Dark Skin Research Articles

Representation of Skin Color, Disease Severity, and Anatomic Location in Hidradenitis Suppurativa Images

Introduction: Hidradenitis suppurativa (HS) is an inflammatory dermatosis disproportionately affecting patients of color. We evaluated characteristics of HS images in dermatology online image resources and textbooks. Methods: Images of HS were collected in December 2021 from online and textbook sources. Data regarding anatomic region, Hurley stage, and Fitzpatrick skin tone (FST) were collected and analyzed. Results: 318 images remained after exclusion criteria. VisualDx contained the highest number of dark skin (FST V-VI) images (59%, 47/79), followed by Google (4%, 2/52) and DermNetNZ (4%, 4/100). In textbook sources, dark skin represented 25% (4/16) of images. Across sources, 47% (151/318) of images represented Hurley stage 2, followed by 32% (101/318) stage 3, and 21% (66/318) stage 1. The axilla (49%, 156/318) was the most common anatomic location featured, followed by the groin (18%, 58/318) and breast/chest (9%, 28/318). Involvement of non-classic locations was represented in 3% (8/318) of images. There was a positive correlation between higher Hurley stage and darker skin (r=0.26, p<0.05). Discussion/Conclusion: Overall there is underrepresentation of dark skin tones, “non-classic” anatomic locations, and mild HS which may lead to missed opportunities for patient education and dermatology training. Dermatologists should take the lead to improve image diversity across educational resources.

The genetic evolution of acral melanoma

Acral melanoma is an aggressive type of melanoma with unknown origins. It is the most common type of melanoma in individuals with dark skin and is notoriously challenging to treat. We examine exome sequencing data of 139 tissue samples, spanning different progression stages, from 37 patients. We find that 78.4% of the melanomas display clustered copy number transitions with focal amplifications, recurring predominantly on chromosomes 5, 11, 12, and 22. These complex genomic aberrations are typically shared across all progression stages of individual patients. TERT activating alterations also arise early, whereas MAP-kinase pathway mutations appear later, an inverted order compared to the canonical evolution. The punctuated formation of complex aberrations and early TERT activation suggest a unique mutational mechanism that initiates acral melanoma. The marked intratumoral heterogeneity, especially concerning MAP-kinase pathway mutations, may partly explain the limited success of therapies for this melanoma subtype.

Genetic Diversity of the Common Black Carp Strain (Cyprinus carpio var. baisenensis)

The Common Black Carp Strain (Cyprinus carpio var. baisenensis), known for its black skin, is commonly cultured in the integrated rice-agriculture (IRA) system in Guangxi province, China. This study aimed to compare the genetic diversity of three common carp strains/populations (Common Black Carp Strain, Huanghe, and Songpu) using resequencing data. The genome-based method reveals a significant difference (p < 0.05) in identified loci and SNP frequency (p < 1 × 10−6) between the Songpu (Sp) or mirror carp and Huanghe (Hh) new strain. Additionally, the Common Black Carp Strain (Bk) exhibits a higher number of Tajima’s D values, possibly due to its population size and mutations within its entire genome. The average value of population nucleotide diversity (π) for the Bk is 1.706 × 10−4 while the mean number for the Hh and Sp strains is 1.691 × 10−4 Heterozygosity analysis results indicate that the Bk has the highest F coefficient compared to the Sp and Hh hybrids. This suggests that the isolated population of the Bk may have experienced a decrease in population size as a result of environmental disturbances in the IRA system. PCA results further reveal that all individuals of the Bk, except for one, are clustered together, while individuals of the Hh form a separate group. On the other hand, Sp displays a distinct distribution pattern. The comparative study of the genetic diversity of the Bk provides baseline data on its genome makeup. Assessing genetic diversity and genetic structure is critical for fisheries management and the conservation of critically endangered fish species.

Navigating Complexities: Vitamin D, Skin Pigmentation, and Race.

