Addressing Diagnostic Challenges in Dermatology for Skin of Color

At the 2025 Society of Dermatology Physician Assistants (SDPA) Annual Summer Conference held in Washington, D.C., Dr. Ginette Okoye, a prominent figure in dermatology and chair of the Department of Dermatology at Howard University College of Medicine, presented a session titled 'Diagnostic Dilemmas: Complex Cases in Skin of Color.' This presentation focused on the significant diagnostic challenges faced by clinicians when treating dermatologic conditions in individuals with richly pigmented skin, a demographic often overlooked in dermatology education.

Dr. Okoye highlighted that dermatologic conditions such as inflammatory, pigmentary, infectious, and autoimmune diseases can present differently in darker skin tones, leading to misinterpretations and missed diagnoses. She emphasized that clinicians must develop an acute awareness of these nuances to improve patient outcomes. In her presentation, she utilized real-world case studies to illustrate her points, underlining the importance of recognizing patterns and conducting thorough clinical assessments.

One example cited by Dr. Okoye involved an 11-year-old boy presenting with a six-month history of facial discoloration and a rash previously diagnosed as eczema. Despite treatment with topical steroids, his condition did not improve. Upon further examination, Dr. Okoye discovered significant muscle weakness, which led her to suspect juvenile dermatomyositis, a condition that can often be confused with less severe ailments due to its subtle presentations. She noted, "When we consider the visual cues present in skin of color, it is critical to approach each case with a refined lens of awareness and understanding."

The session outlined not only the clinical aspects of dermatology in skin of color but also highlighted the necessity for culturally competent communication. Dr. Okoye urged attendees to cultivate trust with diverse patient populations through empathetic dialogue, thereby enhancing the diagnostic process. "Culturally competent communication is essential for building trust and improving diagnostic accuracy," she stated, reinforcing the idea that understanding a patient’s cultural background can significantly impact clinical outcomes.

Dr. Okoye's findings are supported by a growing body of research that underscores the importance of tailored diagnostic strategies in dermatology. According to a study published in the Journal of the American Academy of Dermatology in 2023, patients with skin of color are less likely to receive accurate diagnoses for conditions such as psoriasis and eczema compared to their lighter-skinned counterparts (Smith et al., 2023).

The conference provided an avenue for healthcare professionals to learn about the intricacies of diagnosing dermatologic conditions in skin of color, emphasizing the need for ongoing education and awareness in this critical area of healthcare. By refining diagnostic techniques and fostering a patient-centered approach, dermatologists and physician assistants can improve care delivery and outcomes for individuals with diverse skin tones.

As the field of dermatology continues to evolve, it is imperative for clinicians to stay informed and adapt their practices to address the unique challenges presented by skin of color. The implications of this knowledge extend beyond individual cases, contributing to a broader movement towards equity in healthcare access and treatment efficacy. Dr. Okoye's presentation serves as a vital reminder of the importance of inclusivity in medical education and practice, particularly in a field as visually dependent as dermatology.