Search

The study "Differing features of pemphigus in skin of colour versus white skin" addresses the lack of diversity in dermatologic literature and educational resources, focusing on pemphigus patients with skin of color (SOC) compared to white patients. The research, based on a large cohort study, found no significant differences in demographics, comorbidities, or treatments between SOC and white pemphigus patients after propensity score matching. However, SOC patients showed a higher risk of postinflammatory hyperpigmentation (PIH) and hospitalization compared to white patients, with no difference in mortality risk. The study emphasizes the importance of early diagnosis and treatment for SOC patients to prevent pigmentary changes and highlights the need for more research on dermatologic diseases in underrepresented populations. [Extracted from the article]

Summary: Background: There is no cure or firm clinical recommendations for the treatment of vitiligo. One of the main issues is the heterogeneity of outcome measures used in randomized controlled trials for vitiligo. Objectives: To define successful repigmentation from the patients' point of view and to propose how and when repigmentation should be evaluated in clinical trials in vitiligo. Methods: We conducted three workshops with patients with vitiligo and their parents or caregivers. Workshop 1 was held at World Vitiligo Day (Detroit, MI), workshop 2 at the University of Texas Southwestern Medical Center and workshop 3 at the Vitiligo and Pigmentation Institute of Southern California, University of California. Results: Seventy‐three participants were recruited. Consensus on the following questions was achieved unanimously: (i) the definition of 'successful repigmentation' was 80–100% of repigmentation of a target lesion and (ii) both an objective and a subjective scale to measure repigmentation should be used. Conclusions: This was the largest patients' outcomes workshop. We followed the guidance from the CSG‐COUSIN and the Vitiligo Global Issues Consensus Group. Our recommendations to use percentage of repigmentation quartiles (0–25%, 26–50%, 51–79%, 80–100%) and the Vitiligo Noticeability Scale are based on the best available current evidence. A limitation of the research is that the workshops were conducted only in the U.S.A., due to pre‐existing organisational support and the availability of funding. What's already known about this topic? There are no firm clinical recommendations for the treatment of vitiligo.One of the main issues is the heterogeneity of outcome measures used in randomized controlled trials for vitiligo. What does this study add? Based on international consensus and the best available evidence, repigmentation should be assessed by measuring the percentage of repigmentation in quartiles (0–25%, 26–50%, 51–79%, 80–100%).The cosmetic acceptability of results should also be assessed, for example using the Vitiligo Noticeability Scale. Respond to this article Linked Comment:Wolkerstorfer. Br J Dermatol 2019; 180:454–455. Plain language summary available online [ABSTRACT FROM AUTHOR]

We feel this condition is an under-recognized, difficult-to-treat, and distressing disorder of hypopigmentation in skin of colour patients without a clear understanding of the aetiology and pathogenesis (Figures 1 and 2). The patients in this manuscript have given written informed consent to publication of their case details. [Extracted from the article]

Few studies discuss the co-management of vitiligo and acquired hyperpigmentation disorders (AHD) such as melasma, erythema dyschromicum perstans, post-inflammatory hyperpigmentation, drug-induced hyperpigmentation, and lichen planus pigmentosus. This review discusses clinical studies examining co-management strategies and identifies current practice gaps. Dermatology Life Quality Index scores are higher in individuals with vitiligo or melasma. It is plausible that populations experiencing both conditions may exhibit worsened psychological outcomes because of stigmas and perceived social beauty standards. Standard treatments for vitiligo aim to increase pigmentation, while AHD treatments target decreasing pigmentation, causing potential worsening of contrast between multiple skin tones for patients experiencing both disorders. Tretinoin may prevent narrowband ultraviolet B (NBUVB)-induced hyperpigmentation in patients with vitiligo without altering treatment response and is also beneficial for managing AHD. In addition, the use of oral tranexamic acid to treat melasma does not diminish the response to NBUVB phototherapy. Platelet-rich plasma (PRP) injections and oral Polypodium leucotomos extract may also be beneficial for comanaging vitiligo and AHD. However, practice guidelines are needed to optimize care for this patient population., (© 2025 the International Society of Dermatology.)

Background: Studies have found demographic differences in prescribing patterns for certain inflammatory conditions, including acne., Objective: To investigate acne prescription patterns among patients seen in the private system (PS) and safety-net health care system (SNS) of the University of Southern California (USC)., Methods: This was a multisite, retrospective study of patients obtaining acne care at PS and SNS outpatient dermatology facilities in Los Angeles over a one-year period., Results: Despite similar acne severity, SNS patients were less often prescribed azelaic acid, benzoyl peroxide/clindamycin, benzoyl peroxide/adapalene, sulfacetamide, topical dapsone, and salicylic acid than PS patients (p < 0.001). SNS patients received fewer prescriptions for oral medications including spironolactone, antibiotics, and isotretinoin (p < 0.001). Despite similar acne severity, non-White patients were less frequently prescribed topical retinoids (p = 0.003), benzoyl peroxide/clindamycin (p = 0.003), isotretinoin (p < 0.001) and spironolactone (p < 0.001) than White patients. Despite higher acne severity among Hispanics/Latinos, they were less often prescribed spironolactone and oral antibiotics than their non-Hispanic/Latino counterparts (p = 0.023)., Conclusions: Findings from this study highlight differences in acne prescribing patterns by race/ethnicity and hospital system, which can impact the ability of patients to have successful treatment of their acne and its sequelae., Competing Interests: Declarations. Patient consent: Not applicable. IRB approval status: This study was approved by the USC Institutional Review Board. #UP-20-01465. Competing interests: Dr. Elbuluk has served as a consultant, advisory board member, and/or speaker for Avita, Incyte, VisualDx, La Roche Posay, Beiersdorf, Eli Lilly, Galderma, Pfizer, L’Oreal, McGraw Hill, Dior, Medscape, Abbvie, Takeda, Sanofi. She has received royalties from McGraw-Hill. She has stock options in VisualDx. The remaining authors have no disclosures to report., (© 2025. The Author(s).)