Vitamin D plays a critical role in many physiological functions, including calcium metabolism and musculoskeletal health. This commentary aims to explore the intricate relationships among skin complexion, race, and 25-hydroxyvitamin D (25[OH]D) levels, focusing on challenges the Endocrine Society encountered during clinical practice guideline development. Given that increased melanin content reduces 25(OH)D production in the skin in response to UV light, the guideline development panel addressed the potential role for 25(OH)D screening in individuals with dark skin complexion. The panel discovered that no randomized clinical trials have directly assessed vitamin D related patient-important outcomes based on participants' skin pigmentation, although race and ethnicity often served as presumed proxies for skin pigmentation in the literature. In their deliberations, guideline panel members and selected Endocrine Society leaders underscored the critical need to distinguish between skin pigmentation as a biological variable and race and ethnicity as socially determined constructs. This differentiation is vital to maximize scientific rigor and, thus, the validity of resulting recommendations. Lessons learned from the guideline development process emphasize the necessity of clarity when incorporating race and ethnicity into clinical guidelines. Such clarity is an essential step toward improving health outcomes and ensuring equitable healthcare practices.

Dermoscopy aids in differentiating café-au-lait macules from congenital melanocytic nevi in patients with darker skin phototypes.

Dermoscopy aids in the diagnosis and management of pigmented growths and disorders of pigmentation in children. However, there is limited literature on the dermoscopic appearance of café-au-lait macules (CALMs) and congenital melanocytic nevi in patients with dark skin. We report two cases of young children with dark skin and many hyperpigmented patches in whom dermoscopy was utilized to accurately diagnose CALMs and facilitate testing for neurofibromatosis.

Early identification of pressure injuries in people with dark skin tones: Qualitative perspectives from community-based patients and their carers.

To examine the personal experiences and perceptions of people with dark skin tones and their carers, in relation to pressure injury. Qualitative study using semi-structured interviews. Twenty-two interviews with people with dark skin tone and/or their family carers, who were known to and visited by community nurses for pressure area management or who had been identified as being at high risk for developing a pressure injury were carried out. Thematic analysis of the interview transcripts revealed that skin discolouration towards a darker hue than usual was the commonest symptom identified by participants as a sign of altered skin integrity and potential pressure damage. Four main overarching themes were revealed through comprehensive analysis of the transcripts: (1) indicators of pressure injury; (2) experienced symptoms of pressure damage; (3) trust in healthcare workers; and (4) improving care for populations with dark skin tones. The findings from this study clearly present how early-stage pressure damage is identified among people with dark skin tones. These findings have the potential to reduce health inequality by influencing and informing clinical policies and strategies in practice. Findings could also lead to the development of patient-informed educational strategies for nurses and health workers which will enable the early identification of pressure ulcers among people with dark skin tones. Further research is needed to better understand health disparities in relation to preventable patient safety harm. The findings demonstrate the importance of engaging with and listening to the stories and experiences of people living with pressure damage to help in the early recognition of pressure injuries. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines for qualitative research were followed. A project steering group reviewed information sheets for participants and checked the interview questions were relevant and suitable.

Neonatal cytosteatonecrosis: Hypercalcemia with nephrocalcinosis

Cytosteonecrosis (CSN) is a rare pathology that is poorly described in the medical literature. Its pathogenesis is still poorly elucidated, and it generally develops in the neonatal period. Diagnosed clinically, it presents as indurated, purplish skin patches on fair skin or hyperchromic patches on black skin

Developing augmented reality filters to display visual cues on diverse skin tones

Introduction: Variations in skin tone can significantly alter the appearance of symptoms such as rashes or bruises. Unfortunately, previous works utilizing Augmented Reality (AR) in simulating visual symptoms have often failed to consider this critical aspect, potentially leading to inadequate training and education. This study seeks to address this gap by integrating generative artificial intelligence (AI) into the AR filter design process.Methods: We conducted a 2 × 5 within-subjects study with second-year nursing students (N = 117) from the University of Florida. The study manipulated two factors: symptom generation style and skin tone. Symptom generation style was manipulated using a filter based on a real symptom image or a filter based on a computer-generated symptom image. Skin tone variations were created by applying AR filters to computer-generated images of faces with five skin tones ranging from light to dark. To control for factors like lighting or 3D tracking, 101 pre-generated images were created for each condition, representing a range of filter transparency levels (0–100). Participants used visual analog scales on a computer screen to adjust the symptom transparency in the images until they observed image changes and distinct symptom patterns. Participants also rated the realism of each condition and provided feedback on how the symptom style and skin tone impacted their perceptions.Results: Students rated the symptoms displayed by the computer-generated AR filters as marginally more realistic than those displayed by the real image AR filters. However, students identified symptoms earlier with the real-image filters. Additionally, SET-M and Theory of Planned Behavior questions indicate that the activity increased students’ feelings of confidence and self-efficacy. Finally, we found that similar to the real world, where symptoms on dark skin tones are identified at later stages of development, students identified symptoms at later stages as skin tone darkened regardless of cue type.Conclusion: This work implemented a novel approach to develop AR filters that display time-based visual cues on diverse skin tones. Additionally, this work provides evidence-based recommendations on how and when generative AI-based AR filters can be effectively used in healthcare education.

