key: cord-0712138-n2wizu12 authors: Murase, Jenny E.; Murrell, Dedee F. title: Heralding change within dermatology: Response of the International Journal of Women’s Dermatology (IJWD) to the twin pandemic of racism date: 2021-04-15 journal: Int J Womens Dermatol DOI: 10.1016/j.ijwd.2021.03.008 sha: cd86a862afef2fa2a754a5f2ef6b39a2f39a6dfd doc_id: 712138 cord_uid: n2wizu12 nan With the fallout of the pandemic of 2020 spilling over into 2021, we have seen much change in our world. Indeed, the COVID-19 pandemic continues to affect our daily lives, but recognition of its twin, the pandemic of racism, has had a deep and powerful impact, not only within society at large, but specifically within the field of dermatology. Dermatologists have banded together in support of our skin of color colleagues and patients to address knowledge and practice gaps in patient care, as well as a lack of diversity in our field, issues that were not fully appreciated until this second pandemic brought them to light. In this special issue of IJWD, we commemorate the positive change that we have seen within our dermatologic community this past year. In their piece ''Two Pandemics: Opportunities for Diversity, Equity and Inclusion in Dermatology," Drs. Jenna Lester and Susan Taylor outline the recent change we have witnessed within our field, (Lester and Taylor, 2021) and in ''Turning the Tide: How the Women's Dermatologic Society Leads in Diversifying Dermatology," we celebrate and recognize the achievements of Dr. Lenore Kakita, the first Japanese and Skin of Color Women's Dermatologic Society (WDS) President, as well as the three Black WDS Presidents Drs. Wendy Roberts, Valerie Callender, and Pearl Grimes, all trailblazers within the field of dermatology. In addition, we describe the diversity initiatives within the WDS spearheaded by the WDS Diversity Task Force led by Drs. Mona Gohara and Alison Ehrlich, including a summer research fellowship program for underrepresented minority medical students and networking events to promote professional development (Sekyere et al., 2021) . In fact, several articles in this issue have been authored by students who participated in this program and were mentored by members of WDS leadership and IJWD editorial and advisory boards. Drs. Amy McMichael and Susan Taylor outline the importance of supporting our underrepresented colleagues through allyship in dermatology (Feaster and McMichael, 2021) and interventions to increase minority representation in dermatology (Onyekaba et al., 2021) . Health care disparities for underrepresented minorities is an additional focus of this special issue. The two Women's Health Highlights developed by Drs. Valerie Callender and Jennifer Stein (Davis et al., 2021; Ezenwa et al., 2021) as well as studies by Drs. Ramachandran (Castillo Valladares et al., 2021) and Porter (Song et al., 2021) colleagues outline how to recognize and treat skin cancer in women of color that may otherwise go undetected using the clinical exam and dermoscopy and how to make sunscreen recommendations for cancer prevention. Drs. Lauren Seale and Joyce Park expand on how the American Academy of Dermatology can enhance diversity education for dermatologists (Seale et al., 2021) and how the skin of color educational content of medical student resources can be developed (Perlman et al., 2021) . Drs. Mona Gohara, Jenna Lester, and Aileen Chang speak to the importance of community engagement for advocacy within dermatology, introspection-driven activism, and prioritizing equity and inclusion in Global Health Dermatology (Tran and Gohara, 2021; . Finally, this issue highlights medical issues specific to skin of color populations, including excellent clinical pearls for dermatologists who need additional information on how to make treatment recommendations for patients with high curl index hair (Mayo and Callender, 2021) and camouflaging techniques for Central Centrifugal Cicatricial Alopecia patients (Agor and Ward, 2021) . It emphasizes the importance of using dermoscopy in subclinical lichen planus in skin of color patients and details unique considerations in diagnosing and managing pityriasis rubra pilaris in skin of color patients (Plante et al., 2021) . It examines public health issues arising globally from skin lightening agents and cultural pressures to lighten the skin through an international initiative led by Dr. Shadi Kourosh, (Pollock et al., 2021 ) the #BlackGirlMagic social media movement's effect on black women's self esteem, (Olayinka et al., 2021) , and differences in dermatologic-related advertising in magazines targeted