Keloidal morphea is a rare variant of cutaneous scleroderma that presents with keloid-like plaques and nodules that occur most commonly on the neck, trunk, and proximal extremities. They occur in the absence of trauma or injury. Keloidal morphea most often manifests in patients with skin of color and may be mistaken for keloids and/or hypertrophic scars. This report presents a case of keloidal morphea in a young Black female. While effective therapies are limited, timely diagnosis can initiate the evaluation for systemic sclerosis and other systemic organ involvement. Increased awareness and recognition of keloidal morphea can help prevent dermatologic health disparities, which disproportionately occur in patients of color. J Drugs Dermatol. 2025;24(2):203-204. doi:10.36849/JDD.7960.

Background: Online health-related information (HRI) has expanded access to medical knowledge. While there are benefits to the increasing availability of online HRI, there may be limitations to the accuracy, quality of information, and utilization across patient demographics., Methods: A survey was administered to dermatology outpatients at the Keck School of Medicine of the University of Southern California to examine the utilization of internet and social media for acquiring dermatology-related information (DRI)., Results: A total of 200 patients completed the survey. A majority (90%) indicated utilizing the internet to research information about their dermatological condition. Approximately 74 percent researched their dermatological condition before visiting the dermatologist, and 80 percent researched their condition after seeing a dermatologist. Younger patients (ages 18-25) were more likely to utilize online HRI before and after their visit. When stratified by income level, those with an income of less than $20,000 a year were more likely to search online for symptom management. Overwhelmingly, patients (99%) preferred to receive DRI from a dermatologist over internet or social media., Limitations: A limitation of our study is the exclusion of individuals with dermatologic issues who do not seek in-person dermatologic care, which may contribute to selection bias., Conclusion: There are differences across demographics in the utilization of the internet and social media for obtaining DRI. Understanding patients' interactions with online HRI may allow providers and patients to work synergistically, leveraging online resources to support the dissemination of credible information and optimize patient outcomes., Competing Interests: DISCLOSURES: Dr. Elbuluk has served as a consultant, advisory board member, and/or speaker for Avita, Scientis, Incyte, VisualDx, La Roche Posay, Beiersdorf, Unilever, Eli Lilly, Galderma, Pfizer, L’Oreal, McGraw Hill, Dior, Medscape, Abbvie, Takeda, Sanofi. She has received royalties from McGraw-Hill. She has stock options in VisualDx. The remaining authors have no disclosures to report., (Copyright © 2025. Matrix Medical Communications. All rights reserved.)

Skin color classification can have importance in skin health, pigmentary disorders, and oncologic condition assessments. It is also critical for evaluating disease course and response to a variety of therapeutic interventions and aids in accurate classification of participants in clinical research studies. A panel of dermatologists conducted a literature review to assess the strengths and limitations of existing classification scales, as well as to compare their preferences and utilities. We identified 17 skin classification systems utilized in dermatologic settings. These systems include a range of parameters such as UV light reactivity, race, ethnicity, and degree of pigmentation. The Fitzpatrick skin type classification is most widely used and validated. However it has numerous limitations including its conflation with race, ethnicity, and skin color. There is a lack of validation data available for the remaining scales. There are significant deficiencies in current skin classification instruments. Consensus-based initiatives to drive the development of validated and reliable tools are critically needed., Competing Interests: Conflicts of interest Dr Harvey has served as a consultant for L’Oréal and SkinCeuticals and on advisory boards for AbbVie, Lilly, Bristol-Myers Squibb, and Johnson & Johnson. Dr Alexis has received grants (funds to institution) from LEO Pharma, Novartis, Almirall, Bristol-Myers Squibb, Amgen, Vyne, Galderma, Valeant (now Bausch Health), Cara Therapeutics, Arcutis, Dermavant, AbbVie, and Castle; on advisory board or as a consultant for LEO Pharma, Galderma, Pfizer, Sanofi-Regeneron, Dermavant, Beiersdorf, Ortho, L’Oréal, BMS, Bausch Health, UCB, Vyne, Arcutis, Janssen, Allergan, Almirall, AbbVie, Amgen, VisualDx, Eli Lilly, Swiss American, Cutera, Cara Therapeutics, EPI Health, Incyte, Castle, Apogee, Alphyn, and Canfield; as a speaker for Regeneron, Sanofi-Genzyme, Pfizer, and BMS; and has received royalties from Springer, Wiley-Blackwell, and Wolters Kluwer Health. Dr McKinley-Grant has served as a consultant for Janssen and Determi-Nation. Dr Taylor has served as a consultant/advisor/speaker for AbbVie, Arcutis Biotherapeutics, Inc, Armis Scientific, Avita Medical, Beiersdorf, Inc, Biorez, Inc, Bristol-Myers Squibb, Cara Therapeutics, Dior, Eli Lilly, EPI Health, Evolus, Inc, Galderma Laboratories, LP, GloGetter, Hugel America, Inc, Johnson & Johnson Consumer Products Company, L’Oréal USA, Medscape/WebMD, MJH LifeSciences, Pfizer, Piction Health, Sanofi, Scientis US, UCB, and Vichy Laboratoires; as an author at McGraw-Hill; on the Editorial Board for Practical Dermatology, Cutis, and Archives in Dermatologic Research and a peer reviewer for the British Journal of Dermatology; and as an investigator for Allergan Aesthetics, Concert Pharmaceuticals, Croma-Pharma GmbH, Eli Lilly, and Pfizer. Dr Desai has served as an investigator and/or consultant for Galderma, Pfizer, Lilly, Dermavant, AbbVie, and many other companies; he also holds multiple leadership positions in national and other organizations. Dr Jaleel has received grants from Pfizer, Skin of Color Society, Dermatology Foundation, and the NIH; as a consultant for UCB, Eli Lilly, Novartis, and ChemoCentryx. Dr Kang has served on the advisory board and/or as a consultant for Amore Pacific, CeraVe, Galderma, Eli Lilly, and Jeune. Dr Vashi has served as a consultant for Janssen Biotech, L’Oréal, and Canfield. Dr Elbuluk has served as a consultant for Avita, Scientis, Beiersdorf, Incyte, VisualDx, La Roche Posay, Beiersdorf, and Unilever; on advisory boards for Allergan, Eli Lily, Galderma, Incyte, Janssen, La Roche Posay, and L’Oréal; as speaker for Estee Lauder, La Roche Posay, Scientis, Medscape, Beiersdorf, and Dior; and as an investigator for Avita. Dr Hamzavi has served as a consultant to AbbVie, Pfizer, Incyte, UCB, Boehringer Ingelheim, Sonoma, Union therapeutics, Novartis, Janssen, Avita, Galderma, Almirall, and Vimela; as an investigator for Lenicura, Pfizer, Incyte, Avita, Loreal/Laroche Posay, Clinuvel, ITN, Chemocentyx, Ferndale Laboratories, Inc, Unigen, Inc, and Arcutis; and as a board member and Past-president of the HS Foundation and Global Vitiligo Foundation. Dr Kwatra has served as an advisory board member/consultant for AbbVie, Amgen, Arcutis Biotherapeutics, Aslan Pharmaceuticals, Cara Therapeutics, Castle Biosciences, Celldex Therapeutics, Galderma, Genzada Pharmaceuticals, Incyte Corporation, Johnson & Johnson, LEO Pharma, Novartis Pharmaceuticals Corporation, Pfizer, Regeneron Pharmaceuticals, and Sanofi; and as an investigator for Galderma, Incyte, Pfizer, and Sanofi. Dr Kholi has served as an investigator for Ferndale, Estée Lauder, La Roche Posay Dermatologique, Unigen, Johnson & Johnson, Allergan, Pfizer, Sciton, and Bayer; received support from the American Skin Association for a vitiligo project; was a consultant for Pfizer, Johnson & Johnson, Beiersdorf (previously known as Bayer), and ISDIN; and received salary support from the Dermatology Foundation through a research career development award. Dr Callender has served as an investigator and/or received grants from AbbVie/Allergan, Almirall, Aerolase, Arcutis, Avava, Beiersdorf, Eirion, Eli Lilly, Janssen, L’Oréal, Pfizer, Prollineum, skinbetter science, Symatese, and Teoxane; as a consultant or advisor for Acne Store, Aerolase, Arcutis, Avita Medical, Beiersdorf, Cutera, Dermavant, EPI Health, Jeune Aesthetics, L’Oréal, OrthoDerm, Scientis, Sente, SkinCeuticals, and UCB; as a speaker for Eli Lilly, L’Oréal, and SkinCeuticals; and has received royalties from Elsevier and UpToDate. Author Okeke, Dr Heath, Dr Lester, Dr Vasquez, Dr Rodriguez, Dr Sundaram, Author Brown, and Author Cobb have no conflicts of interest to declare., (Copyright © 2024 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Competing Interests: Conflicts of interest Dr Grimes has served as a clinical investigator and/or consultant for Galderma, Clinuvel, L'Oreal, Johnson & Johnson, LaserOptek, Mother Science, VYNE Therapeutics, RAPT Therapeutics, Incyte, Pfizer, AbbVie/Allergan, SkinBetterScience, and Medscape. Dr Kyei is a speaker for Abbvie, Lilly, Pfizer, and Proctor & Gamble. Dr Alexis has served as a consultant and/or advisory board for Leo, Galderma, Pfizer, Sanofi-Regeneron, Dermavant, Beiersdorf, Ortho, L'Oreal, BMS, Bausch health, UCB, Vyne, Arcutis, Janssen, Allergan, Almirall, Abbvie, Amgen, VisualDx, Eli Lilly, Swiss American, Cutera, Cara, EPI, Incyte, Castle, Apogee, Canfield, and Alphyn. Dr Elbuluk has served as a consultant for Incyte, VisualDx, La Roche Posay, Beiersdorf, and Unilever. She has served on advisory boards for Allergan, Eli Lilly, Galderma, Incyte, Pfizer, Janssen, L'Oreal, and McGraw Hill. She has been a speaker for La Roche Posay, Medscape. Dr Shapiro has served as a clinical investigator and consultant for Pfizer. He has served as a consultant for Lilly, 30 Madison, Lumenis B, DS Laboratories, and holds stock options for Replicel Life Sciences. [Reprint requests: Pearl E Grimes]. Drs Drake, Tatarinova, and Ms Dias have no conflicts of interest to declare.

