Racial Disparities in Atopic Dermatitis Care: Improving Education, Access, and Research

Announcer:
You’re listening to DermConsult on ReachMD. On this episode, Dr. Ruchi Gupta will discuss racial disparities in atopic dermatitis. In addition to being a Professor of Pediatrics and Medicine at Northwestern University Feinberg School of Medicine, Dr. Gupta is also the Founding Director of Northwestern’s Center for Food Allergy and Asthma Research. Let’s hear from Dr. Gupta now.

Dr. Gupta:
When you think of atopic derm, a lot of times you think of redness or erythema, but this is not the case in different skin tones. So one thing I’ve noticed, not only in practice but also in my research, is it’s hard for people to understand atopic derm, especially in the pediatric practice or in early infants with different skin tones. And there’s not a lot out there on what atopic derm looks like in different skin tones.

So an example: in one of our studies when we’re talking about early introduction, we have to look for atopic derm or severe eczema, and pediatricians asked us, “Well, what does that look like?” And we went into the literature, and we cannot find good pictures of infants with atopic derm of different skin tones. So I think there is a lack of education around what it looks like. Another example: I was working with one of our residents in our pediatric clinic, and we had a patient who had atopic derm, and they had dark skin tone, and he came back and told me it was just on his ankles. When I went in, it was all over, but it was complicated because it was darker and raised bumps but not necessarily that erythematous. So educating about what atopic derm looks like in different skin tones will help with the diagnosis.

Now let’s get into racial disparities in treatment. I think one of the big issues in treatment is generalists are very careful with young infants and don’t want to start them on any kind of stronger steroids. So this infant had severe atopic derm, but it didn’t seem like it to our resident, and they wanted to start him on very, very basic hydrocortisone 1 percent. And I see that a lot in pediatrics, so educating generalists about how to start if it is severe eczema and then how do you taper—I think there needs to be a lot of education on that.

Other things that may impact these disparities in diagnosis and treatment outside of recognition include access to care. So how do we improve access to dermatologists for people in underserved populations? A lot of times, we use some of the same treatments that we’ve known tried and true—the steroids—but there are amazing new treatments for atopic derm, including different types of topicals, but also biologics that have really been shown to improve not only the atopic derm, but also quality of life. So how do we make sure that there is access to some of these newer treatments for all groups, including underserved and minority populations?

And then last but not least, I think research is so important, and unfortunately, there are a lot of research gaps in looking at atopic derm and what works best in different racial and ethnic populations.

Announcer:
That was Dr. Ruchi Gupta talking about racial disparities in atopic dermatitis, which she. To access this and other episodes in our series, visit DermConsult on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!