Representation in Figures Depicting Penile Pathology in Urologic Textbooks.

Objectives To investigate whether penile pathologies are presented diversely in urologic textbooks and identify areas where more diverse presentation is warranted. Methods Photographic depictions of penile pathologies in nine urologic textbooks were assigned a Fitzpatrick skin phototype and constitutive skin color. Fitzpatrick skin phototypes ranged from I-VI, and constitutive skin colors were light, fair, medium, and dark. Fitzpatrick skin phototypes I-III were deemed non-skin of color, and IV-VI considered skin of color. Figures were classified based on pathology presented: infectious benign or STI, non-infectious benign, or malignant. Chi-square and odds ratio were used to compare skin color ranges across pathologic categories and determine where a figure depicting skin of color would most likely be encountered. Results Within 116 figures meeting inclusion criteria, 15 (51.7%) infectious/STI pathologies displayed skin of color, while 10 (27.8%) non-infectious benign and 7 (13.7%) malignant pathologies displayed skin of color. Within 85 diagnostic images, 15 (51.7%) images of infections/STIs, 10 (28.6%) non-infectious benign and 4 (19.0%) malignant pathologies presented skin of color (p Conclusions There is a lack of depictions of malignant and non-infectious benign penile pathology on skin of color. This may contribute to continued disparities in the diagnosis and treatment of penile pathologies.