Background: Vitiligo lesions are often challenging to repigment with conventional medical therapies. Surgical autologous melanocyte transfer methods can be utilized for stable vitiligo but demand specialized skills and equipment. A point-of-care autologous cell harvesting device was designed enabling simple preparation of autologous skin cell suspension (ASCS) containing melanocytes, keratinocytes, and fibroblasts providing a straightforward approach for cellular transplantation., Objective: To evaluate the safety and effectiveness of ASCS for repigmentation of stable vitiligo lesions among adults., Methods: A US multicenter, randomized, within-subject controlled trial compared ASCS to narrow band ultraviolet B only (Control) in similar vitiligo lesions. ASCS was applied after laser skin resurfacing and followed by narrow band ultraviolet B treatment. The primary effectiveness endpoint was the proportion of lesions achieving ≥80% repigmentation at week-24. Repigmentation durability was assessed at week-52., Results: Among 25 subjects, 36% of ASCS-treated lesions achieved ≥80% repigmentation at week-24 compared to 0% for Control (P < .025), with durability through week-52. The safety profile of ASCS was acceptable, with favorable patient- and investigator-reported outcomes., Limitations: Study sample size limited robust subgroup analyses., Conclusion: Application of ASCS has potential as a treatment for repigmentation of stable vitiligo lesions with the potential to improve health-related quality of life and reduce burden of disease., Competing Interests: Conflicts of interest Dr Hamzavi has served as an advisory board member for AbbVie; a consultant for Boehringer Ingelheim, AVITA Medical, Galderma Laboratories LP, Incyte, Pfizer, and UCB; a principal investigator for AVITA, Bayer, Estée Lauder, Ferndale Laboratories, Incyte Corporation, Lenicura, L’Oréal, Pfizer, and Unigen; immediate past president of the HS Foundation; and a board member of the Global Vitiligo Foundation. Dr Ganesan is an investigator for AVITA and AbbVie. Dr Mahmoud is an investigator for AVITA. Dr Munavalli is an investigator and speaker for AVITA. Dr Kahn is an investigator and speaker for AVITA and Vericel Inc, a DSMB consultant for Polynovo, and an investigator and medical monitor for Spectral MD. Dr Huang has served on an advisory panel for Incyte and as an investigator for Abbvie. Dr Waibel has served as an advisory board member for Bellamia, Cytrellis Biosystems, and RegenX; a consultant for Allergan, Candela, Cytrellis Biosystems, P&G, Skinceuticals, and Turn.Bio; an investigator for Amgen, ArgenX, Bristol Myers Squibb, Cytrellis Biosystems, Eli Lily, Emblation, Galderma, Horizon, Janssen, Neuronetics, Pfizer, RegenX, Sanofi, Skincueticals, and Shanghi Biopharma, PWB; a speaker for Candela and Eli Lily; she has received a Veterans Affairs Merit Grant - Amputated Veterans. Dr Elbuluk has served as a consultant, advisory board member, and/or speaker for AVITA, Incyte, VisualDx, La Roche Posay, Beiersdorf, Unilever, Allergan, Eli Lilly, Galderma, Pfizer, Takeda, AbbVie, Janssen, Sanofi, L’Oreal, McGraw Hill, Dior, Medscape; she has grant funding from Pfizer, has received royalties from McGraw-Hill and has stock options in VisualDx. Dr Pandya has served as an investigator for Incyte, AVITA, Clinuvel; a consultant for AbbVie, AVITA, Boehringer Ingelheim, Immune Tolerance Network, Incyte, Lilly, Pfizer, Sun, Thalocan, WCG, Villaris, Vimela, Vyne; and has partial owndership of Tara Medical. Drs Weiss, Ahmed, Robinson, Goldman, A. Desai and S. Desai have no conflicts of interest to declare., (Copyright © 2024 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

