Dermatology Conference Spotlights Skin of Color Diagnostic Challenges
At the 2025 SDPA Annual Summer Dermatology Conference in Washington, D.C., experts explored how dermatological conditions manifest differently in diverse skin tones. The session, led by Dr. Ginette Okoye, emphasized the need for a nuanced approach to diagnosis to avoid misinterpretations.
Unveiling Diagnostic Dilemmas
Dr. Okoye, a dermatology chair at Howard University College of Medicine, presented complex cases to demonstrate diagnostic difficulties. Attendees learned how to identify subtle differences in the appearance of common and uncommon skin conditions in darker skin, which often lead to delayed or missed diagnoses.
One case involved an 11-year-old with a six-month history of facial discoloration, especially on the eyelids, and a rash on the back of the hands, previously diagnosed as eczema. The rash did not improve with topical steroids. The patient also had a history of asthma and muscle weakness.
“So what’s our differential diagnosis for this young man?” Dr. Okoye asked. “I really honed in on dermatomyositis. I just want to talk to you about assessing proximal muscle weakness, because this child did have juvenile dermatomyositis.”
—Dr. Ginette Okoye
Importance of Muscle Weakness
Dermatomyositis often manifests as proximal muscle weakness. In children, Dr. Okoye noted, the risk of cancer is not as significant; nevertheless, screening should be done at diagnosis and yearly for five years. The National Institutes of Health indicates that approximately 2-10 per 1,000,000 adults are diagnosed with dermatomyositis annually (NIH, 2024).
Best Practices for Diagnosis
The session emphasized the importance of pattern recognition, thorough clinical assessment, and strategic use of biopsies and lab tests to arrive at accurate conclusions. Dr. Okoye addressed common diagnostic errors affecting patients with skin of color, providing strategies to avoid these pitfalls.
The conference underscored the necessity of culturally competent communication to foster trust and improve diagnostic accuracy across diverse patient populations. Attendees were encouraged to incorporate visual nuance and a patient-centered approach to refine their clinical judgment.
By adopting a more inclusive lens, dermatology PAs and others in attendance enhanced their understanding of diagnosing complex presentations in skin of color.