. 2025 Apr 19;317(1):728.

doi: 10.1007/s00403-025-04219-6.

Rethinking the use of population descriptors in dermatology trials and beyond: disentangling race and ethnicity from skin color

Valerie M Harvey¹, Jenna C Lester², Tarannum Jaleel³, Junko Takeshita^{4

5}, Amy J McMichael⁶, Yvette Miller-Monthrope^{7

8

9}, Nina G Jablonski¹⁰, Jade Lewis³, Andrew F Alexis¹¹, Stafford G Brown¹², Cheryl M Burgess¹³, Angel S Byrd¹⁴, Suephy C Chen^{3

15}, Caryn Cobb¹⁵, Roxana Daneshjou¹⁶, Seemal R Desai^{17

18}, Candrice R Heath¹⁹, Chidubem A V Okeke²⁰, Hema Sundaram^{21

22

23}, Susan C Taylor⁴, Jonathan S Weiss^{24

25}, Jane Y Yoo²⁶, Valerie D Callender^{14

27}

Affiliations

¹ Hampton Roads Center for Dermatology, Virginia Beach, VA, USA. valerieharvey10@gmail.com.
² Department of Dermatology, University of California San Francisco, San Francisco, CA, USA.
³ Department of Dermatology, Duke University School of Medicine, Durham, NC, USA.
⁴ Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
⁵ Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
⁶ Department of Dermatology, Wake Forest University School of Medicine, Winston Salem, NC, USA.
⁷ Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
⁸ Division of Dermatology, Women's College Hospital, University of Toronto, Toronto, ON, Canada.
⁹ Department of Laboratory Medicine, University Health Network, University of Toronto, Toronto, ON, Canada.
¹⁰ Department of Anthropology, The Pennsylvania State University, University Park, PA, USA.
¹¹ Israel Englander Department of Dermatology, Weill Cornell Medical College, New York, NY, USA.
¹² Division of Dermatology, Washington University, St. Louis, MO, USA.
¹³ Center for Dermatology and Dermatologic Surgery, Washington, D.C., USA.
¹⁴ Department of Dermatology, Howard University College of Medicine, Washington, D.C., USA.
¹⁵ Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, USA.
¹⁶ Department of Biomedical Data Science and Dermatology, Stanford School of Medicine, Stanford, CA, USA.
¹⁷ Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
¹⁸ Innovative Dermatology, Plano, TX, USA.
¹⁹ Department of Urban Health and Population Science, Center for Urban Bioethics, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
²⁰ Department of Dermatology, Howard University College of Medicine, Washington, DC, USA.
²¹ Dermatology, Cosmetic & Laser Surgery, Rockville, MD, USA.
²² Dermatology, Cosmetic & Laser Surgery, Fairfax, VA, USA.
²³ Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, University of Manchester, Manchester, UK.
²⁴ Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA.
²⁵ Georgia Dermatology Partners, Snellville, GA, USA.
²⁶ Icahn School of Medicine at Mount Sinai, New York, NY, USA.
²⁷ Callender Dermatology & Cosmetic Center, Glenn Dale, MD, USA.

PMID: 40252110
DOI: 10.1007/s00403-025-04219-6

Rethinking the use of population descriptors in dermatology trials and beyond: disentangling race and ethnicity from skin color

Valerie M Harvey et al. Arch Dermatol Res. 2025.

. 2025 Apr 19;317(1):728.

doi: 10.1007/s00403-025-04219-6.

Authors

Affiliations

¹ Hampton Roads Center for Dermatology, Virginia Beach, VA, USA. valerieharvey10@gmail.com.
² Department of Dermatology, University of California San Francisco, San Francisco, CA, USA.
³ Department of Dermatology, Duke University School of Medicine, Durham, NC, USA.
⁴ Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
⁵ Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
⁶ Department of Dermatology, Wake Forest University School of Medicine, Winston Salem, NC, USA.
⁷ Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
⁸ Division of Dermatology, Women's College Hospital, University of Toronto, Toronto, ON, Canada.
⁹ Department of Laboratory Medicine, University Health Network, University of Toronto, Toronto, ON, Canada.
¹⁰ Department of Anthropology, The Pennsylvania State University, University Park, PA, USA.
¹¹ Israel Englander Department of Dermatology, Weill Cornell Medical College, New York, NY, USA.
¹² Division of Dermatology, Washington University, St. Louis, MO, USA.
¹³ Center for Dermatology and Dermatologic Surgery, Washington, D.C., USA.
¹⁴ Department of Dermatology, Howard University College of Medicine, Washington, D.C., USA.
¹⁵ Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, USA.
¹⁶ Department of Biomedical Data Science and Dermatology, Stanford School of Medicine, Stanford, CA, USA.
¹⁷ Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
¹⁸ Innovative Dermatology, Plano, TX, USA.
¹⁹ Department of Urban Health and Population Science, Center for Urban Bioethics, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
²⁰ Department of Dermatology, Howard University College of Medicine, Washington, DC, USA.
²¹ Dermatology, Cosmetic & Laser Surgery, Rockville, MD, USA.
²² Dermatology, Cosmetic & Laser Surgery, Fairfax, VA, USA.
²³ Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, University of Manchester, Manchester, UK.
²⁴ Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA.
²⁵ Georgia Dermatology Partners, Snellville, GA, USA.
²⁶ Icahn School of Medicine at Mount Sinai, New York, NY, USA.
²⁷ Callender Dermatology & Cosmetic Center, Glenn Dale, MD, USA.