The incidence of inflammatory bowel disease (IBD) is increasing in racial and ethnic minority groups. Cutaneous extraintestinal manifestations (EIMs) of IBD are well-known comorbid conditions that can occur in both active and quiescent IBD. Historically, cutaneous EIMs of IBD are described in White skin with a lack of literature describing these conditions in darker skin tones. This potentially creates a knowledge gap and awareness among providers in recognizing these conditions and offering therapy in a timely manner to non-White patients. This review aims to describe the cutaneous manifestations of IBD in a wide range of skin tones with several examples to improve awareness. With further awareness, this review will enable to provide equitable care to IBD patients with cutaneous EIMs., (© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Current dermatology residency education may be deficient in curricular topics and training related to diversity, equity, and inclusion (DEI). Integrating more DEI topics within residency curricula may improve clinical care delivered to diverse populations and improve cultural humility among trainees. The objective of this electronic Delphi (e-Delphi) study was to reach a consensus on the most important DEI topics for inclusion in dermatology residency program curricula nationwide. Sixty-one DEI-related topics were proposed by an expert panel consisting of dermatologists from the Association of Professors of Dermatology DEI subcommittee and the American Academy of Dermatology Diversity Task Force. Two rounds of anonymous electronic surveys based on a 5-point Likert scale were administered using a modified e-Delphi design. Voluntary participants including residents and academic dermatologists were self-selected after an email was sent to the Association of Professors of Dermatology listserve.

Background: As the racial/ethnic diversity of the US population grows, it is imperative for dermatologists to recognize the nuances in the aesthetic treatment of diverse populations., Objective: This comprehensive review explores the safety and efficacy of botulinum toxin A (BTX-A) in skin of color (SOC) populations and highlights variations in aging patterns, skin properties, and aesthetic concerns in SOC populations., Materials and Methods: A review of PubMed/MEDLINE databases from 2004 to 2024 was performed using combinations of the terms botulinum toxin, SOC, Fitzpatrick, race/ethnicity, and Asian, Latin American, Caribbean, Middle Eastern, African, and Pacific countries., Results: Twenty-three articles examining the use of BTX-A in SOC populations were identified. Twelve studies were from East Asia, 5 from the United States and/or Canada, 3 from South Asia/Southeast Asia, 2 from South America, and 1 from the Middle East. Available data suggest that BTX-A is efficacious and well tolerated in SOC populations., Conclusion: Increased SOC representation in clinical trials may guide the development of tailored treatment approaches to optimize aesthetic outcomes for patients with SOC. A comprehensive knowledge of the variations in aging patterns, skin properties, and aesthetic concerns across SOC populations is essential for providing culturally sensitive cosmetic dermatologic care for diverse populations., (Copyright © 2024 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Skin of color centers (SoCCs) in the United States have helped increase the racial/ethnic diversity of and cultivate cultural competence in practicing dermatologists as well as increase skin of color (SoC) research and education to improve patient care. The objective of this cross-sectional survey study was to provide an in-depth analysis of SoCCs and SoC specialty clinics (SoCSCs) in the United States, including their patient care focus, research, and program diversity. As the US population diversifies, it is important to highlight the programmatic, research, and educational work of existing SoCCs so that they can continue to be supported and so efforts are made to encourage the establishment of future centers at academic medical institutions across the United States.

