May 12, 2022

Student efforts in updating dermatology curriculum lead to increased images of skin of color

Wayne State University School of Medicine students who joined an optional “Skin of Color” module offered in the second-year Dermatology curriculum had more confidence in diagnosing diseases in darker skin tones.

The idea of the module was developed by medical students Kathren Shango and Fouad Abdole, who then worked with classmate Sarah Gonzalez to create the content.

One-quarter of the entire class of 295 students completed the module, which included 13 cases of common skin pathologies in African American patients. A pre- and post-survey performed to assess students’ confidence using a five-point Likert scale showed that the participating medical students demonstrated a statistically significant increase in confidence in diagnosing skin pathologies in skin of color. The existing dermatology lectures were updated to include an increased percentage of images of skin of color in lieu of making a separate mandatory module.

“We chose to investigate this topic because Wayne State University is located in Detroit, with a majority Black population of 80%, but our dermatology curriculum only devoted 9% of its images to skin of color, said Medhi Farshchian, M.D., Ph.D., a fourth-year WSU Dermatology resident who helped Shango, Abdole and Gonzalez with the module and survey.

“In dermatology, skin type is pertinent to patient care, as patients with skin of color may have different clinical presentations of skin diseases. For example, it may be challenging to appreciate erythema on the skin of color due to lack of appropriate training. In addition, treatment of skin diseases may be affected by skin type. There are also diseases that may disproportionately affect skin-of-color patients,” he said.

“Statistics demonstrate that despite having lower incidence of skin cancer, skin-of-color patients face worse prognosis due to delayed diagnosis or misdiagnosis. In addition, many skin-of-color patients are not aware of their risk of skin cancer, especially since the necessity of sun safety practices in skin-of-color patients is constantly being debated,” Dr. Farshchian said. “Moreover, the most common subtype of melanoma that affects skin of color patients is called Acral Lentiginous melanoma which typically presents in non-sun exposed regions of the body and tends to be aggressive. In fact, Bob Marley died of untreated metastatic ALM that began on his toenail.”

Shango, Abdole and Gonzalez worked with Dr. Farshchian and Assistant Professor of Dermatology Meena Moossavi, M.D., on the manuscript “Medical Student Confidence in Diagnosis of Dermatologic Diseases in Skin of Color,” published last month in the journal Clinical, Cosmetic and Investigational Dermatology. Dr. Moossavi mentors Abdole and Gonzalez in the Department of Dermatology’s Student Mentoring Program.

The survey was completed in June 2020. Preliminary findings were presented at the American College of Physicians Residents Day/Medical Students Day 2020, the Wayne State University School of Medicine’s Medical Education Research and Innovation Conference 2020, and at Keck Innovations in Medical Education 2021.

They plan to continue presenting the findings at medical education and dermatology meetings.

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