A 56-year-old woman comes to the clinic with multiple acrochordon-type lesions in both malar regions.A 56-year-old woman presents with multiple skin tag-like lesions on the left side of her face, which, although already present, are now increased in size and number. The patient also reports itching in the affected area. She mentions a previous consultation with a dermatologist 15 years ago for similar, more localized lesions, which were treated with cryotherapy. The patient is of African descent.   A dermatology consultation was requested via teleconsultation, with attached images. The dermatology response was: dermatosis papulosa nigra. Colleagues advise that the diagnosis is seborrheic keratoses nigra of the face, common in people of African descent—benign lesions that do not require treatment. There is a high risk of dyschromia and abnormal scarring if the lesions are removed for cosmetic purposes.To emphasize the importance of integrating all patients in order to practice correct, effective, and fair medicine.The risk of late or incorrect diagnoses has direct implications for the patient's health. Serious pathologies such as acral melanoma, more frequent in people with dark skin, are often detected late due to their atypical presentation, which increases mortality. Conditions such as rosacea and cutaneous lupus can go unnoticed because the characteristic erythema is less visible, while genetic diseases such as sickle cell anemia and keloid formation are significantly more common in populations of African descent, reinforcing the need for a clinical approach adapted to the population.In dermatology, for example, the presentation of many diseases changes radically with skin color. Seborrheic dermatitis, recognized by erythema in light skin, can present as hypopigmented areas in dark skin, making diagnosis difficult. Psoriasis can manifest with purplish or grayish plaques, and post-inflammatory hyperpigmentation following acne is much more prevalent in dark skin. These clinical variations underscore that traditional diagnostic criteria and guidelines, based primarily on light-skinned patients, may not be universally applicable.Traditional textbooks and many clinical guidelines primarily depict pathologies in fair-skinned individuals, which can lead to diagnostic bias. Training healthcare professionals to recognize manifestations in different ethnicities improves diagnostic accuracy and health equity.