Background: Skin of color (SOC) individuals represent a growing market for cosmetic injectables and can have different aesthetic goals and responses to treatment., Objective: A review of the uses, safety, and effectiveness of injectable neuromodulators and dermal fillers in SOC individuals., Methods and Materials: A search of the PubMed/MEDLINE database was conducted from August 1960 to December 2020. Studies that were included either had a focus on SOC (>20% SOC study participants) or dedicated article content commenting on the safety and/or efficacy of injectables in SOC participants., Results: Of the 503 publications identified, a total of 88 articles were selected for this review. Differences in aging and cultural factors can influence aesthetic goals amongst SOC populations. Available data suggests that botulinum toxin (BTX) and dermal fillers are safe and effective in SOC populations, with the largest amount of data existing for Asian populations. There remains a paucity of research on Black and Latinx populations., Conclusion: BTX and dermal fillers are generally effective and well tolerated in SOC populations, particularly Asian populations for which the greatest amount of data exists. More high quality, randomized controlled trials in Black and Latinx populations are warranted., (© 2024 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Many individuals with vitiligo are uncertain about their skin cancer risk, phototherapy risks, and recommended sun protective practices. This study examined the perceived skin cancer risk and sun protective practices among individuals living with vitiligo. A secondary objective was to understand where participants obtain this information. This was a prospective cross-sectional study. An online survey was distributed to vitiligo support group leaders globally who shared the survey with their members. Individuals over the age of 18 and with vitiligo were included. There were 209 survey respondents, the majority were between the ages 35-54 (45.5%, n = 95), female (70.8%, n = 148), White (66.0%, n = 138). Nearly half of respondents believed they were at increased risk of skin cancer because of their vitiligo (45.5%, n = 95) and nearly a quarter (22.5%, n = 47) believed that phototherapy increased their risk of skin cancer. Having vitiligo affected sun protective practices with less than a quarter (24.4%, n = 51) of respondents using sunscreen daily or often prior to their vitiligo diagnosis in comparison to the majority of respondents (60.3%, n = 126) using it after their vitiligo diagnosis. The three most common sources where patients obtained information were the internet and social media (46.4%, n = 97), vitiligo support groups (23.4%, n = 49), and dermatologists (20.6%, n = 43). Despite evidence indicating a decreased risk of skin cancer in individuals with vitiligo and supporting the safety of narrowband ultraviolet B phototherapy, many participants believed they were at an increased risk of skin cancer. Findings were sub-stratified and showed differences in sunscreen usage based on gender, skin color, and percent depigmentation. This study also found nearly half of respondents obtained information related to vitiligo from the internet and social media. The number of participants may limit the generalizability of the findings. Survey questionnaires are also subject to response bias. The findings from this study highlight demographic variations in sunscreen usage which may help guide the development of targeted interventions to improve sun protective behaviors among diverse populations with vitiligo. In addition, this study suggests certain sun protective practices and skin cancer risk perceptions may vary based on extent of depigmentation. Lastly, this study also demonstrates the internet and social media as a popular source for obtaining information, emphasizing the need for dermatologists to leverage various online communication channels to help disseminate accurate information., (© 2024. The Author(s).)

Background: Modified Kligman's formula (mKF) is the gold standard treatment for melasma; however, its prolonged use is not recommended due to side effects. Cysteamine is a potent, safe, and effective depigmenting agent. Here, we conducted a double-blind, randomized, and placebo-controlled clinical trial to assess the efficacy of cysteamine isobionic-amide -- a complex with enhanced depigmenting efficacy -- and compared it to mKF for the treatment of melasma., Methods: This study involved a total of 80 patients divided into 3 groups: cysteamine-isobionic amide, placebo, or mKF. The modified Melasma Area Severity Index (mMASI) score and spectrophotometric evaluation were conducted at baseline, week 4, week 8, and week 16. Dermatological assessment, patients&rsquo; feedback, and satisfaction including quality-of-life scores were also collected., Results: At week 4, cysteamine isobionic-amide and mKF groups showed an equivalent onset of action in terms of mMASI and skin pigmentation contrast reduction. The 2 groups significantly reduced melasma severity and improved the overall skin condition with a comparable efficacy at week 16. Quality of life of melasma patients was significantly improved in the cysteamine isobionic-amide group at week 8 and further at week 16 (P&lt;0.001) compared to the mKF group. Patients&rsquo; feedback and satisfaction were higher with the cysteamine isobionic-amide product compared to mKF., Conclusion: Cysteamine isobionic-amide provided a rapid onset of action and was as effective as the mKF for the treatment of melasma. The data suggest that cysteamine isobionic-amide could potentially be an acceptable alternative to mKF for the long-term treatment of melasma. J Drugs Dermatol. 2024;23(2):9-16.&nbsp; doi:10.36849/JDD.7428.

Background: Melasma is a chronic hypermelanosis of the skin that affects approximately 1% of the global population, predominantly affects women, and is more prevalent in skin of color. Melasma is a common driver for patients with skin of color to seek out a dermatologist for treatment, and ensuring the right approach for these patients is important because some treatments may be associated with adverse side effects. Because of the chronicity of the disease and established psychosocial and emotional impacts, there is a large need to ensure care follows the best available evidence on the treatment of patients with melasma., Objective: Here, we summarized current available topical treatments for melasma with considerations dermatologists should have for their patients with skin of color., Methods: Steering committee consensus on clinical best practices., Results: We describe a flexible and focused treatment algorithm that reflects both treatment and maintenance periods that is a consensus of our extensive clinical experience., Limitations: Use of real-world evidence and potential for individual practice bias., Conclusion: Melasma can be challenging to treat, particularly in patients with skin of color, and our recommendations for best practices for patients in the United States are an important step toward standardizing care., Competing Interests: Conflicts of interest Dr Desai has served as a consultant and/or investigator for Galderma, Pfizer, Dermavant, Scientis, AbbVie, and several other organizations. He also serves in multiple leadership roles with dermatologic organizations. Dr Alexis has received grants from LEO Pharma, Novartis, Almirall, Bristol Myers Squibb, Amgen, Vyne, Galderma, Valeant (now Bausch Health), Cara, Arcutis, Dermavant, AbbVie, and Castle and consulting fees or honoraria from Leo, Galderma, Pfizer, Sanofi-Regeneron, Dermavant, Beiersdorf, Ortho, L’Oreal, Bristol Myers Squibb, Bausch Health, UCB, Vyne, Arcutis, Janssen, Allergan, Almirall, AbbVie, Sol-Gel, Amgen, VisualDx, Eli Lilly, Swiss American, Cutera, Cara, EPI, and Incyte. He has also received speaker fees from Regeneron, Sanofi-Genzyme, Pfizer, and Bristol Myers Squibb. Dr Elbuluk has received fees, research funding, or stock options for consulting, speaking, or participating in advisory boards from Allergan, Avita Medical, Beiersdorf, Estée Lauder, Galderma Laboratories, Incyte, Janssen, La Roche-Posay, L’Oreal, Scientis, Unilever, and VisualDx. Dr Grimes has served as a consultant and/or investigator for Procter & Gamble, Clinuvel, L’Oreal, Galderma Laboratories, LaserOptek, Versicolor Technologies, Incyte, Pfizer, AbbVie/Allergan, and SkinBetterScience. Dr Weiss served on the advisory board for Galderma Laboratories and Valeant Pharmaceuticals International (now Bausch Health), receiving honoraria. He also served as consultant for Abbott Laboratories, Celgene Corporation, LEO Pharma, and Sebacia, receiving honoraria. Dr Hamzavi is a consultant to AbbVie, Pfizer, Incyte, UCB, Boerhinger Ingelheim, Sonoma, Union therapeutics, Novartis, Janssen, Avita, and for Galderma Laboratories. Dr Hamzavi is an investigator for LENICURA, Pfizer, Incyte, Avita, and L’Oreal/La Roche-Posay. He is a board member and past president of the HS Foundation and Global Vitiligo Foundation. Dr Taylor reports service as an investigator for Concert Pharmaceuticals, Croma-Pharma, Eli Lilly, and Pfizer. Dr Taylor has received salaries, fees, honoraria, and stock options as a consultant, advisor, board member, and speaker for Mercer Strategies, AbbVie, Arcutis Biotherapeutics, Armis Scientific, Beiersdorf, Biorez, Cara Therapeutics, EPI Pharma, Evolus, Galderma Laboratories, Glo Getter, Hugel America, Janssen, Johnson & JohnsonJohnson & Johnson, L’Oreal, Medscape/WebMD, MJH Life Sciences, Piction Health, Regeneron, Scientis US, UCB, and Vichy Laboratoires., (Published by Elsevier Inc.)

