Impact of skin of color specialty dermatologic clinics on diagnoses and management

Abstract

Dedicated care of Skin of Color (SOC) individuals is crucial for increasing access and culturally-sensitive management of this population [1]. Although SOC specialty clinics (SOCSC) are becoming increasingly popular, data on these is limited. We seek to describe the first detailed experience from a SOCSC. Demographic and clinical data of the University of Nebraska Medical Center Department of Dermatology’s Ethnic Skin/SOC Clinic were collected. Of 252 patients, 82% were female; mean age was 45.1 years. Self-reported race consisted of Black/African-Americans (86.9%), Other (6.0%), and Asians (3.6%). Hispanics/Latinos constituted 4.8%. The top chief complaints (CC) included acne, itch/rash, and hair loss. Among patients previously seen by a dermatologist, 20.3% had a diagnosis change, 24.3% received a new diagnosis unrelated to CC, and 48.6% had a treatment change. Patients with a prior dermatology visit showed a higher rate of change in diagnosis (20.3% vs. 2.8%) and change in treatment (48.6% vs. 28.0%) than those without. The most common diagnosis changes were itch/rash (29.3%) and hair loss (19%). Changes in treatment were mostly seen in patients with acne (20.8%), and the most common were discontinuation (50%) and switch in antibiotics (11%). In patients with previous dermatologic contact, one out of five patients (20.3%) previously seen by a non-SOC dermatologist had a diagnosis change, one out of four (24.3%) had a new diagnosis, half (48.6%) had a change in treatment, and 17.6% were being diagnosed and treated for the first time after being seen in SOCSC, highlighting the importance of SOC-specialized dermatologists in patient care.