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The oculocutaneous albinism II (OCA2) gene encodes a melanosomal transmembrane protein involved in melanogenesis. Recent genome-wide association studies have identified several single nucleotide polymorphisms within OCA2 genes that are involved in skin pigmentation. Nevertheless, there have been no attempts to modulate this gene to improve skin discoloration. Accordingly, our aim was to identify compounds that can reduce OCA2 expression and to develop a formula that can improve skin brightness and reduce hyperpigmented spots. In this study, we investigated the effects of OCA2 expression reduction on melanin levels, melanosome pH, and autophagy induction through siRNA knockdown. Additionally, we identified several bioactives that effectively reduce OCA2 expression. Ultimately, in a clinical trial, we demonstrated that topical application of those compounds significantly improved skin tone and dark spots compared to vitamin C, a typical brightening agent. These findings demonstrate that OCA2 is a promising target for the development of efficacious cosmetics and therapeutics designed to treat hyperpigmentation. [ABSTRACT FROM AUTHOR]

Background: Skin tone assessment is critical in both cosmetic and medical fields, yet traditional methods like the individual typology angle (ITA) have limitations, such as sensitivity to illuminants and insensitivity to skin redness. Methods: This study introduces an automated image‐based method for skin tone mapping by applying optical approaches and deep learning. The method generates skin tone maps by leveraging the illuminant spectrum, segments the skin region from face images, and identifies the corresponding skin tone on the map. The method was evaluated by generating skin tone maps under three standard illuminants (D45, D65, and D85) and comparing the results with those obtained using ITA on skin tone simulation images. Results: The results showed that skin tone maps generated under the same lighting conditions as the image acquisition (D65) provided the highest accuracy, with a color difference of around 6, which is more than twice as small as those observed under other illuminants. The mapping positions also demonstrated a clear correlation with pigment levels. Compared to ITA, the proposed approach was particularly effective in distinguishing skin tones related to redness. Conclusion: Despite the need to measure the illuminant spectrum and for further physiological validation, the proposed approach shows potential for enhancing skin tone assessment. Its ability to mitigate the effects of illuminants and distinguish between the two dominant pigments offers promising applications in both cosmetic and medical diagnostics. [ABSTRACT FROM AUTHOR]

Implicit (i.e. unconscious) racial biases held by health professionals negatively affect patient–practitioner communication and health outcomes. Implicit biases are typically assessed through implicit association tests (IATs). We extracted cross‐sectional IAT data originating in Australia from two large publicly available data sets hosted by Project Implicit. In total, IATs were available from 1956 healthcare workers (1249 of European ethnicity; 829 professionals/technicians as opposed to support workers). All had participated between 2006 and 2022. Levels of implicit skin tone bias were found to be moderate according to Project Implicit guidelines and substantially greater than zero (d = 0.87). Participants of European ethnicity and older age scored higher, but there were no differences across occupation types (professional vs. support worker) or over years. Consistent with findings around the world, the findings highlight a need for interventions that could reduce implicit bias and thereby improve the healthcare experiences of people from minority groups. [ABSTRACT FROM AUTHOR]

Research on skin tone bias (i.e., bias against members of the same racial group with different skin tones) has been conducted mostly with Black/White targets. We tested skin tone bias with East Asian (Korean) targets and investigated its possible mechanisms. In Study 1, comparisons of impressions between targets with different skin tones (darker‐, medium‐, and lighter‐skinned) showed statistically significant differences in warmth, competence, morality, cleanliness, dangerousness, strongness, and social status. Study 2 revealed that lighter‐skinned Koreans were perceived to be more similar to Whites (vs. Blacks or South Asians), but this perceived similarity did not explain the effect of skin tone on impression ratings. In Study 3, participants showed associations of darker (vs. lighter) skin with rural (vs. urban) areas and with blue‐collar (vs. white‐collar) jobs. However, these associations explained only the skin tone effects on dangerousness. This research demonstrated skin tone bias with East Asian participants and targets. [ABSTRACT FROM AUTHOR]

Skin is the main barrier to protect against harmful environmental influences, one of which is ultraviolet radiation (UVR) which comes from sunlight. Therefore, skin damage due to UVR (photodamage) has gained prominence in dermatology and aesthetic medicine, especially in tropical countries. Guinea pig (GP) as tropical mammal is potential to serve as animal model for skin-related research due to the similarity of their coat pigmentation to that of humans. This research aims to study the skin condition and histomorphometric structure of GP skin with coat color variations. Samples consisted of six adult female GP with tricolor and tortoiseshell patterns. After neatly shaved in 2 x 2 cm² area, skin condition is then evaluated using Skin Analyzer. Skin samples were processed into histological preparations using paraffin method with 10 % NBF as fixative and stained with Hematoxylin & Eosin (H&E) to measure the thickness of epidermis and dermis. Results demonstrated that skin moisture levels do not significantly differ between coat colors, higher levels of sebum and pigmentation correspond with darker coat colors, whereas lower levels of elasticity and collagen are associated with lighter coat colors. Histomorphometric examination showed that in tortoiseshell GP, the thickness of the epidermis and dermis increased with the coat color, but in tricolor GP, the thickness of epidermis and dermis varied. Furthermore, tortoiseshell GP have thicker epidermis and dermis than tricolor GP. It can be concluded that coat color influences the thickness of epidermis and dermis as well as pigmentation pattern of tortoiseshell is suitable as animal model for humans. [ABSTRACT FROM AUTHOR]

Abstract Hyperspectral imaging (HSI) is a new emerging modality useful for the noncontact assessment of free flap perfusion. This measurement technique relies on the optical properties within the tissue. Since the optical properties of hemoglobin (Hb) and melanin overlap, the results of the perfusion assessment and other tissue-specific parameters are likely to be distorted by the melanin, especially at higher melanin concentrations. Many spectroscopic devices have been shown to struggle with a melanin related bias, which results in a clinical need to improve non-invasive perfusion assessment, especially for a more pigmented population. This study investigated the influence of skin tones on tissue indices measurements using HSI. In addition, other factors that might affect HSI, such as age, body mass index (BMI), sex or smoking habits, were also considered. Therefore, a prospective feasibility study was conducted, including 101 volunteers from whom tissue indices measurements were performed on 16 different body sites. Skin tone classification was performed using the Fitzpatrick skin type classification questionnaire, and the individual typology angle (ITA) acquired from the RGB images was calculated simultaneously with the measurements. Tissue indices provided by the used HSI-device were correlated to the possible influencing factors. The results show that a dark skin tone and, therefore, higher levels of pigmentation influence the HSI-derived tissue indices. In addition, possible physiological factors influencing the HSI-measurements were found. In conclusion, the HSI-based tissue indices can be used for perfusion assessment for people with lighter skin tone levels but show limitations in people with darker skin tones. Furthermore, it could be used for a more individual perfusion assessment if different physiological influencing factors are respected.

