Skin Deep is led by the international medical education team, Don’t Forget the Bubbles (DFTB) and the Royal London Hospital (RLH). The aim is to develop a free, open-access bank of high-quality photographs of medical conditions in a range of skin tones for use by both healthcare professionals and the public. The team behind Skin Deep hopes that with time, this will improve education and recognition of conditions in all skin tones, reducing inequalities and improving patient care by ensuring that all children receive a timely diagnosis regardless of their skin colour.
Within paediatrics, the diagnosis of skin conditions and genetic syndromes relies on the recognition of characteristic features which can differ depending on skin tones. Despite this, the vast majority of medical textbooks and online resources only contain pictures of children
or young people with light skin tones. Moreover, descriptions of rashes focus on redness or pallor, both of which are more difficult to recognise in darker skin tones or may not be present at all. This means that children with darker skin tones are often not diagnosed correctly or as quickly as those with lighter skin tones. Some high profile work is already taking place to address this issue, particularly “Brown Skin Matters” set up by Ellen Margolis and “Mind the Gap” from UK medical student Malone Mukwende, which have successfully brought this issue into the spotlight.
DFTB is one of the largest free open access medical education resources available online and the team have strong international collaborative networks. The Skin Deep project started as part of DFTB in June 2020, but the overwhelming response has led to the launch of its very own website and social media channels. Skin Deep will complement and support the existing projects by using a double-pronged approach to increase the quality and quantity of images for medical education.
The team are calling on healthcare professionals and hospitals across the UK and the world to collaborate and be part of the project. They have developed a stream-lined process to setup the project at individual hospital sites, including the appropriate governance and consent processes to ensure patient confidentiality and secure transfer of photographs. This is already successfully in place at the Royal London Hospital paediatric emergency department and many other hospitals across the UK, Australia and South Africa. The team are also calling upon parents and guardians to submit their photographs through this website. All the submitted photographs will be reviewed by a team of dermatologists to provide the correct diagnosis and clinical terms. The images are only used with consent from parents, and pictures of children and case details will be anonymised on the website.