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Foundational academic medical texts facilitate foundational understanding of disease recognition in medical students. Significant underrepresentation of darker skin tones and overrepresentation of lighter skin tones in dermatologic texts, general medical texts, and scientific literature is observed. This compromises the clinical tools of trainees when it comes to darker skin tones. Text publishers and editors are steadily beginning to address these disparities, but bottom-up change from trainees is necessary to comprehensively address this issue. In this article the authors propose institutional review panels as a framework for building awareness of underrepresentation of darker skin tones and ensuring that faculty intentionally share diverse presentations in didactics. They also propose trainee engagement in building diverse medical image libraries and including texts on skin of color in institutional libraries. Empowering trainees to be advocates and call out any implicit or explicit biases in image selection can engender change in this area of medical education. [ABSTRACT FROM AUTHOR]

Skin cancer is less prevalent in people of color than in the white population. However, when skin cancer occurs in non-whites, it often presents at a more advanced stage, and thus the prognosis is worse compared with white patients. The increased morbidity and mortality associated with skin cancer in patients of color compared with white patients may be because of the lack of awareness, diagnoses at a more advanced stage, and socioeconomic factors such as access to care barriers. Physician promotion of skin cancer prevention strategies for all patients, regardless of ethnic background and socioeconomic status, can lead to timely diagnosis and treatment. Public education campaigns should be expanded to target communities of color to promote self-skin examination and stress importance of photoprotection, avoidance of tanning bed use, and early skin cancer detection and treatment. These measures should result in reduction or earlier detection of cutaneous malignancies in all communities. Furthermore, promotion of photoprotection practices may reduce other adverse effects of ultraviolet exposure including photoaging and ultraviolet-related disorders of pigmentation. [Copyright &y& Elsevier]