to women of color (Seale et al., 2021) . Finally, it provides an action plan for every dermatologist to optimize their patient's dermatologic office visit experience when caring for underrepresented minorities, detailed in the paper ''Bridging Racial Differences in the Clinical Encounter: How Implicit Bias and Stereotype Threat Contribute to Healthcare Disparities in the Dermatology Clinic." (Feaster et al., 2021) . The composite of the publications within this special issue allows us to recognize the true threat that came to light during the twin pandemics. Although the second pandemic was instigated by violent acts of racism, it soon became clear that the more pressing and pervasive threat to the everyday lives of our skin of color patients and colleagues lies not in these conspicuous, intentional acts of overt prejudice, but instead in the actions of those who are well-intentioned but unaware, those who are unknowingly complicit within society's Cultural Current [reference http://sec-tion925.com/culture/2020/12/29/ruffins-theory-of-cultural-current]. The danger lies in a society that declares that it ''does not see color." The color of the skin of our patients and colleagues cannot and should not be ignored; on the contrary, it is something to be International Journal of Women's Dermatology j o u r n a l h o m e p a g e : recognized, acknowledged, appreciated, and valued. In fact, it is critically important to understand the potential negative consequences of ''not seeing" color. This recognition moves us forward and allows us to achieve the positive change needed within our field and within society. As dermatologists we recognize that the patient's skin color impacts the diagnostic and therapeutic methodologies that should be taken into consideration to achieve optimal health outcomes for our patients. The color of our patient's skin also affects their office visit and subsequently their health outcome if we do not take the time to understand the role that stereotype threat, implicit bias and microaggression may play in preventing a strong therapeutic alliance. As dermatologists we recognize the critical importance of seeing color. As a dermatologic community, physicians of the skin, hair, and nails, we may be the most equipped to spread the word of its importance to our patients, coworkers, and colleagues, giving rise to positive change needed within our society and within our field. Prioritizing Equity and Inclusion in Global Health Dermatology Camouflaging Techniques for Central Centrifugal Cicatricial Alopecia (CCCA) patients Community Engagement Matters: A Call for Greater Advocacy in Dermatology Allyship in Dermatology Bridging Racial Differences in the Clinical Encounter: How Implicit Bias and Stereotype Threat Contribute to Healthcare Disparities in the Dermatology Clinic Skin Cancer in Women of Color; Epidemiology, Pathogenesis and Clinical manifestations Dermoscopic Features of Neoplasms in Skin of Color: A Review Assessing the Impact of an Intervention to Increase Minority Representation in Dermatology Sunscreen recommendations for patients with SOC in the popular press and in the dermatology clinic A pilot study of skin cancer education in an underserved population at a free skin cancer screening The importance of dermoscopy in subclinical lichen planus in skin of color Pityriasis Rubra Pilaris in Skin of Color #BlackGirlMagic: Impact of the social media movement on Black womens self esteem Two Pandemics: Opportunities for Diversity, Equity and Inclusion in Dermatology Skin of color lacks representation in medical student resources: a cross-sectional study Trends in Sessions in Diversity at the American Academy of Dermatology Annual Meetings Direct-to-consumer derm-related advertising differs in magazines targeted to women of color Turning the Tide: How the Women's Dermatologic Society Leads in Diversifying Dermatology The Dark Side of Skin Lightening: An International Collaboration & Review of a Public Health Issue Affecting Dermatology Responding to the moment: dermatology, health inequity, and a call for introspection-driven activism AOP: It's too tight -Loosen up and let your Hair down The authors in this issue outline ways that we may understand the intricacies involved in caring for patients of darker skin types, and speak to how we can continue to enrich our field by embracing diversity and creating a culture of inclusion. We thank each of them for their contribution to this important Skin of Color and Diversity and Inclusion issue of the International Journal of Women's Dermatology, heralding change in our profession.