Qianghua Quan,1– 3 Haihao Pan,1– 3 Fei Wang,1,2 Siyi Wang,1– 3 Lingli Yang,1– 3 Mixiang Guan,1,2 Quan An1,2 1Research and Development Department, Yunnan Baiyao Group Shanghai Science & Technology Co., Ltd, Shanghai, People’s Republic of China; 2East Asia Skin Health Research Center, Beijing, People’s Republic of China; 3Yunnan Baiyao Group Co. Ltd, Kunming, People’s Republic of ChinaCorrespondence: Haihao Pan; Fei Wang, Email P18811331878@163.com; wangfei@ynbyjk.comPurpose: In the quest for a youthful appearance, women use a variety of anti- aging cosmetics. Defining skin problems is especially important for the selection of anti-aging solutions. However, the skin problems faced by Chinese women at different ages are different. This study aimed at Chinese women aged 20– 40 years old and analyzed facial skin aging characteristics of those with old-perceived age.Patients and Methods: The total of 400 standard facial photographs from Chinese female volunteers aged 20– 40 was assessed by another 126 Chinese women. The facial areas and skin aging characteristics that influenced age estimation were collected at the same time. Skin aging characteristics, including wrinkles, skin tone, pigmentation and pores, were analyzed based on facial photographs. Groupings were made based on deviation of perceived age from chronological age, and skin aging characteristics among groups were compared.Results: The perceived age of Chinese women aged 20– 40 has a moderate correlation with chronological age. Women aged 20– 30 generally had an old-perceived age. Deep skin tone was a prominent problem in this age group, with those who had the older-perceived age observed the darker and redder skin tone. Women aged 31– 40 were perceived partly old but appeared with wrinkle aggravation, as well as deepening of redness, enlarged pores, and increased pigmentation at the mid-face. The perceived older women also had more visible frown lines and darker skin tone at the upper face.Conclusion: The perceived age of Chinese women aged 20– 40 tends to deviate from their chronological age. Women aged 20– 30 with old-perceived age are associated with deep skin tone, even found darker and redder in older-perceived women group, while women aged 31– 40 are associated with wrinkles and deterioration at mid-face area and upper-face problems drive more attention in older-perceived women group.Keywords: perceived age, Chinese female, wrinkles, skin tone, skin aging

We tested whether skin tone would influence pain estimation and whether a colour stereotype (i.e., “darker‐is‐stronger”) moderates the relationship. We manipulated targets' skin tone into three levels (darker/medium/lighter). Participants estimated how much physical or emotional pain the targets would feel in various adverse situations and answered how much they believed objects with darker colours are stronger. Although the differences in estimated pain between the three skin tone conditions were not statistically significant, we found the moderation effect of the colour stereotype on the relationship between skin tone and pain estimation (for physical pain only). Specifically, participants with a stronger colour stereotype expected that darker‐skinned targets would feel less physical pain than lighter skinned ones. [ABSTRACT FROM AUTHOR]

Virtual reality (VR) may be a viable method to observe and describe signals of implicit bias. Using the context of the human papillomavirus vaccine counseling, we sought to describe physicians' communication practices exploring differences when counseling parents with different skin colors. Physicians (N = 90) at an academic primary care center were recruited for a VR study in which they counseled dark or light-skinned parent avatars who expressed hesitation about human papillomavirus vaccination for their adolescent child. Investigators coded previously recorded simulations. Associations between communication and parent skin color were examined using t-tests and Chi-square tests. Both direct (e.g., addressing the concern immediately) and circuitous (e.g., providing alternative information) communication patterns were observed. Physicians used passive voice less commonly when counseling dark-skinned versus light-skinned avatars (p <.05). VR demonstrated feasibility in capturing clinicians' communication behaviors including measuring eight distinct indicators of implicit bias. [ABSTRACT FROM AUTHOR]

Hyperspectral imaging (HSI) is a new emerging modality useful for the noncontact assessment of free flap perfusion. This measurement technique relies on the optical properties within the tissue. Since the optical properties of hemoglobin (Hb) and melanin overlap, the results of the perfusion assessment and other tissue-specific parameters are likely to be distorted by the melanin, especially at higher melanin concentrations. Many spectroscopic devices have been shown to struggle with a melanin related bias, which results in a clinical need to improve non-invasive perfusion assessment, especially for a more pigmented population. This study investigated the influence of skin tones on tissue indices measurements using HSI. In addition, other factors that might affect HSI, such as age, body mass index (BMI), sex or smoking habits, were also considered. Therefore, a prospective feasibility study was conducted, including 101 volunteers from whom tissue indices measurements were performed on 16 different body sites. Skin tone classification was performed using the Fitzpatrick skin type classification questionnaire, and the individual typology angle (ITA) acquired from the RGB images was calculated simultaneously with the measurements. Tissue indices provided by the used HSI-device were correlated to the possible influencing factors. The results show that a dark skin tone and, therefore, higher levels of pigmentation influence the HSI-derived tissue indices. In addition, possible physiological factors influencing the HSI-measurements were found. In conclusion, the HSI-based tissue indices can be used for perfusion assessment for people with lighter skin tone levels but show limitations in people with darker skin tones. Furthermore, it could be used for a more individual perfusion assessment if different physiological influencing factors are respected. [ABSTRACT FROM AUTHOR]

