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Autoimmune bullous diseases in skin of color

      Dermatologic health care disparities disproportionately affect patients with skin of color (SoC), defined as Fitzpatrick skin phototypes IV-VI (light brown, brown, and black skin tones), resulting in delayed treatment and increased morbidity and mortality.
      • Tripathi R
      • Knusel KD
      • Ezaldein HH
      • Scott JF
      • Bordeaux JS.
      Association of demographic and socioeconomic characteristics with differences in use of outpatient dermatology services in the United States.
      Numerous studies predict that by 2060 the White race will be a minority in the United States. Despite the rising SoC population, there remains a scarcity of peer-reviewed literature depicting skin conditions in SoC. In 2006, autoimmune bullous diseases (AIBD) were the fourth most common cause of death from skin disease following skin cancers, ulcers, and bacterial infections.
      • Weinstock MA
      • Chren M-M
      Fitzpatrick’s Dermatology in General Medicine.
      Many factors contribute to diagnostic delay including differences in pigmentation, which can affect the appearance of skin diseases.
      • Kundu RV
      • Patterson S.
      Dermatologic conditions in skin of color: part I. Special considerations for common skin disorders.
      Inflammation with increased blood flow appears red or pink on white skin, whereas on brown or black skin, it is more likely to present as brown or violaceous. Pathologic changes manifest differently in various skin tones, and access to media depicting skin pathologies helps to improve pattern recognition, diagnostic accuracy, and patient outcomes.
      • Alvarado SM
      • Feng H.
      Representation of dark skin images of common dermatologic conditions in educational resources: a cross-sectional analysis.
      We review disparities in presentation and subtle differences in the appearance of bullous diseases in SoC, as well as epidemiology, pathogenesis, clinical features, comorbidities, differential diagnosis and treatment, and its impact on diagnosis in SoC.
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