PMC10862149 DOI: 10.1111/srt.13614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 01/28/2024] [Accepted: 02/01/2024] [Indexed: 02/15/2024]
Affiliation(s)
- Astrid Herzum
- Dermatology DepartmentIRCCS Istituto Giannina GasliniGenovaItaly
| | - Corrado Occella
- Dermatology DepartmentIRCCS Istituto Giannina GasliniGenovaItaly
| | | | - Giulia Ciccarese
- Department of DermatologyUniveristà degli Studi di FoggiaFoggiaItaly
| | | | - Simona Matarese
- Department of NeuroscienceRehabilitationOphthalmologyGeneticsMaternal and Child HealthUniversity of GenoaGenovaItaly
| | - Lucia Marasini
- Department of NeuroscienceRehabilitationOphthalmologyGeneticsMaternal and Child HealthUniversity of GenoaGenovaItaly
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Souto-Neto JA, David DD, Zanetti G, Sua-Cespedes C, Freret-Meurer NV, Moraes MN, de Assis LVM, Castrucci AMDL. Light-specific wavelengths differentially affect the exploration rate, opercular beat, skin color change, opsin transcripts, and the oxi-redox system of the longsnout seahorse Hippocampus reidi. Comp Biochem Physiol A Mol Integr Physiol 2024; 288:111551. [PMID: 37972916 DOI: 10.1016/j.cbpa.2023.111551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
Light is a strong stimulus for the sensory and endocrine systems. The opsins constitute a large family of proteins that can respond to specific light wavelengths. Hippocampus reidi is a near-threatened seahorse that has a diverse color pattern and sexual dimorphism. Over the years, H. reidi's unique characteristics, coupled with its high demand and over-exploitation for the aquarium trade, have raised concerns about its conservation, primarily due to their significant impact on wild populations. Here, we characterized chromatophore types in juvenile and adult H. reidi in captivity, and the effects of specific light wavelengths with the same irradiance (1.20 mW/cm2) on color change, growth, and survival rate. The xanthophores and melanophores were the major components of H. reidi pigmentation with differences in density and distribution between life stages and sexes. In the eye and skin of juveniles, the yellow (585 nm) wavelength induced a substantial increase in melanin levels compared to the individuals kept under white light (WL), blue (442 nm), or red (650 nm) wavelengths. In addition, blue and yellow wavelengths led to a higher juvenile mortality rate in comparison to the other treatments. Adult seahorses showed a rhythmic color change over 24 h, the highest reflectance values were obtained in the light phase, representing a daytime skin lightening for individuals under WL, blue and yellow wavelength, with changes in the acrophase. The yellow wavelength was more effective on juvenile seahorse pigmentation, while the blue wavelength exerted a stronger effect on the regulation of adult physiological color change. Dramatic changes in the opsin mRNA levels were life stage-dependent, which may infer ontogenetic opsin functions throughout seahorses' development. Exposure to specific wavelengths differentially affected the opsins mRNA levels in the skin and eyes of juveniles. In the juveniles, skin transcripts of visual (rh1, rh2, and lws) and non-visual opsins (opn3 and opn4x) were higher in individuals under yellow light. While in the juvenile's eyes, only rh1 and rh2 had increased transcripts influenced by yellow light; the lws and opn3 mRNA levels were higher in juveniles' eyes under WL. Prolonged exposure to yellow wavelength stimulates a robust increase in the antioxidant enzymes sod1 and sod2 mRNA levels. Our findings indicate that changes in the visible light spectrum alter physiological processes at different stages of life in H. reidi and may serve as the basis for a broader discussion about the implications of artificial light for aquatic species in captivity.
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Affiliation(s)
- José Araújo Souto-Neto
- Laboratory of Comparative Physiology of Pigmentation, Department of Physiology, Institute of Biosciences, University of São Paulo, São Paulo, Brazil; Laboratory of Micropollutants, Biophysics Institute Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Daniela Dantas David
- Laboratory of Comparative Physiology of Pigmentation, Department of Physiology, Institute of Biosciences, University of São Paulo, São Paulo, Brazil
| | - Giovanna Zanetti
- Laboratory of Comparative Physiology of Pigmentation, Department of Physiology, Institute of Biosciences, University of São Paulo, São Paulo, Brazil
| | - Cristhian Sua-Cespedes
- Laboratory of Comparative Physiology of Pigmentation, Department of Physiology, Institute of Biosciences, University of São Paulo, São Paulo, Brazil
| | | | - Maria Nathália Moraes
- Laboratory of Molecular Chronobiology, Institute of Environmental, Chemical and Pharmaceutical Sciences, Federal University of São Paulo, São Paulo, Brazil
| | | | - Ana Maria de Lauro Castrucci
- Laboratory of Comparative Physiology of Pigmentation, Department of Physiology, Institute of Biosciences, University of São Paulo, São Paulo, Brazil; Department of Biology, University of Virginia, Charlottesville, United States.
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Vergnaud H, Charton Z, Blumenthal D, Couturaud V, Le Fur M, Loescher E, Caisey L, Gazano G. Lip color diversity: An intricate study. Skin Res Technol 2024; 30:e13583. [PMID: 38284291 PMCID: PMC10823443 DOI: 10.1111/srt.13583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND Lip investigations and characterizations in the literature are less prevalent than for skin, particularly on the topic of color diversity. However, as the consumer demand increases for a nude lip makeup result, that is, shades close to the bare lip color, the identification and modification of lip color is essential for the cosmetic industry. OBJECTIVE The objective was to highlight lip color diversity among three ethnicities (Caucasian, African and Hispanic), through the use of a spectral color measurement device especially adapted to the lip area, and to consider lip color ethnic specificities and overlaps. MATERIALS AND METHODS The inferior natural lip color was measured with a full-face hyperspectral imaging system, SpectraFace (Newtone Technologies, Lyon, France), on 410 healthy women aged 19 to 68 (Caucasian French, Caucasian American, African American, and Hispanic American women). A hierarchical ascending classification, was deployed to determine clusters based on the lip colorimetric parameters along two strategies to identify the best statistical analysis to preserve the lip color diversity. RESULTS Lip color is a continuous color space, with great intra-ethnic and inter-ethnic diversity, especially for African American women in terms of chroma and lightness. Among the two strategies of data analysis, our two-step statistical clustering analysis yielded 11 groups (i.e., 11 lip tones), revealing an accurate representation of the scope of diversity, but also of the overlaps. CONCLUSION The 11 lip tones/colors could potentially serve as target shades for the development of a more diverse and inclusive range of lip cosmetics, such as nude lipsticks.
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Affiliation(s)
| | | | - David Blumenthal
- Université Paris‐SaclayINRAE, AgroParisTech, UMR SayFoodPalaiseauFrance
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