This study examines whether there is a relation between assigned skin tone and parental racial socialization of their young children (ages 5–8). The concurrent mixed methods design combined quantitative and qualitative findings to explore the complexity and role skin tones play in Black parents' messages to their children. In the quantitative strand, 178 Black parents completed a survey and questionnaire. The qualitative strand consisted of a one-on-one interview with 10 parents from the quantitative sample. Quantitative findings revealed that parents who assigned a light skin tone to their children engaged in more specific types of racial socialization than those who assigned a darker skin tone to their children. Analysis of qualitative interviews revealed parents' unique messages based on assigned skin tones. Data from the two strands were integrated using a weaving approach that compared findings from both strands. [ABSTRACT FROM AUTHOR]

Children may notice racial differences (i.e., show racial and/or skin‐tone salience), but deliberately avoid mentioning such differences (i.e., color evasion) with increasing age. This contradiction may be due to prevailing egalitarian social norms about race. Color evasion is understudied among children in China. In a sample of 155 Chinese children (71 girls and 84 boys) aged 7–11 years from urban regions of China, we collected measures of children's racial and/or skin‐tone salience and color evasion as well as their attitudes toward light‐skinned East Asian, tan‐skinned East Asian, and White groups. Analyses revealed that racial differences were salient to Chinese children, and that they showed little color evasion. Skin tone was most salient in children's categorization performance. We found a preference hierarchy where light‐skinned East Asian people were favored most, and White people least. Color evasion was negatively related to Chinese children's positive attitudes toward White people. The findings emphasize the importance of social contexts in shaping children's racial attitudes. [ABSTRACT FROM AUTHOR]

Automatic selfie facial acne grading plays a crucial role in treatment for facial care customers, and it attracts increasing attention with the revolution of telemedicine and virtual beauty. Unfortunately, the limited quantity and quality of the selfie facial dataset greatly challenge the learning of acne grading models. In this paper, we propose a Gated Tone-sensitive Augmented Domain Transfer (GTADT) model to address the selfie facial acne grading problem. A "high-quality" clinical source domain and associated cross-domain data augmentation are introduced to generate sufficient data. Also, an aligned tone-sensitive model with multiple tone subnetworks is devised to bridge the domain gaps. In Addition, two gate networks are devised to capture the correlation between different tone subnetworks in both the label and feature spaces. We establish three selfie facial acne datasets which consist of people across different skin tones, ages, poses, etc. The experimental results on the newly established datasets demonstrate that: 1) both the cross-domain data augmentation, tone-sensitive module, and gate networks can enhance the performance; and 2) the proposed model performs favorably against state-of-the-art methods. We make both the code and datasets publicly available at https://github.com/WRLH/GTADT.git. [ABSTRACT FROM AUTHOR]

Background: Understanding the variances in visual skin changes across all skin tones is important in clinical care. However, the experiences of those teaching skin assessment to pre- and post-registrant nurses are unknown. Aims: To determine the barriers and facilitators experienced in teaching skin assessment across a range of skin tones to pre- and post-registrant nurses. Methods: A cross-sectional, mixed-methods online survey was undertaken throughout February and March 2023 based on the Theoretical Domains Framework of behaviour change. Findings: In this self-selecting sample, most participants were aware of why it was important to include all skin tones when teaching skin assessment and were professionally motivated to include this in their practice. However, resources and support are needed to overcome an unconscious bias in teaching skin tone diversity, resulting in a lack of availability of good quality photographs and educator confidence in their own skills. Educators not considering skin tone when selecting patient cases and relying on people with dark skin tones to highlight where practice is not inclusive may also lead to insufficient exposure for students. Conclusion: There is some awareness of the importance of including diverse skin tones in teaching, but further education and resources are needed. [ABSTRACT FROM AUTHOR]

The oculocutaneous albinism II (OCA2) gene encodes a melanosomal transmembrane protein involved in melanogenesis. Recent genome-wide association studies have identified several single nucleotide polymorphisms within OCA2 genes that are involved in skin pigmentation. Nevertheless, there have been no attempts to modulate this gene to improve skin discoloration. Accordingly, our aim was to identify compounds that can reduce OCA2 expression and to develop a formula that can improve skin brightness and reduce hyperpigmented spots. In this study, we investigated the effects of OCA2 expression reduction on melanin levels, melanosome pH, and autophagy induction through siRNA knockdown. Additionally, we identified several bioactives that effectively reduce OCA2 expression. Ultimately, in a clinical trial, we demonstrated that topical application of those compounds significantly improved skin tone and dark spots compared to vitamin C, a typical brightening agent. These findings demonstrate that OCA2 is a promising target for the development of efficacious cosmetics and therapeutics designed to treat hyperpigmentation.

The stoma care nurse (SCN) assesses peristomal skin during each patient intervention. Living in a diverse multicultural society, the SCN needs to consider dark skin tones and how these are documented. This article looks at how the literature on peristomal skin assessment and available tools discuss skin colour, and compare this with the tissue viability literature. Stoma care and peristomal skin literature features very little about skin colour. Registered nurses are often unaware of the differences when assessing light skin tones versus dark skin tones. The article discusses how to assess for, identify and document problems around peristomal skin with patients who have dark skin tones. The differences in skin breakdown between light skin tones and dark skin tones are highlighted. There needs to be further research and development of tools to assist clinicians in identification and documentation relating to skin tone, thus providing consistency in assessment. [ABSTRACT FROM AUTHOR]

Recent scholarship studying the impact of race-based prejudice has emphasized its rampant persistence throughout all aspects of modern society, including the world of sports. Prior research from American leagues has shown that even referees, trained officials intended to enact neutral judgements, are subject to bias against Black and dark-skinned players. To extend these studies and inform policies aimed at combating racial bias in public spaces more broadly, we report results from a unique dataset of over 6500 player-year observations from the Italian Serie A to examine whether these biases persist in European football. Our results show that darker-skinned players receive more foul calls and more cards than lighter-skinned players, controlling for a range of potential confounders and productivity-relevant mediators. By exploiting an absence of fans induced by the COVID-19 pandemic, we also present preliminary evidence that fans may play a key role in inducing poor calls against darker-skinned players. [ABSTRACT FROM AUTHOR]

