Representation of Skin Color, Disease Severity, and Anatomic Location in Hidradenitis Suppurativa Images
Main Article Content
Keywords
hidradenitis suppurativa, skin of color, Diversity, google, online images, dermatology textbooks
Abstract
Introduction: Hidradenitis suppurativa (HS) is an inflammatory dermatosis disproportionately affecting patients of color. We evaluated characteristics of HS images in dermatology online image resources and textbooks.
Methods: Images of HS were collected in December 2021 from online and textbook sources. Data regarding anatomic region, Hurley stage, and Fitzpatrick skin tone (FST) were collected and analyzed.
Results: 318 images remained after exclusion criteria. VisualDx contained the highest number of dark skin (FST V-VI) images (59%, 47/79), followed by Google (4%, 2/52) and DermNetNZ (4%, 4/100). In textbook sources, dark skin represented 25% (4/16) of images. Across sources, 47% (151/318) of images represented Hurley stage 2, followed by 32% (101/318) stage 3, and 21% (66/318) stage 1. The axilla (49%, 156/318) was the most common anatomic location featured, followed by the groin (18%, 58/318) and breast/chest (9%, 28/318). Involvement of non-classic locations was represented in 3% (8/318) of images. There was a positive correlation between higher Hurley stage and darker skin (r=0.26, p<0.05).
Discussion/Conclusion: Overall there is underrepresentation of dark skin tones, “non-classic” anatomic locations, and mild HS which may lead to missed opportunities for patient education and dermatology training. Dermatologists should take the lead to improve image diversity across educational resources.
References
2. Screen to Script: The Doctor’s Digital Path to Treatment [Internet]. [cited 2022 Feb 19]. Available from: https://www.thinkwithgoogle.com/_qs/documents/692/the-doctors-digital-path-to-treatment_research-studies.pdf
3. Rick JW, Thompson AM, Fernandez JM, Maarouf M, Seivright JR, Hsiao JL, et al. Misdiagnoses and barriers to care in hidradenitis suppurativa: A patient survey. Australas J Dermatol. 2021 Nov;62(4):e592–4.
4. Kurtti A, Austin E, Jagdeo J. Representation of skin color in dermatology-related Google image searches. J Am Acad Dermatol. 2022 Mar;86(3):705–8.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons Attribution (CC BY): lets others distribute and copy the article, to create extracts, abstracts, and other revised versions, adaptations or derivative works of or from an article (such as a translation), to include in a collective work (such as an anthology), to text or data mine the article, even for commercial purposes, as long as they credit the author(s), do not represent the author as endorsing their adaptation of the article, and do not modify the article in such a way as to damage the author's honor or reputation.
Authors retain copyright in their work and license the publisher to publish the content. The publisher is the National Society for Cutaneous Medicine, with production and publishing support provided by OJS, Open Journal Systems,see https://pkp.sfu.
Prior to January 2022, authors transferred copyright to the National Society for Cutaneous Medicine. However, all articles are freely available to anyone in the world. There are no subscription fees, page charges, or article processing charges.