Overcoming digital health inequities to transform current diagnostic practices of melanoma

Abstract

Digital health, the intersection of healthcare and technology, has recently gained popularity. Through incorporating technology with science, the diagnosis, management and treatment of disease can be improved. This transformation, which blossomed during the COVID-19 pandemic, has given patients more autonomy and has improved outcomes. Yet the rise of digital health has also had a downside: some groups, especially those of low socioeconomic status, have been left behind, as they do not have equal access to the same technologies. Furthermore, these technologies were programmed by humans, built on human biases, further exacerbating prejudice. These biases have harmed patients with darker skin tones, as most dermatologic literature focuses on lighter skin tones. Therefore, the images generated by artificial intelligence for teaching purposes are usually biased and inaccurate representations. Recognizing the void, I have been working as part of a team to retrain algorithms and eliminate bias, so that patients with darker skin will be able to benefit from dermatologic technologies. Beginning with collecting and sorting data, the hope is that new technologies capable of detecting melanoma will become accessible for patients with darker skin. Through exploring melanin, the skin’s natural pigment, and its synthesis, one can better understand how melanoma may manifest differently in dark and light skinned individuals. Analysis of some genetic and environmental causes of melanoma addresses why darker skinned individuals might be overlooked, due to the decreased prevalence of the disease in this group. However, all patients deserve that efforts be made to ensure technologies also work for their skin types, especially given increasing melanoma rates and the prevalence of acral lentiginous, the more lethal form, among darker patients. Concluding with an interview about the promising new technologies in the rapidly evolving field of dermatology emphasized the importance of continuing to contribute to this potentially life-saving project.