Why Representation in Dermatology Education #MedEd matters to me, someone with #DarkSkin, in an 8 tweet thread:

~ 4 months ago, I went in to Student Health for a lesion I had for 3 months that wasn't going away, bled sometimes, and was starting to concern me.

I met with a white, male family doctor who took one 15-second look at it and said I could probably find a suitable treatment at drug stores or an aesthetician. He said he couldn't help me. He didn't tell me any alternatives, when to come back, or seem to acknowledge my skin tone.

Flash forward to now, 4 months later, I still had the lesion, it still bled sometimes, and I was still concerned. Now we are in the era of #COVID19 so I could not go in person to Student Health.

I met with a different family physician over the phone, told her the now updated timeline of my lesion, and sent her photos. She acknowledged my concern and my skin tone (which is *always* relevant in derm!). She sent the photos in to dermatology for an e-consult.

They got back swiftly (within an hour #Telemedicine)! They let her know it ~seemed~ like a keloid scar and she prescribed me topical corticosteroids and said when things normalize, I might need injected steroids or to come back in so they could investigate further.

4 months ago I felt dismissed and now I'm closer to getting answers. I can't help but wonder if this is a combo of the complexity of derm presentations in primary care that was ALSO exacerbated by the fact that my scar looked different, perhaps less concerning on my darker skin.

I am a medical student, I knew to go back and advocate for myself for something that was very abnormal for me. Not to settle for a non-diagnosis made *confidently* by someone I felt did not understand me as a patient. Not all patients would go back and do the same.

As we learn in our derm unit, I continue to see lesions only shown on white skin. It continues to be brought up across medical schools. I know work is being done by my peers to improve this. #RepresentationMatters - I hope we remember this whenever we see lesions on dark skin.