Competing Interests: Conflicts of interest Dr Ngo is an investigator for Castle Biosciences studying gene expression in melanoma and is on their Speakers Bureau. Dr Elbuluk is the Director of the Skin of Color and Pigmentary Disorders program as well as the Diversity and Inclusion program at the University of Southern California (USC) Department of Dermatology, Keck School of Medicine. She is also director of curriculum equity at USC Keck School of Medicine. She has served as a consultant for Avita, Scientis, Incyte, VisualDx, La Roche Posay, Beiersdorf, and Unilever. She has served on advisory boards for Allergan, Eli Lilly, Galderma, Incyte, Pfizer, Janssen, La Roche Posay, L'Oreal, McGraw Hill, and Dior. She has been a speaker for La Roche Posay, Scientis, Medscape, Beiersdorf, and Dior. She has received royalties from McGraw-Hill book royalties. She has served as an investigator for Avita. Author Gonzalez, Author Syder, Dr McKenzie, Dr Price, Author Mora Hurtado, and Author Rodman have no conflicts of interest to declare.

Various studies have revealed a disproportionately low representation of skin of color (SOC) dermatology in the medical education system of the United States. This disparity contributes to adverse experiences, missed and/or delayed diagnoses, and overall health inequities for individuals of color. The lack of sufficient SOC education begins at the medical school level and continues throughout residency, fellowship, and beyond formal training. This lack of education can be seen in the dearth of images of common and uncommon skin conditions in darker skin in widely used textbooks and educational resources as well as in the lack of formal training in SOC in many residency programs. Thus far, there have been valuable strides to make dermatologic education more inclusive of all skin colors, but there remains significant work to be done. With the population of the United States expected to continue to diversify and with the expectation that SOC will be a trait of over half of the population of the United States by 2050, it is important to strive for health equity by ensuring that comprehensive and inclusive medical training incorporates SOC. This paper will explore the issue of gaps in medical education in SOC dermatology at all levels and offer a strategic call to action to aid in rectifying this situation., Competing Interests: Conflicts of interest Dr Elbuluk is the director of Diversity and Inclusion as well as Director of the Skin of Color and Pigmentary Disorders program at the University of Southern California Department of Dermatology, Keck School of Medicine and the Director of Clinical Impact for VisualDx. Dr Taylor is the Vice Chair for Diversity, Equity and Inclusion for the Department of Dermatology, Perelman School of Medicine, Co-Chair of the AAD Skin of Color Curriculum Committee, author of the textbook Taylor and Kelly’s Dermatology for Skin of Color, and founder of the Skin of Color Society. Authors Syder, Omar, and Brown-Korsah, Dr McKenzie have no conflicts of interest to disclose., (Copyright © 2022 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Although racial and ethnic demographics are shifting in this country, it is not reflected in the diversity of clinical trial research participants; science, technology, engineering, and mathematics pipeline programs; or the workforce in the field of dermatology. Barriers to recruitment of minority patients for research studies also exist for numerous reasons including lack of education of prospective subjects, lack of awareness of ongoing trials, and mistrust within the health care system. Gaps in the science, technology, engineering, and mathematics pipeline for racial and ethnic minorities, particularly Black, Hispanic/Latinx, and American Indian or Alaska Native, are due in large part to structural racism. Lack of exposure as well as lack of educational, mentorship, and research opportunities contribute to gaps in the dermatology workforce. Having a representative population in the dermatology workforce and in clinical research trial patients is essential for optimum patient care, excellence in the specialty, and knowledge of appropriate treatments for minority populations. This article will discuss knowledge gaps for increasing minority subjects who participate in clinical research trials and discuss mechanisms to engage this community in trial recruitment. Additionally, this article addresses lack of racial and ethnic diversity of the dermatology workforce and performance gaps in the recruitment of racial/ethnic minorities into dermatology., Competing Interests: Conflicts of interest Dr Taylor is the Vice Chair for Diversity, Equity and Inclusion for the Department of Dermatology, Perelman School of Medicine, co-chair of the American Academy of Dermatology Skin of Color Curriculum Committee, an author of the textbook “Taylor and Kelly’s Dermatology for Skin of Color,” and the founder of the Skin of Color Society. Dr Elbuluk is the Director of Diversity and Inclusion and Director of the Skin of Color and Pigmentary Disorders Program at the Department of Dermatology, Keck School of Medicine, University of Southern California, and the Director of Clinical Impact for VisualDx. Dr McKenzie and authors Omar, Syder and Brown-Korsah have no conflicts of interest to declare., (Copyright © 2022 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Acne is a common, chronic inflammatory condition affecting millions of people worldwide, with significant negative impact on quality of life and mental health. Acne is characterized by comedones, inflammatory papules, pustules, and nodulocystic lesions, with long-lasting sequelae including scarring and dyspigmentation, the latter of which is more common in skin of color. The four main pillars of acne pathophysiology include alteration of sebum production and concentration, hyperkeratinization of the follicular unit, Cutibacterium acnes strains, and an inflammatory immune response. Newer research has provided greater insight into these pathophysiologic categories. This greater understanding of acne pathogenesis has led to numerous new and emerging treatment modalities. These modalities include combinations of existing treatments, repurposing of existing agents historically used for other conditions, new topical treatments, novel antibiotics, topical and oral probiotics, and various procedural devices. This article will provide an overview of emerging treatments of acne and their link to our current and improved understanding of acne pathogenesis., (© 2023. The Author(s).)

