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Updated: Jul 18, 2026

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Published on: October 6, 2023
Representation of Skin of Color in Rheumatology Educational Resources
Chay Bae1, Michael Cheng2, Christina N Kraus3
1C. Bae, DO, Fellow, M. Cheng, DO, Assistant Professor, S. Desai, MD, Associate Professor, Division of Rheumatology, Department of Medicine, University of California Irvine; chaybae.do@gmail.com.
Objective:
To investigate the availability of images representing Black, Indigenous, and people of color in rheumatology educational resources.
Methods:
Color images were collected from 5 major educational resources and cataloged by the resources they came from, underlying rheumatic conditions, and skin type. Fitzpatrick skin type (FST) was used to categorize images into "light," "dark," or "indeterminate." The images were initially scored by a fellow in the Division of Rheumatology and subsequently validated by a faculty member from the Department of Dermatology.
Results:
Of the thousands of images reviewed, 1604 images met study criteria. FST validation from the Department of Dermatology resulted in the recoding of 111 images. The final scoring revealed 86% of the images to be light skin, 9% of images to be dark skin, and 5% of images to be indeterminate.
Conclusion:
The paucity of dark skin images in rheumatology resources is incongruent with current diversity estimates in the US. Significant efforts should be made to incorporate images of Black, Indigenous, and people of color into educational resources.
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