Monthly Archives

August 2018

Ask a mentor Amy McMichael

Ask a Mentor Q&A Recap – Dr. Amy McMichael

By Skin of Color Update Agenda

We had the opportunity to ask a mentor,  Dr. Amy McMichael, chair and professor of dermatology at Wake Forest University Health Sciences and Skin of Color Update faculty, questions about establishing a career in academics, finding a mentor, and better serving patients of color.  See all of her insightful answers below.

Q1: I previously attended the Skin of Color Seminar Series (now Skin of Color Update) and while sitting in the audience, I noticed that many of attendees appeared to be white physicians. Do you think there’s a representation problem in Dermatology, and could it be impacting our patients?

However, we know from other research in the house of medicine that Dermatology is second only to Orthopedics in having the worst representation of African Americans. Also identified as a major problem is the poor pipeline of under-represented minorities in college, medical school, and ultimately, in residency. We all have lots of work to do in terms of mentoring at every level to get the pipeline full of appropriate candidates.

In addition to this, we need to all be thoughtful about looking at residency applicants who may not be traditional, but who would make resilient and excellent dermatologists.

Q2: Most dermatologists (at least most of the ones I know) seem to think they don’t need special training for treating patients of color and can’t seem to acknowledge that a gap in training exists. As a dermatologist of color, I find it personally frustrating. Do you find this to be true among your peers?  If so, how do you address this with them?

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Psoriasis Skin of Color Alexis

Psoriasis in Skin of Color: Are there differences in Presentation and Treatment?

By Sessions

While previously thought to be a rare diagnosis in non-white racial ethnic groups, more recent data has shown that psoriasis in patients with skin of color is much more common than was once thought. Dr. Andrew Alexis spoke during the Skin of Color Seminar Series (now Skin of Color Update) in New York City on May 5th, 2018 on this condition and on the important differences in clinical characteristics, diagnosis, and treatment of psoriasis in skin of color.

Beginning with the diagnosis of psoriasis in skin of color, it is important to be aware that the classic red plaque typically seen in Caucasian skin may appear more violaceous or even red-brown in our skin of color patients.  This can be confusing with the similar appearing, but histologically unique entity, lichen planus. Pay close attention to the distribution of the plaques—extensor surfaces and asymptomatic will favor psoriasis whereas flexural and pruritic may favor lichen planus. Other conditions that may be more common in our skin of color patients such as sarcoidosis or hypertrophic discoid lupus also need to be considered.

Once a diagnosis of psoriasis is established, it is important to understand the intricacies of treating the psoriasis in skin of color patients. For example, when treating psoriasis of the scalp, it is important to select practices and treatments that are compatible with the patients’ hair care regimen and hair texture. It is critical to determine how frequently patients are washing their hair and how feasible it is for patients to use a daily solution or medication on the scalp. One potential option shown to have clinical benefit is a mixture of calcipotriene and betamethasone dipropionate in a castor oil vehicle.

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Excerpt provided with permission. Originally published by Next Steps in Dermatology. All rights reserved.