美国国家公共电台 NPR Diagnostic Gaps: Skin Comes In Many Shades And So Do Rashes

 

DAVID GREENE, HOST:

All right. So if you go to a dermatologist¹ with, say, a rash, chances are the doctor's going to want to take a look, right? So much of diagnosing skin conditions comes down to what the doctor sees. But as Deena Prichep reports, some are raising concerns about whether doctors are getting the whole picture in their training.

ELLEN BUCHANEN WEISS: Can you show Mama how to blow bubbles? No? (Laughter).

DEENA PRICHEP, BYLINE²: Like a lot of new parents, Ellen Buchanen Weiss is pretty into her kid.

WEISS: We adopted him when he was 11 days old. He is gentle, sweet, hilarious³, on the go all day. (Laughter).

PRICHEP: And like a lot of new parents, Buchanen Weiss had all sorts of questions during that blurry⁴ first year, like after her son's 12-month vaccinations⁵, when he broke out in a rash.

WEISS: I'm trying to figure out, would I be paranoid if I went to the doctor at this point? Is that a reasonable thing to do? So I started Googling it.

PRICHEP: We're talking image searches. Also looking at pages from the Mayo Clinic, CDC. But her son has brown skin.

WEISS: And it became immediately clear to me that the vast majority of even common skin conditions are on white skin. You have to scroll⁶ down, like, 80 pictures to find a single one on brown skin.

LYNN MCKINLEY-GRANT: It's not surprising, but it is concerning. Very concerning.

PRICHEP: Dr. Lynn McKinley-Grant is a dermatology professor at Howard University and president of the Skin of Color Society. She knows there's a gap, and not just on the Internet.

MCKINLEY-GRANT: Often in medical schools, they have limited pictures of diseases in skin of people of color.

PRICHEP: And that's a big problem. Medical school is a lot of pattern recognition, especially when it comes to dermatology. You see picture after picture to encode them into your brain. And if you don't see pictures of different skin types, you may not be able to diagnose them. Take rashes.

MCKINLEY-GRANT: You'll hear a term called erythema.

PRICHEP: Erythema, the official medical term, from the Greek word for red. But rashes don't always look red on dark skin. They can look kind of purple or barely show up at all.

MCKINLEY-GRANT: So I've had patients who have said they go in and they tell the doctor that they have redness, and the doctor can't see it. They're like, well, there's nothing there, you know, just put some lotion⁷ on and go home.

PRICHEP: McKinley-Grant says schools are making an effort to diversify⁸ training materials. But they've still got a ways to go, and this problem could get even worse. Dr. Roxana Daneshjou is a dermatology resident at Stanford. For her Ph.D., she's looking at artificial intelligence.

ROXANA DANESHJOU: If we don't fix the biases¹⁰ that we have in health care before we jump to training a computer to do it, we're just going to actually perpetuate¹¹ those biases.

PRICHEP: The computer learns the same way students do. Daneshjou and her team feed in image after image to create a tool that can help doctors recognize patterns. And when there aren't images of darker skin, the algorithm, like a doctor, won't be as good at diagnosing people of color, whether that's an allergic¹² reaction or a Lyme disease rash or skin cancer.

DANESHJOU: Addressing bias⁹ and improving diversity are not tangential¹³ issues. They are actually central to providing equitable¹⁴ health care.

PRICHEP: So how do you get more diverse images? There are resources, especially for doctors and medical students. But people have to seek them out. And sometimes they don't even realize what's missing. For Ellen Buchanen Weiss, who couldn't find pictures that looked like her son, the answer was right on her phone.

WEISS: I thought to myself, well, you know, I could just open an Instagram account.

PRICHEP: Buchanen Weiss launched Brown Skin Matters in August, posting pictures of skin conditions on people of color. And in just a few months, she got over 7,000 followers¹⁵.

WEISS: I expected moms to want this resource, but I've been surprised at how much of the attention has been from medical professionals.

PRICHEP: All of the dermatologists¹⁶ we spoke¹⁷ with stressed that this is not a substitute for a medical exam. But it is a resource, and it's helping¹⁸ raise awareness¹⁹ of the problem, which is one of the first steps to making sure that the picture of the future looks a little different. For NPR News, I'm Deena Prichep.

(SOUNDBITE OF SONG, "BROWN SKIN")

INDIA.ARIE: (Singing) Brown skin. You know I love...

