The BAD recognises the healthcare inequities facing people of color across the world, and within the UK, and strongly denounces racism in any form. We believe that representation of all skin types in dermatology textbooks, research and image databases is important.

In response to Guardian article, we would like to clarify the following: https://www.theguardian.com/world/2020/sep/28/covid-19-skin-rash-website-criticised-for-lack-of-bame-examples

The website hosts images taken and uploaded by members of the public themselves, rather than by doctors or medical photographers, through the COVID-19 Symptom Study app. The app was developed by health science company ZOE. The app launched a survey on social media and through the app which specifically called for images of suspected COVID-19 skin signs on darker skin to be uploaded, a proportionally low number of images on non-white skin were received compared to white skin. The reasons for this need to be examined, but may in part be because rashes on darker skin can be difficult to photograph.

The British Association of Dermatologists was keen to fund and help develop a free, easy to access website on which these Covid-19 rash images could be made available for the public and healthcare workers to see, and we wanted to get the available images online as soon as possible, in case they can help people in assessing their symptoms, and to help reduce the spread of the disease. Of the original images, the quality was very variable. A team of volunteers removed those which were blurry, of low quality, did not show a Covid rash, or had other issues such as the person being identifiable in the image.

It has been reported that only two of the images of the site are of darker skin types; this is not correct, although the number is still lower than we would like. Following feedback, we are now planning to upload images of darker skin tones even where the rash is less clear, as this may be preferable to not featuring images that fully represent all skin types. Our overall intention with this project was to provide a public service to help people during a difficult time, certainly not to cause division or distress, and we sincerely hope we can achieve this.