Lyudmyla Bezpalko,1 Andriy Filipskiy2 1Plastic and Aesthetic Surgery Department, Clinical Hospital of Lviv Railway, Lviv, Ukraine; 2Radiology Department, Postgraduate Faculty, Danylo Halytsky Lviv National Medical University, Revive Aesthetic Medicine Clinic, Lviv, UkraineCorrespondence: Lyudmyla Bezpalko, Plastic and Aesthetic Surgery Department, Clinical Hospital of Lviv Railway, Ivana Ohiienka St. 5, Lviv, Lviv Oblast, Lviv, Ukraine, 79000, Tel +380322264308, Fax +380322264308, Email bezpalkolu@gmail.comIntroduction: Nowadays patients want to get an immediate result from skin rejuvenation techniques without sign of injections and consequent limitations in social life. Therefore, the least traumatic, more effective, and longer lasting treatment approach for skin quality improvement should be favored.Purpose: Assess skin quality outcomes by clinical examination and self-reporting in patients treated with two non-crosslinked hyaluronic acid (HA) products, injected by cannula. Investigate the skin thickness and the longevity of dermal fillers in soft tissues by ultrasound examination.Patients and Methods: Fifteen female patients (mean age 41 years) were selected for injection with two non-crosslinked HA products (one for each hemiface and hemi neck). Subdermal injections were performed bilaterally and the retrograde linear fanning technique with a 25G 50 mm cannula from three entry points was used. An ultrasound examination of the skin layers thickness was carried out before the procedure and every 6– 7 days up to three weeks, when patients skin quality improvement was assessed by GAIS (Global Aesthetic Improvement Scale) and patients asked about their satisfaction level.Results: On the right hemiface, the use of the non-crosslinked HA-product with lidocaine was not associated with pain in the sites of injection. On both face sides, the signs of bruising or edema were minor and not associated with downtime or social life limitation after the procedure. After three weeks, despite both injected products could not be detected by ultrasound technique, signs of skin stimulation and skin layers hydration were still observed: The dermis became thicker on both hemifaces while the epidermis became thinner but showed more pronounced radiance and densification effect on the right hemiface.Conclusion: Subdermal injections of non-crosslinked HA “skin boosters” could be a good option for minimal traumatic and effective 3-week lasting skin quality improvement.Keywords: HA, skin booster, lidocaine, tissue longevity, ultrasound scan, skin tone, skin texture

Background: Skin tone and pigmented regions, associated with melanin and hemoglobin, are critical indicators of skin condition. While most prior research focuses on pigment analysis, the capability to simulate diverse pigmentation conditions could greatly broaden the range of applications. However, current methodologies have limitations in terms of numerical control and versatility. Methods: We introduce a hybrid technique that integrates optical methods with deep learning to produce skin tone and pigmented region‐modified images with numerical control. The pigment discrimination model produces melanin, hemoglobin, and shading maps from skin images. The outputs are reconstructed into skin images using a forward problem‐solving approach, with model training aimed at minimizing the discrepancy between the reconstructed and input images. By adjusting the melanin and hemoglobin maps, we create pigment‐modified images, allowing precise control over changes in melanin and hemoglobin levels. Changes in pigmentation are quantified using the individual typology angle (ITA) for skin tone and melanin and erythema indices for pigmented regions, validating the intended modifications. Results: The pigment discrimination model achieved correlation coefficients with clinical equipment of 0.915 for melanin and 0.931 for hemoglobin. The alterations in the melanin and hemoglobin maps exhibit a proportional correlation with the ITA and pigment indices in both quantitative and qualitative assessments. Additionally, regions overlaying melanin and hemoglobin are demonstrated to verify independent adjustments. Conclusion: The proposed method offers an approach to generate modified images of skin tone and pigmented regions. Potential applications include visualizing alterations for clinical assessments, simulating the effects of skincare products, and generating datasets for deep learning. [ABSTRACT FROM AUTHOR]

Background: Health inequalities and poorer outcomes have been identified for patients with dark skin tones. The reasons are multi-factorial, but may include delayed treatment due to a lack of recognition of early clinical signs of physiological deterioration. Within the medical literature there is a light skin tone bias, leading to healthcare professionals having insufficient knowledge regarding the assessment of patients with different skin tones, which may result in reduced confidence and create patient safety issues. The aim of this scoping review was to explore the confidence levels of healthcare professionals when assessing patients of different skin tones. Methods: The methodology followed scoping review frameworks set out by Arksey and O'Malley (2005), the Joanna Briggs Institute (Peters et al., 2020) and the PRISMA extension for Scoping Reviews (PRISMA-ScR) (Tricco et al., 2018). Searches for literature were performed between February and June 2022 using electronic databases EBSCO (Academic Search Complete, the Allied Complementary Medicine Database, e-journals, MEDLINE, CINAHL), British Nursing Index (ProQuest), Scopus, Web of Science, Zetoc, UpToDate, Google Scholar, NICE Evidence, ResearchGate, Opengrey and the British Association of Dermatologists. No date range was specified, expanders were left on and the findings were screened using inclusion and exclusion criteria. Included papers were synthesised using narrative synthesis. Results: Thirteen papers were identified, and the extracted data charted by the paper's origin, sample size, profession and confidence levels. Our synthesis revealed reduced confidence in assessing, managing and diagnosing skin conditions in dark skin tones. A lack of training was cited by different health professionals, but undertaking tailored training and experiential learning increased confidence. Conclusions: There is a safety issue for patients with dark skin tones, as healthcare professionals lack clinical confidence in managing and treating all ethnicities equally. Tangible diversity within healthcare training is required, supported by inclusive skin tone imagery and appropriate terminology within medical literature. [ABSTRACT FROM AUTHOR]

