As part of the ACR’s pledge to be a leader for inclusion and change for members, trainees, staff and rheumatology patients, the ACR is holding a special image competition in conjunction with ACR Convergence 2021 dedicated exclusively to images of rheumatic disease in skin of color.
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Explore This IssueJuly 2021
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“We started discussing the lack of diversity in our images years ago in the ACR’s Collaborative Initiatives Department (COIN) as part of our general focus on health disparities and equity issues in rheumatology,” says ACR Board of Directors member-at-large S. Sam Lim, MD, MPH, professor of medicine and epidemiology, Emory, Atlanta.
With more than 2,000 images, the ACR Image Library is a major repository of high-quality images of rheumatic diseases used by rheumatologists around the world. Every year new images are added to the collection, making this an up-to-date, dynamic resource for teaching and education. The underrepresentation of skin of color in the ACR Image Library represents a significant educational gap. “The gap was highlighted at ACR Convergence 2020, with the presentation of an abstract on the topic of the lack of diversity in rheumatologic images,” Dr. Lim continues.
In their study, “Healthcare Practitioner Confidence Assessing Rashes in Patients of Skin of Color with Lupus,” Kannuthurai et al. found, “Healthcare providers are less confident evaluating lupus-related rashes in skin of color compared to fair skin, representing a disparity between provider confidence and the patient population lupus traditionally affects. … Over 90% of participants were interested in education on this topic.”
“The lack of diversity in images and illustrations is an issue that has been brought to COIN’s attention—both to staff and volunteer leaders—time and time again,” says ACR Vice President of Strategic Initiatives Sheryl McCalla. “We’ve attempted to address the need by discussion of the importance of diverse imagery in continuing medical education activities that we’ve developed, putting in an application for grant money to support collecting diverse images and, now, working with the ACR’s education department to increase the number of images that represent rheumatic conditions on skin of color in the Image Library.”
Ms. McCalla continues, “We are reminded by members that the competition is only one way to diversify the Image Library and that diversifying the images is only one piece in a larger puzzle.”
Learn more about the ACR Image Library.
“Diversifying the Image Library will obviously take time,” says Dr. Lim. “In parallel, the challenge will be to decide where to go from here. How does the ACR incorporate these images into training and educational opportunities? How can we better collaborate with the international community to expand the breadth of images, not only to capture diversity in skin color, but also to represent ethnic and cultural differences? For example, how does one examine someone wearing a burka, and how does that influence dermatologic findings?”