Acne vulgaris can be associated with hyperpigmentation, particularly in individuals with skin of color. This acne-induced macular hyperpigmentation (AMH), also called postinflammatory hyperpigmentation, is often long lasting and negatively impacts quality of life. Large-scale, randomized, controlled clinical trials with regard to the treatment of acne and AMH are lacking. For this reason, evidence-based treatment recommendations cannot be made. However, AMH is a common condition, and it is important for clinicians to have guidance on management strategies. The authors, a group of 10 board-certified dermatologists, conducted a modified Delphi consensus process to reach a consensus on first-line therapy for AMH and determine whether therapeutic choices change in different patient subgroups. We reached a consensus that most patients with acne and AMH should receive early and efficacious acne treatment with a topical retinoid and benzoyl peroxide. Therapies aimed at addressing AMH-including hydroquinone, azelaic acid, chemical peel, or antioxidants-may also be considered for enhancing the effect of the treatment regimen on acne and pigmentation. Chemical peels may be used as adjunctive or second-line therapy. This article details the results of the Delphi process, reviews relevant literature for providing recommendations for AMH, and discusses appropriate treatment options., Competing Interests: Conflicts of interest Dr Taylor has served as a consultant, advisory board member, speaker, and/or investigator for AbbVie, Allergan Aesthetics, Arcutis Biotherapeutics, Armis Scientific, Avita Medical, Beiersdorf, Bristol Myers Squibb, Cara Therapeutics, Concert Pharmaceuticals, Croma-Pharma GmbH, Dior, Eli Lilly, EPI Pharma, Evolus, Galderma Laboratories LP, GloGetter, Hugel America, Johnson & Johnson Consumer Products Company, L’Oreal USA, MedScape, Pfizer, Piction Health, Sanofi, Scientis, UCB, and Vichy Laboratories. Dr Elbuluk has served as a paid consultant and/or advisory board member or speaker for Allergan, Beiersdorf, La Roche Posay, VisualDx, Scientis, Galderma Laboratories LP, Zosano, Incyte, Estee Lauder, Scientis, and Avita and has received fees for being a Unilever partner. Dr Grimes has served as a consultant for Galderma Laboratories LP, UpToDate, and Proctor & Gamble; received grants from Incyte, VT Technologies, Pfizer, SUN, and Arcutis; and has lectured for Scientis (Cyspera). Dr Chien has served as a consultant and/or advisory board member for Galderma Laboratories LP and Under Armour; has served as an investigator for and received grants from Boots Walgreen Alliance and Amorepacific, Inc; and has been a contributing author receiving honoraria for UpToDate, Inc. Dr Hamzavi has served as a consultant and/or advisory board member for Galderma Laboratories LP, AbbVie, Incyte, Pfizer, UCB, Boehringer Ingelheim, and Clarify Medical; has served as an investigator for Pfizer Inc, Bayer, Lenicura, Incyte, Estee Lauder, Ferndale Laboratories, Inc, Galderma Laboratories LP, L’Oreal, Unigen, Arcutis, and Avita; and is cochair of the Global Vitiligo Foundation. Dr Alexis has served as a consultant and/or advisory board member for Leo, Galderma, Pfizer, Sanofi-Regeneron, Dermavant, Beiersdorf, Valeant, L’Oreal, BMS, Bausch health, UCB, Vyne, Arcutis, Janssen, Allergan, Almirall, AbbVie, Sol-Gel, Amgen, VisualDx, Eli Lilly, Swiss American, and Cutera; has served as a speaker for Regeneron, SANOFI-Genzyme, Pfizer, and BMS; and has received royalties from Springer Verlag, Wiley Blackwell, and Wolters Kluwer. Dr Weiss has served as a speaker for AbbVie, Almirall, Galderma Laboratories LP, Ortho Dermatologics, Regeneron, and Sanofi; consultant and/or advisory board member for Cassiopia, Cutera Inc, Dr Reddy, EPI Health, Foamix, Galderma Laboratories LP, Incyte, Leo Pharma, Novartis, Ortho Dermatologics, and UCB; and investigator for AbbVie, Aclaris, Bausch Health, Celgene/Amgen, Cutera, Endo, Foamix, Galderma Laboratories LP, Leo Pharma, Moberg, and Novartis. Dr Kang has served as a consultant and investigator for Almirall and Galderma Laboratories LP. Dr Desai serves as a consultant and/or investigator for a variety of different organizations, including Galderma, Pfizer, Incyte, Eli Lilly, L’Oreal, and others. He also serves in numerous leadership capacities within dermatology. Dr Gonzalez has no conflicts of interest to declare., (Copyright © 2023. Published by Elsevier Inc.)