PMID: 40252110
DOI: 10.1007/s00403-025-04219-6

Abstract

Importance: Race and ethnicity as population descriptors in research and clinical practice have often been a subject of debate, drawing heightened scrutiny in recent years. Criticism focuses on their oversimplification and misapplication, which fail to capture the complexity of human health and genetic diversity. There is growing recognition that these categories, rooted in outdated social constructs, do not accurately reflect biological differences.

Observations: Historically, race and ethnicity have been used as proxies for genetic variation and skin color, despite the understanding that these constructs are not biologically defined. The Skin of Color Society's second Meeting the Challenge Summit, attended by over 100 U.S. and international participants, highlighted several key themes: (1) the need for transparency in the rationale behind using population descriptors and decision-making processes; (2) recognizing the role of race and racism in dermatology; (3) exploring the intersection of dermatology, skin color, and cultural influences; (4) understanding the context of population descriptor usage; (5) developing improved, objective tools for classifying skin color; and (6) advancing research and creating guidelines.

Conclusions and relevance: There is an urgent need to reconsider the use of race and ethnicity as population descriptors in dermatology research. Current systems, which conflate social identity with biological markers, perpetuate health disparities and limit the accuracy of clinical data. Moving forward, more specific descriptors such as skin color, alongside socially determined factors, will be crucial in achieving meaningful diversity and inclusivity in clinical research.

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Conflict of interest statement

