Prevention of racialized medicine in pediatric dermatology: A call to re-examine skin tone typing.

ABSTRACT

The Fitzpatrick skin phototype (FSPT), a biologic concept originally constructed in light-skinned patients to measure UVA sensitivity, is widely used today across pediatric dermatology as a proxy for race, a social and political construct. We outline why this is problematic and could contribute to racially inequitable care and discuss the broader question of whether skin tone is relevant to measure in all cases. We propose that, instead of indiscriminately measuring skin tone in all clinical cases, pediatric dermatologists choose the skin characterization variable most relevant to their patient's condition. This both avoids conflating skin tone with race and more broadly quells the myth of racial essentialism and the resultant practice of racialized medicine, which history has shown is used as justification for discriminatory and harmful practices toward racially marginalized groups.