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Miscellaneous Letter
88 (
5
); 678-679
doi:
10.25259/IJDVL_947_2021
pmid:
35962487

Evaluating skin colour representation in the Indian Journal of Dermatology, Venereology and Leprology

Rutgers New Jersey Medical School, New Jersey, United States
Icahn School of Medicine at Mount Sinai, New York, United States
The George Institute of Global Health, University of New South Wales, Sydney, Australia
Department of Dermatology, University of California, San Francisco, United States
Corresponding author: Dr. Jenny Murase, Department of Dermatology, University of California, San Francisco, California, United States. jemurase@gmail.com
Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Ohri S, Sun M, Wilson BN, Murrell DF, Murase JE. Evaluating skin colour representation in the Indian Journal of Dermatology, Venereology and Leprology. Indian J Dermatol Venereol Leprol 2022;88:678-9.

Sir,

Skin tone is important to the clinical presentation of many cutaneous diseases; however, studies indicate a lack of skin of colour training in dermatology education in many countries, including the United States and Australia.1,2 Several conditions, such as acne keloidalis nuchae and pseudofolliculitis barbae, are more common in darker skin types.3 There is a need for increased representation of such conditions and the type of patients they affect in dermatology textbooks and research literature, particularly in countries such as India where the Fitzpatrick skin types ranges from III to VI.4 We, therefore, aimed to evaluate the representation of published articles related to skin of colour patients in the Indian Journal of Dermatology, Venereology and Leprology (IJDVL).

We evaluated the archives of the IJDVL and 51 other top dermatology journals (according to Journal Impact Factor) from January 2018 through October 2020 and classified each journal according to the criteria developed to assess skin of colour relevance. IJDVL was classified as a non-international clinical skin of colour journal, as it is owned by the National Indian Association.5 We created novel criteria to assess diversity in the dermatologic literature and classified the surveyed titles and available articles into two tiers [Table 1].

Table 1:: Criteria and classification for skin of colour relevant articles
Tier 1A Title specifically addresses skin of color, skin type, or race and ethnicity.
Tier 1B Title specifically addresses a country or continent where the majority of the population is Fitzpatrick skin type III-VI.
Case reports from countries where the majority of the population is Fitzpatrick skin type III-VI.
Tier 1C Title specifically addresses socioeconomic or health disparities that are relevant to under-represented minority patients.
Tier 1D Title specifically addresses issues regarding diversity and inclusion in the field of dermatology.
Tier 1E Case reports from a country where the majority of the population is not Fitzpatrick skin type III-VI that include image or text presenting a person of color.
Tier 2 Title specifically addresses skin and hair diseases that are particularly relevant to patients of Fitzpatrick skin types III-VI due to hair type or pigment presence in skin.

Our study found that the IJDVL had 317 (55.8%) skin of colour-related articles over 568 articles from 2018 to 2020. The vast majority of these articles were classified as Tier 1B, describing patients originating from Asia or the Caribbean, and particularly focusing on patients of South Asian descent [Table 2].

Table 2:: Yearly percentages for skin of colour articles in Indian Journal of Dermatology, Venereology and Leprology
Tier 1A Tier 1B Tier 1C Tier 1D Tier 1E Tier 2 Total SOC* Total Articles %
2018 11 106 0 0 0 9 126 221 57.0
2019 8 75 0 0 1 13 97 190 51.1%
2020 9 77 0 0 0 8 94 157 59.9%
Total 28 258 0 0 1 30 317 568 55.8%

IJDVL ranked second highest among the selected journals for skin of colour representation with 55.8% related articles, which is significantly greater than the 16.8% mean percentage across all 52 journals from 2018 to 2020. These results align with the population that IJDVL serves and solidifies its position as a leader in the skin of colour dermatology. We commend the IJDVL for referencing Fitzpatrick skin type in certain articles and for using the skin of colour-related keywords to reference many of its relevant publications. We recommend the journal standardises presenting patients with Fitzpatrick skin type and using the keyword “skin of colour” when applicable.

Collaboration across global communities is needed to improve diversity and inclusion in dermatology and the IJDVL is in a unique position to guide top dermatology journals. Given its international status and its leadership in publishing skin of colour content, the journal can serve as a model for other top dermatology journals as we strive for greater diversification of dermatology literature.

Declaration of patient consent

Patient consent is not required as there are no patients in this study.

Financial support and sponsorship

Nil.

Conflict of interest

There are no conflicts of interest.

References

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