In two studies, participants completed an implicit attractiveness task with faces as primes varying on (a) facial features from Afrocentric to Eurocentric and (b) skin tone from dark to light, and target pictures of environmental scenes varying in attractiveness. On each trial, participants were briefly primed with a face. Next, they categorized a target picture as either attractive or unattractive as quickly as possible. In addition, in Study 2, participants rated the same faces on an attractiveness scale. While results of Study 1 showed that when faces were medium in skin tone, participants were more accurate when primed with a Eurocentric face responding to attractive targets, but also more accurate when primed with an Afrocentric face responding to unattractive targets, a more powerful Study 2 failed to replicate this effect. There was no relationship between participants' explicit ratings of attractiveness and accuracy rates in the implicit attractiveness task. [ABSTRACT FROM AUTHOR]

This article engages enduring problematics such as the historical roots of colorism and the role of light-skinned people of color in sustaining colorism. Understanding power dynamics and their role in colorism within and across racial groups is a central piece of this article, followed by an analysis of the evolving role of intersectionality in the field. New scholars have taken the field of colorism in promising new directions, exemplified in several articles in this volume, including colorism and mental health, the politics of color measurement, colorism and the one-drop rule, and the experiences of youth and colorism. [ABSTRACT FROM AUTHOR]

Abstract Problem : Visual racism refers to both the underrepresentation and inappropriate representation of darker skin types in medical education. By not teaching medical students and resident physicians to recognize common conditions in darker skin, it perpetuates biases that contribute to healthcare disparities for racial and ethnic minoritized groups. In this paper we describe our efforts to engage in institutional anti-racism work by addressing imbalances in representation of darker skin types in visual teaching images within our institution’s curriculum. Intervention : We initially surveyed preclinical medical students regarding their perceptions of skin color representation in two courses. Researchers recorded the skin types of all teaching photographs in these courses in 2020. We then provided feedback and education to faculty, proposing that they increase brown and black skin color representation in educational content. During 2021, we reviewed the same courses and surveyed students again to ascertain the implementation and impact of our proposal. Context : We applied our intervention to two courses, Host & Defense (H&D) and Skin, Muscle, Bone, and Joint (SMBJ) since both courses utilize a large number of teaching images. Impact : From 2020 to 2021, both H&D and SMBJ significantly increased the proportion of visual teaching images that included darker skin types, with an increase from 28% to 42% in H&D and 20% to 30% in SMBJ. Significantly more students in the courses’ 2021 iterations (73% in H&D, 93% in SMBJ) felt that lectures had appropriate representations of darker skin types when compared to students who took the course in 2020 (8% in H&D, 51% in SMBJ). Students in 2021 felt more confident in recognizing dermatological signs and symptoms in patients with darker skin than students in 2020. The majority of students in both 2020 and 2021 reported wanting to see a gradient of skin types for every dermatological condition discussed. Lessons learned : Our work suggests that addressing visual racism can be achieved partly by setting expectations for increased visual representation, collaborating across educational departments, and establishing clear metrics for assessing implementation. Future interventions will require a continual feedback loop of monitoring learning material, assessing faculty and student perception, refining resources, and recommending revisions to improve visual representation across the entire curriculum. [ABSTRACT FROM AUTHOR]

This study examined the moderating effects of skin tone and skin tone satisfaction on the relations between gendered racial microaggressions and traumatic stress symptoms among self-identified Black women between 18 and 50 years old (N = 237). It was hypothesized that skin tone and skin tone satisfaction would moderate the relation between gendered racial microaggressions and traumatic stress, such that having a darker skin tone and lower levels of skin tone satisfaction would exacerbate the association between gendered racial microaggressions and traumatic stress symptoms. Results from two hierarchical multiple linear regression analyses indicated skin tone satisfaction significantly moderated the association between gendered racial microaggressions and traumatic stress symptoms, whereas skin tone did not. Findings suggest that skin tone satisfaction may play a bigger role in buffering or exacerbating the link between gendered racial microaggressions and mental health among Black women than skin tone alone. The results can inform future research and clinical practice on the important role of skin tone satisfaction in the link between gendered racial microaggressions and traumatic stress among Black women. [ABSTRACT FROM AUTHOR]

While much research explores how skin tone alongside race/ethnicity and gender intersect to pattern the health of U.S. citizens, less research has examined these processes among U.S. immigrants. We employed ordered and logistic regression to model mental and self-rated health among multiple racial/ethnic immigrant groups using data from two waves of the New Immigrant Survey (N = 2358). Models suggested darker skin shades were associated with higher likelihood of mental health challenges regardless of gender or racial/ethnic identity, though a multiplicative analysis suggested a pronounced gender difference among Black immigrants. In addition, women reported worse self-rated health relative to men; however, the difference for Asian women was smaller than for Black or White women, and Latina women had slightly better self-rated health than Latino men. Indicators of health were not uniform among immigrants of color, illustrating the importance of an intersectional framework that includes skin tone alongside the traditional racial/ethnic binary categories. [ABSTRACT FROM AUTHOR]

Introduction There are vast differences in clinical presentations of melanoma across skin tones. Individuals with darker skin tones tend to have a higher prevalence of advanced-stage melanoma, which correlates with increased mortality. We designed this interactive workshop to increase nursing and medical trainees’ awareness of the epidemiology, prevention, and treatment of melanoma in individuals of darker skin tones. Methods The Kern model was used in the design, implementation, and evaluation of the workshop. The 75-minute workshop consisted of a PowerPoint presentation, video-based reflection activities, and case studies. Evaluation consisted of pre- and postworkshop questionnaires. The workshop was implemented two times among 63 nursing students, 11 medical students/residents, and six medical faculty. Results Seventy-one participants completed the pre- and postworkshop evaluations. A comparison of pre- and postworkshop responses utilizing the Wilcoxon matched-pair signed rank test showed a statistically significant increase in learners’ confidence to address each learning objective. Discussion Through this interactive educational presentation, medical and nursing trainees can gain heightened awareness of melanoma across various skin tones, especially unique presentations in darker skin tones.

