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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2025; 13(36): 116656
Published online Dec 26, 2025. doi: 10.12998/wjcc.v13.i36.116656
Published online Dec 26, 2025. doi: 10.12998/wjcc.v13.i36.116656
Skin tone bias in online psoriasis imagery: Insights from an international study
Aman Sandhu, Sanya Ailani, Department of Medicine, Drexel University College of Medicine, Philadelphia, PA 19104, United States
Smitesh Padte, Department of Medicine, WellSpan York Hospital, York, PA 17403, United States
Priyal Mehta, Department of Medicine, St. Vincent Hospital, Worcester, MA 01608, United States
Neha Deo, Department of Dermatology, University of Colorado, Boulder, CO 80309, United States
Salim Surani, Department of Medicine, University of Houston, Houston, TX 77004, United States
Rahul Kashyap, Department of Research, WellSpan York Hospital, York, PA 17403, United States
Author contributions: Sandhu A wrote the original draft; Sandhu A and Ailani S designed the research study and conducted the formal analysis; Sandhu A, Ailani S, Padte S, Mehta P, Deo N, Surani S, and Kashyap R performed the investigation; Sandhu A, Ailani S, and Kashyap R developed the methodology and curated the data; Sandhu A and Kashyap R generated the visualizations; Kashyap R supervised the research. All authors reviewed and edited the manuscript.
Institutional review board statement: This study is considered Institutional Review Board exempt because no patient-identifying health information was sought or recorded.
Informed consent statement: All participants were informed of the nature of the study and provided with the option to participate voluntarily. Informed consent has been waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: All the data are presented in the article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Salim Surani, MD, FACP, FCCP, Professor, Department of Medicine, University of Houston, 4302 University Drive, Houston, TX 77004, United States.
Received: November 17, 2025
Revised: December 3, 2025
Accepted: December 12, 2025
Published online: December 26, 2025
Processing time: 38 Days and 13.4 Hours
Revised: December 3, 2025
Accepted: December 12, 2025
Published online: December 26, 2025
Processing time: 38 Days and 13.4 Hours
Core Tip
Core Tip: In this global observational study, online psoriasis image search results across major web browsers were systematically analyzed to assess the representation of skin tone. Lighter skin tones overwhelmingly predominated early search results, while darker skin tones were consistently ranked lower in visibility, limiting early exposure for patients of color. These findings reinforce a lack of diverse dermatologic imagery worldwide and underscore the need for more equitable medical resources.