TOPLINE:

Black children had lower dermatology use for atopic dermatitis (AD), acne, hidradenitis suppurativa (HS), infantile hemangioma (IH), and psoriasis in a study despite higher disease frequencies for AD, acne, and HS.

METHODOLOGY:

• Researchers conducted a multicenter, cross-sectional study using electronic health record (EHR) data from eight US children’s hospitals in the PEDSnet system from January 2009 to July 2022, with data analyzed from January 3 to March 26, 2024.
• A total of 536,776 patients (mean age 6.4 years; 51.5% female; 44.3% White, 27.9% Black, 14.1% Hispanic, 6.4% Asian, 0.3% Native Hawaiian or Other Pacific Islander, 8.4% non-Hispanic) were included, comprising children with at least one dermatology clinic visit or at least two nondermatology clinic visits coded for AD, acne, IH, psoriasis, or HS.
• Most patients had AD (n = 377,970), followed by acne (n = 139,632), IH (n = 54,305), psoriasis (n = 11,339), and HS (n = 5722).
• Primary outcomes were disease frequency per 100,000 children and the proportion of children using outpatient dermatology care for each condition, stratified by race and ethnicity using self-reported data from EHRs.

TAKEAWAY:

• AD (10,469 per 100,000), HS (194 cases per 100,000), and acne (2821 cases per 100,000) were more common among Black children than among children of any other race, including White children (3099, 39.1, and 1449 cases per 100,000, respectively).
• Cases per 100,000 were lowest for IH (290 per 100,000) and psoriasis (100 per 100,000) among Black children compared with children of other races. (Cases of IH and psoriasis were 764 and 153 per 100,000, respectively, among White children.)
• The proportion of patients using dermatology care was lowest among Black patients for all five conditions: 19.1% for AD, 39.4% for HS, 28.2% for acne, 34.6% for IH, and 62.9% for psoriasis. Dermatology use ranged from 35% (for AD) to 70.6% (for psoriasis) for White children, 42.4% (for AD) to 82.4% (for psoriasis) for Asian children, 51.6% (for IH) to 90.6% (for psoriasis) for American Indian or Alaska Native children, and 53.8% (for IH) to 78% (for psoriasis) for Native Hawaiian and Other Pacific Islander children.
• The proportion of Hispanic vs non-Hispanic children using dermatology care was 35.6% vs 28.4% for AD, with similar patterns for acne (57.5% vs 40.0%), IH (57.3% vs 50.2%), psoriasis (78.4% vs 70.1%), and HS (58.8% vs 47.1%).

IN PRACTICE:

“This study found that, at participating PEDSnet children’s hospitals, Black children had high frequencies of AD, acne, and HS, yet low proportions of dermatology use,” the authors of the study wrote. “Further work,” they added, “is needed to understand whether these patterns represent appropriate care use or care gaps in the pediatric population.”

SOURCE:

The study was led by Nicolas G. Quan, University of Colorado, Aurora, Colorado, and was published online on May 6 in JAMA Dermatology.

LIMITATIONS: 

Limitations included the retrospective design, missing demographic data, and potential errors in EHR data. Researchers could not assess disease severity, referral patterns, travel distance, or other structural barriers to specialty care. Findings were limited to tertiary pediatric health systems participating in PEDSnet and may not generalize to other care settings.

DISCLOSURES:

The study received funding from the Children’s Surgery Culshaw Young Investigators Award, the Dermatology Foundation Pediatric Dermatology Career Development Award, and the Pediatric Dermatology Research Alliance (PeDRA) fellowship grant. Several authors reported receiving grants, personal fees, and other support from various organizations and drug companies, including the National Institutes of Health, PeDRA, Abeona Therapeutics, Arcutis Biotherapeutics, BioCryst, Boehringer Ingelheim, and Castle Creek Biosciences. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.