Eczema, acne and psoriasis in skin of colour: a qualitative UK-based study

Background
Inflammatory dermatoses have a varied prevalence and appearance in diverse skin tones. The under-representation of people with skin of colour in medical education and clinical trials is widely acknowledged. However, there has been limited research on experiences from a patient perspective.

Aim
To explore the experiences of eczema, acne and psoriasis in adults with skin of colour in the UK.

Design and Setting
A qualitative study of 20 people with eczema, acne and psoriasis and skin of colour, recruited using online methods. Methods Participants took part in online, one-to-one, semi-structured interviews. NVivo qualitative data analysis software was used to code and organise the data. Reflexive thematic analysis was used to generate themes using an iterative approach.

Results
Participants were mostly female (65%), Asian/Asian British ethnicity (45%) and had eczema (55%). We identified eight themes: (i) delayed or missed diagnosis; (ii) preferences regarding healthcare professionals; (iii) lack of online information and social media use; (iv) misunderstanding in cultural communities; (v) concerns about treatment and lack of research in skin of colour; (vi) complementary and alternative medicine use; (vii) experiences and impact of dyspigmentation; and (viii) challenges with structural racism.

Conclusions
The themes generated highlight the unique experiences and challenges faced by UK adults with eczema, acne and psoriasis. The findings can help guide diagnostic approaches, culturally sensitive communication and treatment discussions for patients with skin of colour. Further research is needed in this under-represented group.