Disorders of hyperpigmentation are common and challenging conditions which can arise due to a myriad of etiologic factors. Many of them can present across skin types but are more common in skin of color individuals with Fitzpatrick skin types III-VI. Facial hyperpigmentation, in particular, can have a significant impact on the quality of life of affected individuals due to its increased visibility. This article provides a comprehensive review of disorders of facial hyperpigmentation including epidemiology, pathogenesis, diagnostic considerations, and treatment approaches for these conditions., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Radiofrequency (RF) and radiofrequency microneedling (RFM) for rhytides, scarring, and skin rejuvenation are believed to have a lower risk of postprocedural dyspigmentation in darker skin types., Objective: To explore the safety and efficacy of RF and RFM in Fitzpatrick skin Types III to VI., Methods and Materials: A systematic review of PubMed/MEDLINE databases from 2000 to 2021 using combinations of the terms radiofrequency, microneedling, skin of color, and Fitzpatrick was performed. Exclusion criteria included non-Fitzpatrick skin Types III-VI patient population, nonprimary articles, nonskin radiofrequency, and nonhuman studies., Results: Thirty-five articles addressing the use of RF or RFM in skin of color were identified-22 for skin rejuvenation, 7 for acne scars, 4 for nonacne scars, 1 for hyperpigmentation, and 1 for acne treatment. Seven studies noted transient postinflammatory hyperpigmentation, 1 observed mild prolonged hyperpigmentation, and only 1 study reported permanent scarring., Conclusion: Radiofrequency and RFM seem to have a low risk of scarring or hyperpigmentation in skin of color. This review demonstrates that these procedures have been successfully used primarily for rhytides, acne scarring, and skin rejuvenation. However, a large proportion of the studies lack strong quality evidence., (Copyright © 2023 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Clinical trials are an essential component of research for determining the safety and efficacy of treatments for medical diseases. In order for the results of clinical trials to be generalizable to diverse populations, they must include participants at ratios that are reflective of national and global populations. A significant number of dermatology studies not only lack racial/ethnic diversity but also fail to report data on minority recruitment and enrollment. Reasons for this are multifold and are discussed in this review. Although steps have been implemented to improve this issue, greater efforts are needed for sustained and meaningful change., Competing Interests: Conflicts of interest Dr N. Elbuluk is the director of the USC Dermatology Diversity and Inclusion Program as well as the Director of the Skin of Color and Pigmentary Disorders Program at the USC Department of Dermatology, Keck School of Medicine., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Skin of color (SOC) populations include those who identify as Black/African, Hispanic/Latinx, Asian/Pacific Islander, American Indian/Native Alaskan, Indigenous Australian, Middle Eastern, biracial/multiracial, or non-White; this list is far from exhaustive and may vary between and within cultures. Recent genetic and immunological studies have suggested that cutaneous inflammatory disorders (atopic dermatitis, psoriasis, and hidradenitis suppurativa) and malignancies (melanoma, basal cell carcinoma, and cutaneous T-cell lymphoma) may have variations in their immunophenotype among SOC. Additionally, there is growing recognition of the substantial role social determinants of health play in driving health inequalities in SOC communities. It is critically important to understand that social determinants of health often play a larger role than biologic or genetic factors attributed to "race" in health care outcomes. Herein, we describe the structural, genetic, and immunological variations and the potential implications of these variations in populations with SOC. This article underscores the importance of increasing the number of large, robust genetic studies of cutaneous disorders in SOC to create more targeted, effective therapies for this often underserved and understudied population. Part II of this CME will highlight the clinical differences in the phenotypic presentation of and the health disparities associated with the aforementioned cutaneous disorders in SOC., Competing Interests: Conflicts of Interest Dr Taylor is the Vice Chair for Diversity, Equity and Inclusion for the Department of Dermatology, Perelman School of Medicine. She is Co-Chair of the AAD Skin of Color Curriculum Committee, an author of the textbook, Taylor and Kelly's Dermatology for Skin of Color, and the founder of the Skin of Color Society. Dr Elbuluk is the Director of Diversity and Inclusion, as well as Director of the Skin of Color and Pigmentary Disorders Program at the USC Department of Dermatology, Keck School of Medicine. She is also the Director of Clinical Impact for VisualDx. Brown-Korsah, McKenzie, Omar, and Syder have no conflicts of interest to declare., (Copyright © 2022 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Skin of color (SOC) patients are projected to comprise the majority of the population by 2044, yet knowledge gaps in the clinical presentation and treatment of both common and uncommon dermatologic conditions in skin of color persist. Improved awareness of disparities that disproportionately impact SOC patients is necessary to address health inequity in the field of dermatology. The first part of this CME discussed structural, genetic, and immunophenotypic differences in SOC in common inflammatory disorders as well as cutaneous malignancies. The second part of this CME highlights clinical differences in the phenotypic presentation of the inflammatory disorders of atopic dermatitis, psoriasis, and hidradenitis suppurativa as well as the cutaneous malignancies of melanoma, basal cell carcinoma, and cutaneous T-cell lymphoma. Health disparities associated with each of these conditions are also discussed., Competing Interests: Conflicts of interest Dr Taylor is the vice chair for Diversity, Equity, and Inclusion for the Department of Dermatology, Perelman School of Medicine. She is co-chair of the AAD Skin of Color Curriculum Committee, an author of the textbook, Taylor and Kelly's Dermatology for Skin of Color, and the founder of the Skin of Color Society. Dr Elbuluk is the director of Diversity and Inclusion as well as director of the Skin of Color and Pigmentary Disorders program at the USC Department of Dermatology, Keck School of Medicine. She is also the director of Clinical Impact for VisualDx., (Copyright © 2022 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Postinflammatory hypopigmentation is an acquired form of hypopigmentation that occurs secondary to an exogenous or endogenous insult to the skin. It can occur in all skin phototypes but is more visually apparent in skin of color. Due in part to greater attention given to its counterpart, postinflammatory hyperpigmentation, there is a dearth of literature describing this entity and treatment options remain limited. This review provides a comprehensive update on the pathogenesis, diagnostic evaluation and treatment of postinflammatory hypopigmentation, with a focus on newly reported treatment modalities.

Dermoscopy has traditionally been used for the diagnosis of neoplasms and more recently in the evaluation of inflammatory conditions. Recent observational studies have suggested a role for dermoscopy in identifying and differentiating acquired pigmentary disorders. This comprehensive review will summarize the growing literature on the use of dermoscopy for pigmentary disorders. A literature review was performed on PubMed dating from inception to October 2020. The following pigmentary disorders were included in this study: melasma, solar lentigines, poikiloderma of Civatte, exogenous ochronosis, lichen planus pigmentosus, erythromelanosis follicularis faciei et colli, pigmented contact dermatitis, Riehl's melanosis, postinflammatory hyperpigmentation, erythema dyschromicum perstans, ashy dermatosis, confluent and reticulated papillomatosis, acanthosis nigricans, pityriasis versicolor, tinea versicolor, idiopathic guttate hypomelanosis, and vitiligo. Search terms used included each pigmentary disorder along with the terms "dermoscopy" or "dermatoscopy." Relevant case reports and case series were included. Many pigmentary disorders have unique and distinguishable features on dermoscopy. Given that these disorders can be clinically challenging for clinicians and emotionally distressing for patients, dermoscopy provides an additional, useful tool in the evaluation and assessment process., (© 2021 the International Society of Dermatology.)

Alopecia has been one of the more common concerns reported at teledermatology (TD) visits during the COVID-19 pandemic. In light of the growing use of TD, a team of experts were consulted to develop workflows for virtual hair and scalp examinations, with particular consideration for skin of color patients.