Declarations. Competing interests: VMH serves as a consultant for AbbVie, Bristol Myers Squibb, Janssen, Johnson & Johnson, and L’Oréal, receiving honoraria; and serves as an advisory board member for SkinCeuticals, receiving honoraria. JCL serves as a consultant for Google and L’Oréal and an advisory board member for Mattice Biosciences. TJ serves as a principal investigator for UCB; receives research fellow support from Pfizer Inc., via the Skin of Color Grant, and from UCB; and serves as a consultant for Eli Lilly, Novartis, and UCB, receiving honoraria. JT serves as a consultant for Incyte Corporation, receiving honoraria; and receives research grants from Pfizer Inc., and Bristol Myers Squibb (paid to the Trustees of the University of Pennsylvania). AJM has received research grants from Concert, Procter & Gamble, Incyte, Revian; serves as a consultant to Lilly, Janssen, Pfizer, Arcutis, Almirall, AbbVie, CeraVe, Galderma, Bristol Myers Squibb, Sanofi Regeneron, Sun Pharma, UCB, Procter & Gamble, Revian, Johnson & Johnson, L’Oréal, Leo, receiving honoraria; and has received royalties from Informa/Taylor and Francis, and McGraw Hill. YMM serves as an advisory board member for AbbVie, Bristol Myers Squibb, Boehringer Ingelheim, Fresenius Kabi, Incyte Corporation, Janssen, L’Oréal, Sanofi, Sun Pharma, Novartis, and UCB, receiving honoraria; and serves as a consultant for AbbVie, L’Oréal, and Galderma Laboratories, L.P., receiving honoraria. NGJ serves as an advisory board member for L’Oréal, receiving honoraria. JL has no relevant conflicts of interest to disclose. AFA is a consultant for AbbVie, Allergan, Almirall, Alphyn, Amgen, Apogee, Arcutis, Avita Medical, Bausch health, Beiersdorf, BMS, Canfield, Cara, Castle, Cutera, Dermavant, Eli Lilly, EPI, Galderma, Genentech, Genzyme, Incyte, Janssen, Leo, L’Oréal, Ortho, Pfizer, Sanofi-Regeneron, Swiss American, UCB and VisualDx, a speaker for BMS, J&J, Janssen, Regeneron and Sanofi-Genzyme, receives equipment from Aerolase, grants from AbbVie, Amgen, Arcutis, Castle, Dermavant, Galderma and Leo, and royalties from Elsevier, Springer, Wiley-Blackwell and Wolters Kluwer Health. SGB has no relevant conflicts of interest to disclose. CMB has no relevant conflicts of interest to disclose. ASB is the inaugural recipient of the Skin of Color Society Career Development Award, as well as the Society for Investigative Dermatology Freinkel Diversity Fellowship Award, and a recipient of the Robert A. Winn Diversity in Clinical Trials Career Development Award (Winn CDA) funded by Bristol Myers Squibb Foundation (BMSF); serves as a consultant for Senté, Inc. and Sonoma Biotherapeutics; and serves as an advisory board member for Novartis, receiving honoraria. SCC has no relevant conflicts of interest to disclose. CBCC has no relevant conflicts of interest to disclose. RD reported stock options from Revea and MDalgorithims, as well as personal fees from Pfizer, Frazier Healthcare Partners, and L’Oréal; and has a patent for 17/937 714 pending. SRD has no relevant conflicts of interest to disclose. CRH is a consultant for Arcutis, Apogee, Avita, Dermavant, Lilly, Janssen, Johnson and Johnson, Kenvue, Pfizer, Regeneron, Sanofi, L’Oréal, Nutrafol, and WebMD. Investigator/Research/Research Development Funding paid to institution: Eli Lilly and Company, CorEvitas, Janssen, Robert A. Winn Diversity in Clinical Trials Award Program established by the Bristol Meyers Squibb Foundation, and recipient of a Skin of Color Society Career Development Award. CAVO has no relevant conflicts of interest to disclose. HS has no relevant conflicts of interest to disclose. SCT is a past employee of Mercer Strategies and was on the board of directors; serves as a consultant to Arcutis Biotherapeutics, Inc, Beiersdorf, Inc., Bristol Myers Squibb, Cara Therapeutics, Dior, and Sanofi, receiving honoraria; serves as a consultant to Armis Biopharma, GloGetter, and Piction Health, receiving stock options; serves as an advisory board member for AbbVie, Avita Medical, Beiersdorf, Inc., Biorez, Inc., Eli Lilly, EPI Health, Evolus, Inc., Galderma Laboratories, L.P., Hugel America, Inc., Incyte, Johnson & Johnson Consumer Products Company, L’Oréal USA, Medscape/WebMD, Pfizer, Scientis US, UCB, and Vichy Laboratories, receiving honoraria; serves as a speaker for Beiersdorf, Inc, Catalyst Medical Education LLC, LearnSkin, Medscape/WebMD, and MJH LifeSciences; has received royalties from McGraw Hill; is an investigator for Allergan Aesthetics, Concert Pharmaceuticals/Sun Pharma, Croma-Pharma GmbH, Eli Lilly, and Pfizer, receiving grants and research funding; and serves on the editorial board for Practical Dermatology, Cutis, and Archives in Dermatologic Research, and as a peer-reviewer for British Journal of Dermatology. JSW serves as an advisory board member for Bristol Myers Squibb, Dermavant Sciences, Foamix, Galderma Laboratories, L.P., Incyte Corporation, Novartis, and UCB receiving honoraria; serves as a consultant for Arcutis, Inc., Biofrontera, Cutera, Inc., Leo Pharma Inc, Ortho Dermatologics, and UCB, receiving fees or honoraria; is an investigator for AbbVie, Bausch Health, Biofrontera, Bristol Myers Squibb, Cutera, Inc., Dermavant Sciences, Foamix, Galderma Laboratories, L.P., Leo Pharma, Mindera, Moberg Pharma North America LLC, Novartis, Palvella Therapeutics, and Verrica Pharmaceuticals Inc., receiving grants and research funding; and serves as a speaker for AbbVie, Arcutis, Inc., Galderma Laboratories, L.P., Ortho Dermatologics, Regeneron, and Sanofi Genzyme, receiving honoraria. JY has no relevant conflicts of interest to disclose. VDC serves as a researcher for Avava, Galderma, I Know Skincare, Janssen, Prollenium, Skinbetter Science, Symatese, and Teoxane; serves as a researcher/consultant for AbbVie/Allergan, Incyte, L’Oréal Aesthetics, and Pfizer; serves as a consultant for Acne Store, Aerolase, Avita Medical, Beiersdorf, Cutera, Dermavant, Juenes Aesthetics, Orthoderm, and SkinCeuticals; serves as a consultant/speaker for Arcutis; serves as a researcher/consultant/speaker for Eli Lilly; and has received royalties from UpToDate.

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Rethinking the use of population descriptors in dermatology trials and beyond: disentangling race and ethnicity from skin color

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Rethinking the use of population descriptors in dermatology trials and beyond: disentangling race and ethnicity from skin color

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