Andrew F. Alexis, MD, MPH: Disparities in Care for Patients with Skin of Color

In this HCPLive interview segment, Andrew F. Alexis, MD, MPH, delved further into the topic of addressing disparities in care for patients of diverse backgrounds, a topic he covered in his talk presented at the Fall Clinical Dermatology 2023 Conference for PAs & NPs.

Alexis is known for his work both as Vice-Chair for Diversity and Inclusion at the Department of Dermatology and as Professor of Clinical Dermatology at Weill Cornell Medical College in New York City.

“I showed examples of patients where the chief complaint might be pigmentary in nature,” Alexis noted. “And it takes a little bit of digging and overall evaluation of the patient to fully assess, so we'll perform a thorough exam to identify the primary cause of that pigmentation.”

Alexis added that there are examples he used in his talk of patients who had come in complaining of discoloration on their scalp.

“Which, on closer inspection, turned out to be discoid lupus involving the scalp,” he said. “And without carefully looking for the source of the pigmentation, and identifying some of the clues to that specific disease such as discoid erythematous plaques with follicular plugging, you wouldn't make the diagnosis. And so searching for that cause, biopsy when needed, as in the example of discoid lupus that I showed, treating the underlying disease is paramount.”

When asked what some of the biggest takeaways he hopes viewers of his conference presentation might have gotten from his talk, he explained some of the biggest points.

“Number one, when faced with postinflammatory hyperpigmentation, identify the primary cause and treat that effectively and longitudinally, so that new areas of dispigmentation don't develop,” Alexis noted. “This applies to countless inflammatory dermatoses, including atopic dermatitis, psoriasis, and others.”

He continued to discuss some of the biggest takeaways from his presentation.

“Second, I spent a fair amount of time talking about hair and scalp disorders. And so traction alopecia and CCCA are 2 very common hair and scalp disorders that we see disproportionately in our patients with skin of color, especially women of African descent,” Alexis explained. “And so, when diagnosing these conditions, it's important to recognize that they do have an inflammatory basis, and so the treatment of these does involve a solid anti-inflammatory regimen.”

He noted that this regimen could include oral doxycycline for its anti-inflammatory effects, as well as intralesional corticosteroids or topical corticosteroids.

To find out more about the contents of Alexis’s presentation from the conference, view the interview above.

The quotes included in this article were edited for the purposes of clarity.