A wound care practitioner will likely encounter and care for an increasing number of patients with a wider variety of skin tones on a daily basis. However, wound care research and education does not yet reflect the realities of clinical practice, resulting in compromised care provision and the reinforcement of healthcare inequities. Here, Francesca Ramadan outlines both the quantitative and qualitative steps that can be taken to facilitate more inclusive and culturally sensitive care provision in research, education and clinical practice. [ABSTRACT FROM AUTHOR]

Sleep shortage is a major concern in modern life and induces various psycho-physical disorders, including skin problems. In cosmeceutics, females are aware that sleep deprivation worsens their facial skin tone. Here, we measured the effects of sleep deprivation on facial skin yellowness and examined yellow chromophores, such as bilirubin and carotenoids, in blood serum as potential causes of yellowness. Total sleep deprivation (0 h sleep overnight, N = 28) and repeated partial sleep deprivation (4 h sleep for 5 consecutive days, N = 10) induced significant increases in facial skin yellowness. The higher yellowness was sustained even after both sleep deprivation types stopped. However, circulating levels of yellow chromophores were unchanged in the total sleep deprivation study. Neither circulating interleukin-6 nor urinary biopyrrin levels were affected by total sleep deprivation, suggesting that apparent oxidative stress in the body was not detected in the present total deprivation protocol. Facial redness was affected by neither total nor repeated partial sleep deprivation. Therefore, blood circulation may play a limited role in elevated yellowness. In conclusion, facial skin yellowness was indeed increased by sleep deprivation in our clinical studies. Local in situ skin-derived factors, rather than systemic chromophore change, may contribute to the sleep deprivation-induced elevation of facial skin yellowness. [ABSTRACT FROM AUTHOR]

Colorism literature examines how skin tone—alongside prototypical group features and hairstyles—correlates with socioeconomic, health, and political outcomes. Yet few studies have explicitly operationalized how skin tone shapes Latinos' experiences of racialization in "new" U.S. destinations. Here, we draw on a large, representative sample of Mexican immigrants (N = 500) living in two large metropolitan areas (Atlanta and Philadelphia) to investigate how skin tone shapes their perceptions about the frequency and sources of discrimination. Even after controlling for demographic, economic, and immigration–specific factors, including ethnoracial self–identification, we show darker skin tone is significantly associated with higher reports of racial discrimination, discrimination specifically from U.S.-born Whites, and a stronger tendency to struggle internally in response. Together, these results support colorism literature's argument that skin tone is distinct from race and offer new insights into how skin tone shapes the lived experiences of Mexican immigrants outside the U.S. Southwest. [ABSTRACT FROM AUTHOR]

Knowledge regarding skin tone preferences and their influence on skincare behaviors among people of color is limited. The objective of this study was to determine whether there is a difference between ideal and actual skin tone among people of color and whether this difference is associated with tanning and sunscreen use. This was a one-time, voluntary, anonymous, electronic survey designed in REDCap and delivered through ResearchMatch, a national electronic, recruitment tool. Eligible participants were at least 18 years old and self-identified as Black, Asian, Latinx, American Indian/Alaskan Native or Mixed Race. In total, 548 completed survey results were analyzed using SAS. Only the Latinx population was found to have a significant preference for tanner skin (p < 0.05). The Latinx population had significantly more subjects that participated in outdoor tanning than both the Black (p < 0.0001) and Asian population (p < 0.05). Latinx participants who indicated a preference for tanner skin were 2.8 times more likely to never use sunscreen than those without this preference (OR = 2.821, CI = 1.029–7.732, p < 0.05). Our findings have implications for how dermatologists screen, treat, and educate Latinx and skin of color populations. [ABSTRACT FROM AUTHOR]

A key phenomenon to gauge the degree of ethnoracial integration is the pattern of assortative mating based on ethnoracial characteristics. However, possibly because of the assumption that class and not race is the relevant factor in the Mexican stratification regime, assortative mating based on ethnoracial characteristics has been an understudied phenomenon in the country. Based on a multidimensional perspective and using a novel national representative survey, we analyze ethnoracial homogamy patterns in Mexico using four dimensions: skin tone, ethnoracial identification, indigenous language, and Mayan surname. For comparative purposes, we also calculate and control for educational homogamy in our analysis. Results indicate that ethnoracial homogamy is significantly different to educational homogamy and that it differs among dimensions: the highest likelihood of ethnoracial homogamy is found in the linguistic dimension and the lowest in the skin tone dimension. Comparatively, ethnoracial identification and Mayan surname have intermediate levels of homogamy. [ABSTRACT FROM AUTHOR]

Introduction: Skin radiance products achieve perceivable benefits with different sort of mechanism of action. Aims: To use two non‐invasive instrumental devices to evaluate the effectiveness of a cosmetic formula designed to improve skin reflectance while respecting skin integrity. Patients and Methods: Subjects (N = 43) aged 18–50 years old had healthy skin of phototype V–VI and Individual Typology Angle between −10° and −50°. The treatment was applied twice weekly for 4 weeks on a delineated area of the back, and an adjacent area was left untreated. Instrumental and clinical scoring assessments of treated and untreated skin were performed at baseline and Day 26. Results: Between baseline and Day 26, reflectance (Delta L*) increased by 1.27 points and was considered as clinically relevant. Dermatologist clinical scoring of radiance significantly improved from 2.6 to 3.6 after 4 weeks of treatment and the Skin Color Chart Clarity level significantly decreased from a score of 15.5 to 14.3, representing a skin reflectance improvement. Conversely, the change between baseline and Day 26 in Mexameter Melanin Density was not clinically different for treated skin versus untreated skin (difference of 2.54). At Day 26, changes from baseline for Mexameter Melanin Density and Delta L* parameters appeared to be uncorrelated (r = −0.036). Conclusions: This combination of two non‐invasive devices can be useful to confirm that a product can modulate skin reflectance without modifying constitutive pigmentation. The formula tested in this study did not interfere with constitutive melanogenesis. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine how much celebrity endorsement stimulates skin color racism in the cosmetics industry. Design/Methodology/Approach: The data were collected from Google Scholar and Web of Science published articles, and researchers had chosen 45 research articles. Some of the research articles used a quantitative research approach while others had used qualitative research approach. And for the current study, content analysis has been used. Findings: The study finds that celebrity endorsement does influence and promote racism, implying that when celebrities promote fairness products, people perceive themselves inferior due to darker skin tone that gives birth to the notion of racism. Brand Image intervenes in the relationship between Celebrity Endorsement and Racism, and also, intervenes in the relationship between Celebrity Endorsement and Purchase Intention. Limitations: This study is only limited to Google Scholar and Web of Science directory. Only forty‐five articles were taken from 2001 to 2021 year. Real examples were taken from all over the world, but especially from the Less Developed countries like Pakistan and India due to the huge population, rising income, and surging cosmetics industry. Hence, the findings of this study cannot be generalized to the Technologically Advanced Countries. Implications: It is obvious that firms design advertisement campaigns that can get consumers' attention. For this purpose, they engage celebrities to evoke more interest and awareness as well as perception. The study will help the management of different brands to understand that how they can improve their advertisements in a way that does not promote racism. And the celebrities, signing contracts with brands that promote racism, will keep in mind the negative influence these endorsements have on society while companies will make sure that they are also not promoting racism by making such promotional campaigns. [ABSTRACT FROM AUTHOR]