Does Laterality in Breast Cancer still have the Importance to be Studied? A Meta-analysis of Patients with Breast Cancer.

Breast cancer (BC) is one of the most common cancers in the world. Studies show that left-sided BC in pre and post-menopausal women leads to double the risk of worse morbidity and mortality and the reasons are uncertain. Finding the relationship between BC laterality and other possible risk factors can be advantageous for the prognosis of BC. This present study aimed to analyze the relationship between BC laterality and possible risk factors. A total of 6089 studies were screened. 23 studies from 1971 to 2021 met the inclusion criteria and were included in the meta-analysis. A pooled relative risk was generated via meta-analysis with a 95% confidence interval. Left-side BC laterality was significant (p < 0.00001) in the women populations compared to the right side based on the pooled size with possible high-risk factors, including handedness, older women, body mass index, people with black skin, invasive type carcinoma, and estrogen receptor-negative BC. These findings suggest that there may be a complex interplay of genetic, environmental, and lifestyle factors that contribute to left-side BC laterality. Results suggest an increased rate of BC on the left side, with high-risk factors contributing to BC laterality, which may be useful in predicting prognosis. This study provides significant insights into the relationship between high-risk factors and BC laterality. By identifying potential risk factors associated with left-side BC, it may be possible to improve the ability to predict prognosis and develop more targeted treatment strategies. This information could be particularly useful for healthcare providers and patients, as it may guide decisions regarding screening, prevention, and treatment, ultimately improving patient outcomes and reducing the overall burden of BC.

Fanon’s Postcolonial Critique of Hegelian Recognition and Buck-Morss’ Haiti Thesis

This philosophical investigation interrogates the relationship between G.F.W. Hegel’s concept of the master-slave dialectic in The Phenomenology of Spirit and the critique and reformulation of it by Frantz Fanon in Black Skin, White Masks. As a means of contextualization and expansion of Hegel’s original textual account, I consider Susan Buck-Morss’ seminal defense through grounding the dialectic in Hegel’s possible historical knowledge of the Haitian Revolution. I conclude that despite a compelling picture, Buck-Morss’ insights are unable to fully vindicate Hegel from the rebukes of Fanon, and as a result, Hegel’s phenomenology necessitates a concrete analysis of the actual conscious experiences of the racialized and colonized subject in order to realize its aims.

What Makes a Mimic? Orange, Red, and Black Color Production in the Mimic Poison Frog (Ranitomeya imitator).

Aposematic organisms rely on their conspicuous appearance to signal that they are defended and unpalatable. Such phenotypes are strongly tied to survival and reproduction. Aposematic colors and patterns are highly variable; however, the genetic, biochemical, and physiological mechanisms producing this conspicuous coloration remain largely unidentified. Here, we identify genes potentially affecting color variation in two color morphs of Ranitomeya imitator: the orange-banded Sauce and the redheaded Varadero morphs. We examine gene expression in black and orange skin patches from the Sauce morph and black and red skin patches from the Varadero morph. We identified genes differentially expressed between skin patches, including those that are involved in melanin synthesis (e.g. mlana, pmel, tyrp1), iridophore development (e.g. paics, ppat, ak1), pteridine synthesis (e.g. gch1, pax3-a, xdh), and carotenoid metabolism (e.g. dgat2, rbp1, scarb2). In addition, using weighted correlation network analysis, we identified the top 50 genes with high connectivity from the most significant network associated with gene expression differences between color morphs. Of these 50 genes, 13 were known to be related to color production (gch1, gmps, gpr143, impdh1, mc1r, pax3-a, pax7, ppat, rab27a, rlbp1, tfec, trpm1, xdh).

Vitamin D Deficiency in Childhood: A Review

Vitamin D is primarily obtained through sun exposure and diet, but factors like dark skin tone, limited time outside, and poor dietary habits can contribute to low levels of this essential vitamin. Getting enough Vitamin D is really important for kids' health, but a lot of them don't get enough because they don't spend enough time in the sun, don't eat well, or have trouble absorbing it. Not having enough can cause weaker bones, more infections, long-term illnesses, and problems with the immune system. To avoid this, children need to spend more time in the sun, eat foods rich in Vitamin D, and maybe take some supplements as well. In summary, this review highlights the importance of addressing vitamin D deficiency in children for their overall health and well-being.

