Skin of Color Savvy: Live at RAD 2025 with Tiffany Mayo, MD, and Raj Chovatiya, MD, PhD

Welcome to Skin of Color Savvy: The Art and Science of Treating Patients of Color!

In this special on-site episode of Skin of Color Savvy: The Art and Science of Treating Patients of Color, by the Skin of Color Society (SOCS) and HCPLive, dermatologists Raj Chovatiya, MD, PhD, and Tiffany Mayo, MD, engage in a wide-ranging discussion on atopic dermatitis in skin of color, recorded live from the 2025 Revolutionizing Atopic Dermatitis (RAD) Conference in Nashville, Tennessee. Together, the 2 leading voices in dermatology examine diagnostic challenges, patient communication, and the future of topical therapy—offering both clinical insights and actionable strategies for improving care across diverse skin tones.

The conversation begins with an exploration of diagnostic disparities in atopic dermatitis. Mayo highlights how historical underrepresentation of skin of color in dermatologic imagery, along with erythema being a primary clinical feature, contributes to delayed diagnosis in patients with richly pigmented skin. Chovatiya echoes this, noting the visual bias in dermatology and the importance of rethinking severity grading in atopic dermatitis, which often relies on erythema not easily visible in darker skin. Both clinicians emphasize that postinflammatory pigment alteration—especially hyperpigmentation—is not only common in patients of color but often more distressing to patients than the disease itself.

The episode stresses the importance of eliciting patient priorities during consultation. Mayo urges clinicians to directly ask, “What bothers you most?” as pigment changes may be more concerning to patients than active eczema. She also outlines counseling strategies to clarify that medications aren’t the cause of pigment alteration, but rather the disease itself, helping to maintain treatment trust and adherence.

The discussion transitions into clinical pearls for differentiating atopic dermatitis from its mimickers—particularly in darker skin tones. Mayo shares her use of dermoscopy to enhance diagnostic accuracy in cases where morphology is subtle, while Chovatiya recommends palpation as a basic but powerful tool. Both caution against under-recognizing active disease in richly pigmented skin and recommend incorporating validated patient-reported outcome measures like POEM scores to capture disease burden when visual cues are misleading.

As the discussion turns to treatment, the hosts spotlight the growing role of targeted, nonsteroidal topical therapies. Mayo outlines her real-world use of agents such as tapinarof, roflumilast, and ruxolitinib, citing their long-term safety, tolerability, and usefulness across diverse presentations. She emphasizes that simple regimens, monotherapy when possible, and flexible formulations (such as foams) are key to promoting adherence, especially among patients with textured hair, facial involvement, or sensitive skin.

Chovatiya highlights the inclusivity of recent clinical trials, particularly for tapinarof, noting their deliberate enrollment of racially diverse participants and design parameters that more closely mimic real-world behavior. Data from long-term extension studies show that even with intermittent use, patients can maintain control of their disease—an important message for busy individuals who struggle with daily application. Roflumilast and ruxolitinib offer similarly flexible maintenance strategies, supporting proactive or as-needed regimens that match the heterogeneity of atopic dermatitis in the real world.

The episode closes with a mutual call for “intentionality” in atopic dermatitis care: in diagnosis, treatment selection, trial design, and patient communication. Mayo reminds listeners that patients of color may not exhibit textbook signs, making it essential to gather layered diagnostic data and engage patients around their lived experiences. Chovatiya reinforces that clinicians must recognize the multidimensional nature of atopic dermatitis—its signs, symptoms, comorbidities, and psychosocial burden—and approach every patient with individualized, culturally responsive care.

To learn more about SOCS’s mentorship programs and initiatives, visit Skin of Color Society.

Editor’s note: This podcast summary was edited through the use of artificial intelligence tools.