This study addresses two questions. First, why do Black Americans exhibit worse health outcomes than White Americans even at higher levels of socioeconomic status (SES)? Second, are diminished health returns to higher status concentrated among Black Americans with darker skin color? Novel hypotheses are tested with biosocial panel data from Add Health, a nationally representative cohort of Black and White adolescents who have transitioned to adulthood. We find that White and light-skin Black respondents report improved health after achieving higher SES, on average, while their darker-skin Black peers report declining health. These patterns persist regardless of controls for adolescent health status and unmeasured between-person heterogeneity. Moreover, increased inflammation tied to unfair treatment and perceptions of lower status helps to account for patterns of diminished health returns for dark-skin Black groups. Our study is the first to document skin tone heterogeneity in diminished health returns and one of few studies to identify life course stress processes underlying such disparities. We consider additional processes that could be examined in future studies, as well as the broader health and policy implications of our findings. [ABSTRACT FROM AUTHOR]

Scholars have been interested in the relationship between skin tone and health since at least the 1970s; however, no study, to our knowledge, has analyzed a diverse immigrant sample. In this study, we use the New Immigrant Survey and interactions to examine how skin tone and race/ethnicity - alongside gender - jointly pattern BMI among Legal Permanent Residents. Our approach allows for the analysis of BMI among multiple racial/ethnic immigrant groups, while considering skin tone. Our results document that darker skin shades are associated with higher BMI, but only for women. Further, we also tease out the relationship between gender and race/ethnicity for BMI, which allows us to better understand this critical connection for new immigrants' health in the United States. Together, our results highlight that BMI jointly varies by skin tone and race/ethnicity, which emphasizes the importance of an intersectional approach, especially for new immigrant women of color. [ABSTRACT FROM AUTHOR]

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We conducted a targeted review of the literature exploring racial phenotypicality bias (RPB): perceivers' sensitivity to within‐race variation in facial target features in perceptions and judgment of others. This review revealed evidence that two distinct mechanisms underlying these effects, categorical and featural, tend to be conflated in the literature. The categorical route suggests that the pathway from target cues to stereotype application is mediated by category activation. The featural route suggests that the pathway from target cues to stereotype application is direct, bypassing category activation. The categorical route is more closely represented when researchers discuss RPB, and more often of empirical focus. With a focus on research exploring RPB toward African American people, we explain the two routes and evidence supporting their distinction. We next offer evidence estimating the degree to which they may be conflated in the empirical literature and discuss limitations to our approach. Next, we describe some potential implications of this conflation for theory, research, and applications concerning RPB. Finally, we end with some recommendations for future empirical research. [ABSTRACT FROM AUTHOR]

Smartphone-based colorimetry has been widely applied in clinical analysis, although significant challenges remain in its practical implementation, including the need to consider biases introduced by the ambient imaging environment, which limit its potential within a clinical decision pathway. In addition, most commercial devices demonstrate variability introduced by manufacturer-to-manufacturer differences. Here, we undertake a systematic characterization of the potential imaging interferences that lead to this limited performance in conventional smartphones and, in doing so, provide a comprehensive new understanding of smartphone color imaging. Through derivation of a strongly correlated parameter for sample quantification, we enable real-time imaging, which for the first time, takes the first steps to turning the mobile phone camera into an analytical instrument - irrespective of model, software, and the operating systems used. We demonstrate clinical applicability through the imaging of patients' skin, enabling rapid and convenient diagnosis of cyanosis and measurement of local oxygen concentration to a level that unlocks clinical decision-making for monitoring cardiovascular disease and anemia. Importantly, we show that our solution also accounts for the differences in individuals' skin tones as measured across the Fitzpatrick scale, overcoming potential clinically significant errors in current optical oximetry.