Investigation on the influence of the skin tone on hyperspectral imaging for free flap surgery

Hyperspectral imaging (HSI) is a new emerging modality useful for the noncontact assessment of free flap perfusion. This measurement technique relies on the optical properties within the tissue. Since the optical properties of hemoglobin (Hb) and melanin overlap, the results of the perfusion assessment and other tissue-specific parameters are likely to be distorted by the melanin, especially at higher melanin concentrations. Many spectroscopic devices have been shown to struggle with a melanin related bias, which results in a clinical need to improve non-invasive perfusion assessment, especially for a more pigmented population. This study investigated the influence of skin tones on tissue indices measurements using HSI. In addition, other factors that might affect HSI, such as age, body mass index (BMI), sex or smoking habits, were also considered. Therefore, a prospective feasibility study was conducted, including 101 volunteers from whom tissue indices measurements were performed on 16 different body sites. Skin tone classification was performed using the Fitzpatrick skin type classification questionnaire, and the individual typology angle (ITA) acquired from the RGB images was calculated simultaneously with the measurements. Tissue indices provided by the used HSI-device were correlated to the possible influencing factors. The results show that a dark skin tone and, therefore, higher levels of pigmentation influence the HSI-derived tissue indices. In addition, possible physiological factors influencing the HSI-measurements were found. In conclusion, the HSI-based tissue indices can be used for perfusion assessment for people with lighter skin tone levels but show limitations in people with darker skin tones. Furthermore, it could be used for a more individual perfusion assessment if different physiological influencing factors are respected.

Acne vulgaris in black pediatric patients: clinical presentation, treatment patterns, and unique needs.

Acne vulgaris is a common dermatological diagnosis observed in pediatric patients with skin of color, often resulting in scarring, keloid formation, and post-inflammatory hyperpigmentation, significantly impacting their quality of life. This exploratory retrospective chart review included 77 black pediatric patients seen at a tertiary care center for acne vulgaris between 2018 and 2023. We analyzed demographics, acne descriptors, and treatment modalities. The most common acne morphology was comedonal acne (83.6%), with 71% of the patients being female. Significant age differences were observed particularly for acne at the chin and overall face. Treatment regimens commonly prescribed included combinations of adapalene and benzoyl peroxide (22%), topical antibiotics, tretinoin, and benzoyl peroxide (34%). Given the higher risk of sequelae for patients with darker skin, it is crucial to address their unique treatment needs. This study highlights the distinctive characteristics of acne in black pediatric patients and calls for further research to enhance our understanding and treatment of this population. Limitations include the lack of direct patient interactions and reliance on chart data. Further studies are needed to compare acne presentation in skin of color of other populations, refining our knowledge of acne clinical presentation, complications, and treatment modalities for diverse patient populations.

Targeted metabolomics revealed the seasonal plasticity of skin color and pigment metabolites in ornamental koi carp

The koi carp is an ornamental fish that was obtained through artificial selection from the common carp (Cyprinus carpio L.). The most economically important traits of koi are their beautiful skin patterns in bright colors. As seasonality is an important factor in the biology and ecology of fish, we thus assumed that seasonal changes are involved in regulating the formation of skin color and patterns of koi carp. The white, red, cyan, and black skin colors from four varieties of scaleless koi carp (Doitsu Shiromuji (W), Doitsu Kohaku (WR), Doitsu Showa Sanke (WRI), and Kumonryu (WI)) were evaluated using the CIELab color space (lightness, redness, and yellowness) in different seasons. Compared to winter, the yellowness of the white color in all koi varieties decreased in summer and autumn. The black skin color areas in WRI and WI koi increased in summer and autumn compared to winter. The yellowness of the red color decreased only in WRI koi, while no changes were observed in WR koi. Targeted metabolomics analysis revealed that the levels of the structural pigment guanine of all koi varieties showed significant seasonal variation. Of seven detected carotenoids, the zeaxanthin and tunaxanthin contents in W, WI, and WRI koi changed with the seasons, while none of the carotenoids in WR koi were altered. Of the seven potential regulatory metabolites, epinephrine, melatonin, and cyclic adenosine monophosphate (cAMP) in all four koi varieties showed the highest levels in winter. A correlation analysis suggested that the seasonal changes in white skin color occurred through the epinephrine-cAMP pathway; melanin-dependent and carotenoid-dependent skin color changes occurred through melatonin in koi carp. This study demonstrated the seasonal plasticity of skin color in koi carp regulated by melatonin and epinephrine, associating with variety and color specificity.

