Physicians must recognize variations in atopic dermatitis (AD) presentation across different races, as highlighted by Dr. Melinda M. Rathkopf at the Annual Allergy, Asthma and Immunology CME Conference. AD is more prevalent and severe among Black, Hispanic, Asian, and Pacific Islander children, though treatment guidelines generally remain consistent. Diagnosing AD in darker skin can be challenging due to the subtler appearance of erythema. Social determinants of health, like access to care, further complicate diagnosis and treatment in minority populations.
Biological factors, such as ceramide levels and inflammatory responses, also vary by ethnicity. Black patients have lower ceramide/cholesterol ratios, impacting skin barrier integrity, while Japanese and Korean patients show different inflammatory profiles than European patients. These differences suggest that treatment approaches may need to be tailored based on skin type. Dr. Rathkopf emphasized the importance of increasing the representation of skin color in medical education, literature, and the healthcare workforce to improve the care of AD in diverse populations.
Reference: Gawel R. Challenges remain in diagnosing, treating skin of color with atopic dermatitis. Healio. Published August 22, 2023. Accessed August 19, 2024. https://www.healio.com/news/allergy-asthma/20230822/challenges-remain-in-diagnosing-treating-skin-of-color-with-atopic-dermatitis