Background: Photoplethysmography (PPG) is a technology routinely used in clinical practice to assess blood oxygenation (SpO 2 ) and pulse rate (PR). Skin pigmentation may influence accuracy, leading to health outcomes disparities., Objective: This systematic review and meta-analysis primarily aimed to evaluate the accuracy of PPG-derived SpO 2 and PR by skin pigmentation. Secondarily, we aimed to evaluate statistical biases and the clinical relevance of PPG-derived SpO 2 and PR according to skin pigmentation., Methods: We identified 23 pulse oximetry studies (n=59,684; 197,353 paired SpO 2 -arterial blood observations) and 4 wearable PR studies (n=176; 140,771 paired PPG-electrocardiography observations). We evaluated accuracy according to skin pigmentation group by comparing SpO 2 accuracy root-mean-square values to the regulatory threshold of 3% and PR 95% limits of agreement values to +5 or -5 beats per minute (bpm), according to the standards of the American National Standards Institute, Association for the Advancement of Medical Instrumentation, and the International Electrotechnical Commission. We evaluated biases and clinical relevance using mean bias and 95% CI., Results: For SpO 2 , accuracy root-mean-square values were 3.96%, 4.71%, and 4.15%, and pooled mean biases were 0.70% (95% CI 0.17%-1.22%), 0.27% (95% CI -0.64% to 1.19%), and 1.27% (95% CI 0.58%-1.95%) for light, medium, and dark pigmentation, respectively. For PR, 95% limits of agreement values were from -16.02 to 13.54, from -18.62 to 16.84, and from -33.69 to 32.54, and pooled mean biases were -1.24 (95% CI -5.31 to 2.83) bpm, -0.89 (95% CI -3.70 to 1.93) bpm, and -0.57 (95% CI -9.44 to 8.29) bpm for light, medium, and dark pigmentation, respectively., Conclusions: SpO 2 and PR measurements may be inaccurate across all skin pigmentation groups, breaching U.S. Food and Drug Administration guidance and industry standard thresholds. Pulse oximeters significantly overestimate SpO 2 for both light and dark skin pigmentation, but this overestimation may not be clinically relevant. PRs obtained from wearables exhibit no statistically or clinically significant bias based on skin pigmentation., (©Sanidhya Singh, Miles Romney Bennett, Chen Chen, Sooyoon Shin, Hamid Ghanbari, Benjamin W Nelson. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 10.10.2024.)

Students of color, particularly women of color, face substantial barriers in STEM disciplines in higher education due to social isolation and interpersonal, technological, and institutional biases. For example, online exam proctoring software often uses facial detection technology to identify potential cheating behaviors. Undetected faces often result in flagging and notifying instructors of these as “suspicious” instances needing manual review. However, facial detection algorithms employed by exam proctoring software may be biased against students with certain skin tones or genders depending on the images employed by each company as training sets. This phenomenon has not yet been quantified nor is it readily accessible from the companies that make this type of software. To determine if the automated proctoring software adopted at our institution and which is used by at least 1,500 universities nationally, suffered from a racial, skin tone, or gender bias, the instructor outputs from ∼357 students from four courses were examined. Student data from one exam in each course was collected, a high-resolution photograph was used to manually categorize skin tone, and the self-reported race and sex for each student was obtained. The likelihood that any groups of students were flagged more frequently for potential cheating was examined. The results of this study showed a significant increase in likelihood that students with darker skin tones and Black students would be marked as more in need of instructor review due to potential cheating. Interestingly, there were no significant differences between male and female students when considered in aggregate but, when examined for intersectional differences, women with the darkest skin tones were far more likely than darker skin males or lighter skin males and females to be flagged for review. Together, these results suggest that a major automated proctoring software may employ biased AI algorithms that unfairly disadvantage students. This study is novel as it is the first to quantitatively examine biases in facial detection software at the intersection of race and sex and it has potential impacts in many areas of education, social justice, education equity and diversity, and psychology.

Racial disparities in education have put a spotlight on the role of teachers and the school environment that is created for students. As teachers are seen as a vital element of school climate, the interactions between teachers and students can have a significant effect on students' success. The purpose of this study was to examine the associations between race, skin tone, and teacher–student relationship (TSR) quality. Data drawn from the Fragile Families and Child Wellbeing Study included 995 ethnically and racially diverse adolescents. Hierarchical regression analyses revealed that being Black, Hispanic, or Multi-racial was significantly associated with TSRs. However, there were no between-group differences in TSRs across racial categories. Skin tone was not a significant predictor of TSRs and did not moderate the relationship between race and TSRs. Findings raise important implications for teacher training and professional development focused on culturally relevant practices that support optimal student interactions and provide promising evidence for school connectedness as an intervening mechanism in improving TSR quality, particularly for students of color. [ABSTRACT FROM AUTHOR]

When Matthew Knowles, the African American biological father of Beyoncé Giselle Knowles-Carter (born September 4, 1981), commonly known as Beyoncé, publicly acknowledged the role of his daughter's skin tone to her success, his comments resulted in great controversy. While some agree with Knowles statements, others believe his comments ignore and/or minimize the hard work that his daughter has contributed to her own success. In addition to the comments that he made regarding his daughter's skin tone, Knowles acknowledges that "unconscious rage," fostered by intra-racial racism, motivates him to seek romantic partners who were Caucasian or Black females with Caucasian-like physical features. This manuscript examines comments provided by Yahoo bloggers to the story "Beyoncé's Father Got Some Strong Reactions after Claiming She's Successful Because Of Her Skin Color," which was published on February 6, 2018 and written by Sarah Jasmine Montgomery. This manuscript will use the tenants of White Supremacy and Phenomenology to reveal the validity of Knowles' statements regarding his daughter's skin tone, as well as other ways in which she and other artists have changed their physical characteristics (lightened their skin) in order to appeal to a larger audience. [ABSTRACT FROM AUTHOR]

Sallow and/or dull skin appearance is greatly attributable to the yellow components of skin tone. Bilirubin is a yellow chromophore known to be made in the liver and/or spleen and is transported throughout the body via the blood stream. Recent publications suggest bilirubin may be synthesized in other cells/organs, including the skin. We found human keratinocytes express the transcripts involved in bilirubin biosynthesis. In parallel, we also found human keratinocytes could indeed synthesize bilirubin in monolayer keratinocytes and in a 3D human skin-equivalent model. The synthesized amount was substantial enough to contribute to skin yellowness. In addition, oxidative stress enhanced bilirubin production. Using UnaG, a protein that forms a fluorescent species upon binding to bilirubin, we also visualized the intracellular expression of bilirubin in keratinocytes. Finally, we screened a compound library and discovered that the sucrose laurate/dilaurate (SDL) combination significantly reduced bilirubin levels, as well as bilirubin-mediated yellowness. In conclusion, bilirubin is indeed synthesized in epidermal keratinocytes and can be upregulated by oxidative stress, which could contribute to chronic or transient yellow skin tone appearance. Application of SDL diminishes bilirubin generation and may be a potential solution to mitigate yellowish and/or dull skin appearance. [ABSTRACT FROM AUTHOR]