Unlawful Homicide of Two Ugly and Disabled Victims in a Japanese Tale Based on a True Story

It is extremely rare for an ugly wife to be killed by her husband because of her ugliness. The aim of this study is to draw inferences regarding the treatment of children and women who were disfigured or disabled during the Japanese Edo period. “Shiryo-Gedatsu Monogatari-Kikigaki”, reportage literature based on a true story was analyzed. Yoemon remarried Osugi, and her son Suke was born with an ugly face and unnatural legs. Yoemon hated Suke and urged Osugi to abandon Suke, and in the end, Osugi threw Suke into the river and killed him. Yoemon and Osugi later had a daughter and named her Rui. Rui had a very similar appearance to Suke. Thus, the village people called her Kasane, saying that Suke was reborn. Kasane married Yagoro, who became the second Yoemon. Yoemon disliked Kasane for her ugly appearance, so he killed her by pushing her into the river and continued to take subsequent wives, but each of them died after marriage. After the sixth marriage, his only child, Kiku, was tormented by Kasane’s spirit. About the appearance of Kasane, Kiku said: “The woman named Kasane had black skin, one eye was rotten, her nose was crushed, her mouth was wide, her face was marred with boils, her hands were bent, and one leg was short. She had the appearance of a scary old woman, like I had never seen before.” Through this story, we learn that there has been widespread hatred for children or women with an ugly appearance.

Performance of a Wearable Ring in Controlled Hypoxia: A Prospective Observational Study.

Over recent years, technological advances in wearables have allowed for continuous home monitoring of heart rate and oxygen saturation. These devices have primarily been used for sports and general wellness and may not be suitable for medical decision-making, especially in saturations below 90% and in patients with dark skin color. Wearable clinical-grade saturation of peripheral oxygen (SpO2) monitoring can be of great value to patients with chronic diseases, enabling them and their clinicians to better manage their condition with reliable real-time and trend data. This study aimed to determine the SpO2 accuracy of a wearable ring pulse oximeter compared with arterial oxygen saturation (SaO2) in a controlled hypoxia study based on the International Organization for Standardization (ISO) 80601-2-61:2019 standard over the range of 70%-100% SaO2 in volunteers with a broad range of skin color (Fitzpatrick I to VI) during nonmotion conditions. In parallel, accuracy was compared with a calibrated clinical-grade reference pulse oximeter (Masimo Radical-7). Acceptable medical device accuracy was defined as a maximum of 4% root mean square error (RMSE) per the ISO 80601-2-61 standard and a maximum of 3.5% RMSE per the US Food and Drug Administration guidance. We performed a single-center, blinded hypoxia study of the test device in 11 healthy volunteers at the Hypoxia Research Laboratory, University of California at San Francisco, under the direction of Philip Bickler, MD, PhD, and John Feiner, MD. Each volunteer was connected to a breathing apparatus for the administration of a hypoxic gas mixture. To facilitate frequent blood gas sampling, a radial arterial cannula was placed on either wrist of each participant. One test device was placed on the index finger and another test device was placed on the fingertip. SaO2 analysis was performed using an ABL-90 multi-wavelength oximeter. For the 11 participants included in the analysis, there were 236, 258, and 313 SaO2-SpO2 data pairs for the test device placed on the finger, the test device placed on the fingertip, and the reference device, respectively. The RMSE of the test device for all participants was 2.1% for either finger or fingertip placement, while the Masimo Radical-7 reference pulse oximeter RMSE was 2.8%, exceeding the standard (4% or less) and the Food and Drug Administration guidance (3.5% or less). Accuracy of SaO2-SpO2 paired data from the 4 participants with dark skin in the study was separately analyzed for both test device placements and the reference device. The test and reference devices exceeded the minimum accuracy requirements for a medical device with RMSE at 1.8% (finger) and 1.6% (fingertip) and for the reference device at 2.9%. The wearable ring meets an acceptable standard of accuracy for clinical-grade SpO2 under nonmotion conditions without regard to skin color. ClinicalTrials.gov NCT05920278; https://clinicaltrials.gov/study/NCT05920278.

