Alameda Health System Dermatology Chief Dr. Leon Clark on tackling health disparities, rebuilding patient trust, and caring for black and brown skin

Dr. Leon Clark was perplexed when a patient walked into his dermatology clinic with large blisters on his skin.

It wasn’t the diagnosis that stumped him – he immediately identified the rash as bullous pemphigoid, a treatable condition – but rather, that the disease was so severe and hadn’t been diagnosed and treated sooner.

Dr. Leon Clark

Dr. Leon Clark

Research shows that skin diseases are likely undercounted in Black patients like Clark’s, and can be more deadly for people of color. Misdiagnoses and delays in treatment, often at the hands of doctors who aren’t trained to detect disease in brown skin, are just a few of the many ways that racism directly impacts people’s health.

Clark said it’s common for him to see patients with 90% of their skin covered in skin diseases like eczema, who have been told by previous doctors that it’s just dry skin. Skin diseases including eczema can look different in white skin versus darker-colored skin.

“Someone who’s not familiar with what eczema looks like on Black skin may say, ‘Oh this is mild,’” Clark said. “It affects how aggressively it’s treated. I see it all the time, unfortunately.”

According to Clark and his peers, education is part of the problem. Every picture of skin disease he was shown in medical school appeared on white skin. There is now a national conversation around diversifying teaching materials, as well as recruiting more doctors of color, but that work has only just begun.

Clark joined Alameda Health System (AHS) because he wanted to help people who needed it the most. He founded AHS’s dermatology division in 2020 and has continued to expand it since then. Patients can now get dermatology care at the Wilma Chan Highland Hospital Campus, Eastmont Wellness and Hayward Wellness. The clinics fill a critical need in the community, treating about 4,000 patients per year, many of whom wouldn’t be able to get dermatology treatment otherwise.

“These patients tend to be more sick and have more severe skin disease,” he said. “They tend to need more complex care, and they can’t really get that in private practice. That leads them to us. We’re the one-stop shop for some of these folks.”

Clark continues to see patients three times a week. He finds time to mentor younger dermatologists who want to start their own clinics at community hospitals. And, he’s especially passionate about helping patients who suffer from a disease called hidradenitis suppurativa, or HS, which is more common in patients of color.

“It’s a terribly morbid condition that affects Black and Latino populations,” Clark said. “And it’s one that if you catch early and treat early, you can make a huge difference in someone’s life.”

Rebuilding patients’ trust in the medical system is critical for getting them care. Dermatologists can’t help folks if they refuse to go to the doctor – an all-too-common problem for people who have been dismissed by doctors in the past. But Clark said it’s never too late to get help. He once treated a man who had skin cancer on his back for more than two decades.

“Because patients had seen many different doctors, they felt like they weren’t listened to, they felt like the severity of their disease wasn’t taken seriously,” he said. “There is a huge access issue, and the only way to address it is to rebuild trust.”