1 dermatologist   

n.皮肤科医师

参考例句：

• I think you should see a dermatologist first.我想你应当先看皮肤科大夫。
• The general practitioner referred her patient to a dermatologist.家庭医生把她的病人交给了皮肤科医生。

2 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

3 hilarious   

adj.充满笑声的，欢闹的；[反]depressed

参考例句：

• The party got quite hilarious after they brought more wine.在他们又拿来更多的酒之后，派对变得更加热闹起来。
• We stop laughing because the show was so hilarious.我们笑个不停，因为那个节目太搞笑了。

4 blurry   

adj.模糊的；污脏的，污斑的

参考例句：

• My blurry vision makes it hard to drive. 我的视力有点模糊，使得开起车来相当吃力。 来自《简明英汉词典》
• The lines are pretty blurry at this point. 界线在这个时候是很模糊的。 来自《简明英汉词典》

5 vaccinations   

n.种痘，接种( vaccination的名词复数 )；牛痘疤

参考例句：

• Vaccinations ensure one against diseases. 接种疫苗可以预防疾病。 来自《简明英汉词典》
• I read some publicity about vaccinations while waiting my turn at the doctor's. 在医生那儿候诊时，我读了一些关于接种疫苗的宣传。 来自《简明英汉词典》

6 scroll   

n.卷轴，纸卷；(石刻上的)漩涡

参考例句：

• As I opened the scroll,a panorama of the Yellow River unfolded.我打开卷轴时，黄河的景象展现在眼前。
• He was presented with a scroll commemorating his achievements.他被授予一幅卷轴，以表彰其所做出的成就。

7 lotion   

n.洗剂

参考例句：

• The lotion should be applied sparingly to the skin.这种洗液应均匀地涂在皮肤上。
• She lubricates her hands with a lotion.她用一种洗剂来滑润她的手。

8 diversify   

v.（使）不同，（使）变得多样化

参考例句：

• Our company is trying to diversify.我们公司正力图往多样化方面发展。
• Hills and woods diversify the landscape.山陵和树木点缀景色。

9 bias   

n.偏见，偏心，偏袒；vt.使有偏见

参考例句：

• They are accusing the teacher of political bias in his marking.他们在指控那名教师打分数有政治偏见。
• He had a bias toward the plan.他对这项计划有偏见。

10 biases   

偏见( bias的名词复数 )； 偏爱； 特殊能力； 斜纹

参考例句：

• Stereotypes represent designer or researcher biases and assumptions, rather than factual data. 它代表设计师或者研究者的偏见和假设，而不是实际的数据。 来自About Face 3交互设计精髓
• The net effect of biases on international comparisons is easily summarized. 偏差对国际比较的基本影响容易概括。

11 perpetuate   

v.使永存，使永记不忘

参考例句：

• This monument was built to perpetuate the memory of the national hero.这个纪念碑建造的意义在于纪念民族英雄永垂不朽。
• We must perpetuate the system.我们必须将此制度永久保持。

12 allergic   

adj.过敏的，变态的

参考例句：

• Alice is allergic to the fur of cats.艾丽斯对猫的皮毛过敏。
• Many people are allergic to airborne pollutants such as pollen.许多人对空气传播的污染物过敏，比如花粉。

13 tangential   

adj.离题的，切线的

参考例句：

• Too much time was spent discussing tangential issues.太多的时间花在了讨论那些无关紧要的问题上。
• They thought the whole thing was a side-show, tangential to the real world of business.他们认为整件事情只是一个插曲，和真正的商界没有多大关系。

14 equitable   

adj.公平的；公正的

参考例句：

• This is an equitable solution to the dispute. 这是对该项争议的公正解决。
• Paying a person what he has earned is equitable. 酬其应得,乃公平之事。

15 followers   

追随者( follower的名词复数 )； 用户； 契据的附面； 从动件

参考例句：

• the followers of Mahatma Gandhi 圣雄甘地的拥护者
• The reformer soon gathered a band of followers round him. 改革者很快就获得一群追随者支持他。

16 dermatologists   

n.皮肤病学家( dermatologist的名词复数 )

参考例句：

• Today dermatologists agree that the experiments were not conducted well. 今天，皮肤病学者承认，当时的实验操作上有误。 来自互联网
• Dermatologists consistently recommend the low-cost old favorites, but of good-quality. 皮肤学家一致推荐物美价廉的老品牌。 来自互联网

17 spoke   

n.（车轮的）辐条；轮辐；破坏某人的计划；阻挠某人的行动 v.讲，谈（speak的过去式）；说；演说；从某种观点来说

参考例句：

• They sourced the spoke nuts from our company.他们的轮辐螺帽是从我们公司获得的。
• The spokes of a wheel are the bars that connect the outer ring to the centre.辐条是轮子上连接外圈与中心的条棒。

18 helping   

n.食物的一份&adj.帮助人的，辅助的

参考例句：

• The poor children regularly pony up for a second helping of my hamburger. 那些可怜的孩子们总是要求我把我的汉堡包再给他们一份。
• By doing this, they may at times be helping to restore competition. 这样一来, 他在某些时候,有助于竞争的加强。

19 awareness   

n.意识，觉悟，懂事，明智

参考例句：

• There is a general awareness that smoking is harmful.人们普遍认识到吸烟有害健康。
• Environmental awareness has increased over the years.这些年来人们的环境意识增强了。