Monte Carlo simulation of the effect of melanin concentration on light-tissue interactions for transmittance pulse oximetry measurement.

Questions about the accuracy of pulse oximeters in measuring arterial oxygen saturation ( ) in individuals with darker skin pigmentation have resurfaced since the COVID-19 pandemic. This requires investigation to improve patient safety, clinical decision making, and research. We aim to use computational modeling to identify the potential causes of inaccuracy in measurement in individuals with dark skin and suggest practical solutions to minimize bias. An in silico model of the human finger was developed to explore how changing melanin concentration and arterial oxygen saturation ( ) affect pulse oximeter calibration algorithms using the Monte Carlo (MC) technique. The model generates calibration curves for Fitzpatrick skin types I, IV, and VI and an range between 70% and 100% in transmittance mode. was derived by inputting the computed ratio of ratios for light and dark skin into a widely used calibration algorithm equation to calculate bias ( ). These were validated against an experimental study to suggest the validity of the Monte Carlo model. Further work included applying different multiplication factors to adjust the moderate and dark skin calibration curves relative to light skin. Moderate and dark skin calibration curve equations were different from light skin, suggesting that a single algorithm may not be suitable for all skin types due to the varying behavior of light in different epidermal melanin concentrations, especially at 660nm. The ratio between the mean bias in White and Black subjects in the cohort study was 6.6 and 5.47 for light and dark skin, respectively, from the Monte Carlo model. A linear multiplication factor of 1.23 and exponential factor of 1.8 were applied to moderate and dark skin calibration curves, resulting in similar alignment. This study underpins the careful re-assessment of pulse oximeter designs to minimize bias in measurements across diverse populations.

Exploring the bias: how skin color influences oxygen saturation readings via Monte Carlo simulations.

Our goal is to understand the root cause of reported oxygen saturation ( ) overestimation in heavily pigmented skin types to devise solutions toward enabling equity in pulse oximeter designs. We aim to gain theoretical insights into the effect of skin tone on curves using a three-dimensional, four-layer tissue model representing a finger. A finger tissue model, comprising the epidermis, dermis, two arteries, and a bone, was developed using a Monte Carlo-based approach in the MCmatlab software. Two skin tones-light and dark-were simulated by adjusting the absorption and scattering properties within the epidermal layer. Following this, curves were generated in various tissue configurations, including transmission and reflection modes using red and infrared wavelengths. In addition, the influence of source-detector (SD) separation distances on both light and dark skin tissue models was studied. In transmission mode, curves did not deviate with changes in skin tones because both pulsatile and non-pulsatile terms experienced equal attenuation at red and infrared wavelengths. However, in reflection mode, measurable variations in curves were evident. This was due to differential attenuation of the red components, which resulted in a lower perfusion index at the red wavelength in darker skin. As the SD separation increased, the effect of skin tone on curves in reflection mode became less pronounced, with the largest SD separation exhibiting effects similar to those observed in transmission mode. Monte Carlo simulations have demonstrated that different light pathlengths within the tissue contribute to the overestimation of in people with darker skin in reflection mode pulse oximetry. Increasing the SD separation may mitigate the effect of skin tone on readings. These trends were not observed in transmission mode; however, further planned research using more complex models of the tissue is essential.

Non-Binary and Trans-Inclusive AI: A Catalogue of Best Practices for Developing Automatic Gender Recognition Solutions

Artificial intelligence (AI) has significantly optimized processes across various sectors, enhancing efficiency and transforming digital interactions. However, as AI becomes more integrated into daily life, concerns about its social impacts and inherent biases have emerged. This study explores how AI technologies, such as facial recognition and Automatic Gender Recognition (AGR), can perpetuate and amplify societal prejudices, especially against transgender and non-binary individuals. The 2018 case of Amazon's Rekognition technology, which exhibited high false positive rates for individuals with dark skin, highlights the risks of algorithmic bias and mass surveillance. Given these challenges, this research performed performed a systematic mapping study of the literature on AI to present an analysis of problems and respective causes brought by facial recognition and AGR applications to trans and non-binary people. In a second phase, we developed and empirically assessed a catalog of 19 best practices for an ethical AI development grounded in Justice, Equity, Diversity, and Inclusion principles. We aim to establish ethical standards that promote inclusivity to trans and non-binary people, mitigating algorithmic discrimination.