Enhancing Dermatologic Care for Patients with Skin of Color

At the 2025 Elevate-Derm Summer Conference in Park City, Utah, Buchi Neita, MCMSc, PA-C, a board-certified physician assistant at Epiphany Dermatology in Peachtree City, Georgia, emphasized the critical need for improved dermatologic care for patients with skin of color. Neita's presentations focused on recognizing common conditions that often go misdiagnosed and strategies to build trust with patients, particularly in light of significant demographic shifts anticipated in the United States.

According to the U.S. Census Bureau, it is projected that by 2044, over 50% of the U.S. population will belong to minority groups. This demographic change underscores the urgency for healthcare professionals to enhance their understanding of skin conditions prevalent in diverse populations. Neita stated, "It is imperative that all of us learn how to correctly diagnose and treat patients of color, and a lot of that starts with that patient relationship," during her interview at the conference.

Neita’s clinical session highlighted several benign conditions commonly observed in patients with skin of color, such as longitudinal melanonychia and pigmentary demarcation lines. Recognizing these conditions is crucial for avoiding misdiagnosis, which can lead to inappropriate treatments. She also addressed more prevalent issues such as post-inflammatory hyperpigmentation and acne keloidalis nuchae. Neita cited evidence from a 2023 study in the Journal of Dermatological Treatment, which indicates that 1% over-the-counter diclofenac gel, applied twice daily for three months, can effectively treat acne keloidalis. Furthermore, she advocated for aggressive management of keloids through intralesional triamcinolone injections at intervals of four to six weeks.

The discussion also encompassed scarring alopecias, with Neita emphasizing the importance of early intervention for conditions like central centrifugal cicatricial alopecia. She advised clinicians to consider biopsies or initiate treatment promptly when patients report symptoms such as central scalp tenderness or breakage. Additionally, she warned against the common misdiagnosis of traction alopecia, advocating for careful differentiation from androgenetic alopecia and frontal fibrosing alopecia.

Neita also discussed the unique presentations of skin cancer in individuals with darker skin tones, noting that basal cell carcinoma tends to be pigmented and that squamous cell carcinoma is frequently found in non-sun-exposed areas. She urged vigilance for acral lentiginous melanoma, particularly when nail pigmentation changes over time.

In her second session focused on building rapport with patients, Neita addressed the historical context of mistrust among individuals with skin of color, referencing the infamous Tuskegee syphilis study. To foster stronger relationships, she recommended strategies such as connecting on shared ground, actively listening, and ensuring effective communication, including the use of interpreters when necessary. Neita highlighted the importance of performing thorough skin examinations under optimal lighting conditions to identify subtle signs of inflammation.

Neita concluded her presentation by stressing the necessity for continuous education among healthcare providers regarding the unique dermatological needs of patients with skin of color. She encouraged attendance at specialized conferences and engagement with relevant literature to improve patient care. As the U.S. population becomes increasingly diverse, the demand for culturally competent healthcare practices will become ever more critical, highlighting the importance of initiatives such as those presented by Neita at the Elevate-Derm Summer Conference.

### References 1. Neita, B. Dermatologic conditions in skin of color. Presented at: 2025 Elevate-Derm Summer Conference; July 24-27, 2025; Park City, UT. 2. Neita, B. The art of connection: building meaningful rapport with skin of color patients. Presented at: 2025 Elevate-Derm Summer Conference; July 24-27, 2025; Park City, UT. 3. Centers for Disease Control and Prevention. About the untreated syphilis study at Tuskegee. Updated September 4, 2024. Accessed July 28, 2025. https://www.cdc.gov/tuskegee/about/index.html