Taylor Simmons was diagnosed with eczema, an inflammatory skin condition, when she was five years old. Then, in high school, lighter patches contrasting with Simmons’ dark skin appeared on her cheeks. This new symptom was nothing like his eczema. She was visiting several dermatologists looking for an explanation before learning about a burgeoning field called “color skin dermatology,” which eventually helped provide an answer about her new skin symptoms. The journey to a diagnosis has been long and infuriating.
Simmons says that in her search for an answer, she was first diagnosed with vitiligo, an autoimmune disease where the skin loses patches of pigmentation. Google searches for the disease looked very different from Simmons’ symptoms, so she sought a second opinion. Then, Simmons explains, she was told she had pityriasis alba, a form of eczema, only to be diagnosed a few years later with a pigmentation disorder called progressive macular hypomelanosis. Each time, she says, she was prescribed a new medication, but none of them worked. During this time, the spots were spreading to other areas of her face besides her arms and legs, and also becoming unbearably itchy.
Simmons was self-conscious about her skin and tried to hide the eczema flare-ups and lighter patches of skin as best she could. « I haven’t worn short-sleeved shirts, tank tops, shorts or dresses for almost 10 years, » she told SELF.
Frustrated, in March 2020, Simmons made an appointment with Valerie Harvey, MDa dermatologist who sits on the board of directors of the Colored skin societya professional skin health awareness group for people of color.
After performing a biopsy, Dr. Harvey diagnosed Simmons with mycosis fungoides, a type of blood cancer that affects the skin. In lighter skin types, the disease manifests as red spots, so doctors who are unaware of the appearance of mycosis fungoides on dark skin may misdiagnose the disease.
Research shows that Simmons’ experience is not unusual. According to a review of studies published in 2016 in Convincing medicine.1 This is one of the main reasons why black individuals generally have more advanced cases when they are diagnosed, in addition to lower survival rates compared to other races.
Too often, people of color are misdiagnosed or have delayed diagnoses because some doctors don’t know how skin conditions show up on all skin tones, says Nada Elbuluk, MDassociate professor of dermatology at Keck School of Medicine at the University of Southern California.
“There are thousands of these cases,” Dr Elbuluk told SELF. « It happens all the time. »
Simmons’ story is just one example of the steep obstacles people of color face when seeking skin care and treatment.
The challenges of inclusivity in dermatology
Last year, the Centers for Disease Control and Prevention called racism a major public health threat because of its role in perpetuating health disparities. People of color often have higher rates of illness and death from various conditions, as well as more severe disease courses. For example, even though black people are less likely than white people to develop melanoma, they are more likely to die from the disease if they do develop it. According to a report published by the American Cancer Society. But these factors are not the only ones contributing to inequalities in health care – homogeneity within medical training and the medical field also plays an important role.