title: Racial differences in the treatment of pigmentation disorders in outpatient settings: analysis of US national practice data.
abstract: OBJECTIVE
  Pigmentary disorders tend to disproportionately affect individuals with darker skin pigmentation. An understanding of why certain patients or races present more frequently to physicians would help guide attempts for early interventions and education for these patients.
  
  
  METHODS
  Data from the National Ambulatory Medical Care Survey (1996-2000) were used to examine associations between the race/ethnicity of the patient and the type of skin-related visit. We examined the impact of non-white (and separately, black) individuals and Hispanic ethnicity on the probability of a pigmentary disorder or non-pigmentary disorder-related outpatient physician visit in weighted multivariate logistic regression models.
  
  
  RESULTS
  Non-white patients have a higher probability of a pigmentary disorder-related skin condition visit than white patients (RR: 1.30; 95% CI: 1.29, 1.31). Black patients are more likely than non-black patients to be seen for a pigmentary disorder (RR: 1.04; 95% CI: 1.03, 1.04). Hispanic patients are less likely to be seen for a pigmentary disorder (RR: 0.90; 95% CI: 0.90, 0.91). This is in contrast to non-pigmentary skin disorder-related visits, where non-white, black, as well as Hispanic patients have a lower probability of visits than white individuals.
  
  
  CONCLUSIONS
  There is a race-related differential in the treatment of pigmentary skin disorders, with non-white patients having a probability of receiving more care for these conditions in US outpatient settings. This lends support to our hypothesis that darker pigmentation in non-white populations is the driver of a differential in the utilization of pigmentation-related skin visits.
authors.affiliation: Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, NC, USA. Rajesh.Balkrishnan@uth.tmc.edu
authors.forename: R
authors.initials: R
authors.lastname: Balkrishnan
authors.forename: S R
authors.initials: SR
authors.lastname: Feldman
authors.forename: A J
authors.initials: AJ
authors.lastname: McMichael
authors.forename: K E
authors.initials: KE
authors.lastname: DeHart
authors.forename: K
authors.initials: K
authors.lastname: Cayce
authors.forename: A B
authors.initials: AB
authors.lastname: Fleischer
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data*; D044383:Black People; D019538:Health Care Surveys; D006801:Humans; D010859:Pigmentation Disorders / Q000208:ethnology* / Q000628:therapy; D014481:United States; D044465:White People; D001741:Black or African American