Eczema in skin of color – current paradigms and challenges

Pediatric atopic dermatitis, its clinical presentation, differential diagnoses, comorbidities, diagnostic criteria, severity scores, outcome measures, management options starting from traditional interventions to what’s new on the horizon, and the very much required emphasis on disease burden, impact on quality of life, and cost of illness have been the subject of intense research. A PubMed search with keywords of atopic eczema revealed a result of mindboggling 42,722 articles, and restricting the search to pediatric atopic eczema provided 7320 results. However, a search for articles focused on atopic eczema in skin of color led to a paltry 243 research items, and in this sub-category, pediatric atopic eczema articles were only 44. This is surprising as it is well known that the phenotype of atopic dermatitis, the clinical presentation, the sequelae, especially the dyspigmentation and impact on quality of life, are significantly different from the less pigmented skin. In addition, when the search keywords are modified to pediatric eczema in skin of color, it provides only 26 research items.^[1] Indian Journal of Skin Allergy, with its focus on skin allergy and eczemas, hopes to bridge this gap. In this issue, we have an article on the role of dermoscopy in the diagnosis of eczemas, a niche area that will have considerable variation in skin color.^[2] Furthermore, in this issue, we have included the first part of symposium focused on pediatric eczemas. Dr. Maitreyee Panda is the guest editor for this symposium. This specially curated symposium focuses on diverse aspects of pediatric eczemas. We have included genetic polymorphism in atopic eczema (with a special emphasis on skin of colour), the psychosocial impact of atopic eczema on skin of color, and the role of cleansers and moisturizers in managing pediatric eczemas.^[3-5] We will also focus on the often-ignored topic of pediatric contact dermatitis, including emerging allergens. The latter is especially relevant given its bidirectional association with atopic eczema.^[6] Look out for the second part of the symposium that will help us delve deep into the eczema enigma! We also hope that future research in eczema, including atopic dermatitis, will especially include patients of skin color to better delineate unique issues being faced by them and optimize their management.

These are exciting times in atopic dermatitis management, and we have several targeted therapeutic options. A succinct review of these molecules and their targets by Dr. Kin Leong and co-authors is included in this issue.^[7] The studies including patients from India, Egypt, and Thailand, highlight the need to document and share research data on urticaria and contact dermatitis in skin of color.^[8-10] The very interesting image contributions, case reports, and case letters to the editor will make for interesting reading, as they cover unusual presentations, novel therapeutic usage, and adverse effects. We hope to keep receiving your contributions to the journal, which helps document the diversity of clinical presentation in patients with allergy, a circumstance that makes dermatology so challenging and satisfying.

As we complete 4 years of publishing this journal focused on all aspects of skin allergy, I would take this opportunity to thank all our colleagues for their interest and support for the journal, best exemplified by the journal’s performance. The usage statistics of this free access journal have demonstrated a heartening trajectory of growth, including an increase of total downloads from 5,38,759 in April 2024 to 13,21,389 in August 2025 (increase of 59.2%) and of PDF downloads from 4,72,372 to 9,58,810 (increase of 50.7% ).^[11,12]

I am signing off with the repeated request to keep reading and contributing to the Indian Journal of Skin Allergy, and we would welcome your feedback at editor@skinallergyjournal.com.