How do you use the Fitzpatrick skin type classification? Plus dermatology and coronavirus

Wednesday, March 18, 2020

The Fitzpatrick skin type (FST) often is used as a proxy for constitutive skin color, which can lead to confusion. Dr. DeLeo speaks with Dr. Susan Taylor and her colleagues Olivia Ware and Jessica Dawson about the racial limitations of FST in clinical practice. They discuss other classification systems for assessment of skin type and highlight the challenges of creating one system to classify an infinite number of skin tones.

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We also bring you the latest in dermatology news and research:

1. Paper from Wuhan on dermatology and coronavirus

2. Patients accept artificial intelligence in skin cancer screening

3. Dermatologists best at finding work satisfaction in the office

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Things you will learn in this episode:

  • In its early stages, the Fitzpatrick scale was designed to guide dosage for patients undergoing phototherapy by determining who burned and who tanned on exposure to UV light.
  • The Fitzpatrick skin type has been incorrectly associated with visual stereotypical skin color cues, most likely because there is no other widely adopted classification system for skin color that can be applied to all skin.
  • In clinical practice, many providers inappropriately use the FST to describe patients’ constitutive skin color or race/ethnicity rather than their propensity to burn.
  • The FST is automatically included in the physical examination portion of many standardized note templates, even for patients without phototherapy needs.
  • Providers who do not identify as having skin of color may be more likely to use FST to describe constitutive skin color, compared with providers with skin of color.
  • A more detailed and diverse system to describe constitutive skin color in clinical practice is needed. “The world is becoming so diverse, and there are so many different hues, races, ethnicities, and as dermatologists in the forefront we need to be able to identify pigmentary disorders, identify who will have adverse reactions to a variety of procedures, and thinking about how to do that is really the first step in accomplishing our goal,” explains Dr. Taylor.

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Hosts: Nick Andrews; Vincent A. DeLeo, MD (University of Southern California, Los Angeles)

Guests: Susan C. Taylor, MD (University of Pennsylvania, Philadelphia); Olivia R. Ware (Howard University, Washington); Jessica E. Dawson (University of Washington, Seattle)

Show notes by: Alicia Sonners, Melissa Sears, Elizabeth Mechcatie

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Podcast Participants

Vincent A. DeLeo, MD
Vincent A. DeLeo, MD, is from the Keck School of Medicine of the University of Southern California, Los Angeles, and the Icahn School of Medicine at Mount Sinai, New York, New York. He also is the editor in chief of Cutis and the author of more than 200 publications. He is a leading expert on contact dermatitis, sunscreens, and photosensitivity. Dr. DeLeo is a consultant for Estée Lauder.