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Dr April Armstrong: Clinician Education Needed to Overcome AD Treatment Barriers


April Armstrong, MD, MPH, of University of California, Los Angeles, gave an overview of her Fall Clinical Dermatology session on treating atopic dermatitis (AD) in patients with diverse skin tones and weighed in on how to address related treatment barriers.

April Armstrong, MD, MPH, professor and chief of dermatology at University of California, Los Angeles, summarized her Fall Clinical Dermatology session, "Solving the Puzzle: Caring for Patients With Atopic Dermatitis and Diverse Skin Tones," and explained how to overcome related treatment barriers.


Can you give an overview of your session, "Solving the Puzzle: Caring for Patients With Atopic Dermatitis and Diverse Skin Tones"?

In this session, I teamed up with Dr. Alexis, and we talked about caring for patients with atopic dermatitis and diverse skin tones. Now, this is a really important topic because we know that atopic dermatitis presents differently in patients with different skin tones.

Specifically, we went over the unique presentations that can be present in patients with diverse skin tones. For example, we talked about how the erythema, or the redness, can look violaceous, or a red-brownish color, in that particular patient population. Also, we talked about how in African Americans, for example, follicular eczema, can be more prevalent, and it's important to recognize that and to distinguish it, for example, from other types of skin diseases.

Furthermore, we also looked at different technologies that are currently being used to measure the degree of inflammatory response in the skin and accounting for the differences in the skin tones.

Finally, we talked about different measures that are actually validated in patients with skin of color and ensuring that the measure that we use to quantify disease activity is not only validated in certain skin types but it's validated across the different skin tones. It was a very exciting session, and Dr. Alexis and I had a great time discussing this topic that's very important to both of us.

In your eyes, what are some of the barriers that still need to be faced in treating diverse patients with atopic dermatitis? What do you think are the next steps in doing so?

I think that one of the barriers that exists in terms of effectively caring for patients with diverse skin tones is that education of the clinicians. Studies have shown that, for example, some dermatologists may not be as comfortable in diagnosing different skin diseases in patients with diverse skin tones. Partly, this has to do with the educational environment that they grew up in. Possibly, the patient population that they were treating weren't as diverse.

When we think about this, exposing our trainees, our residents, our medical students, to patients with diverse skin tones, and really emphasizing that as part of our educational curriculum, I think will be very helpful with regards to accurate diagnosis of skin diseases.

As importantly, I think more research is being done in health care delivery to understand how we can better care for patients with diverse skin tones and also in different geographic areas, as well.

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