NHS image platform fights misdiagnosis in non-white patients

A free image library, showing how diseases appear on different skin tones, has been launched to help prevent misdiagnosis for people with darker skin.

Many medical conditions appear differently based on skin tone, but typically healthcare images primarily feature people with lighter skin.

The REFRAME image bank, funded by the NHS and led by the University of the West of England, includes more than 3,000 high-resolution medical images of individuals of different backgrounds, ages and health conditions to show how illness presents on a wide range of skin tones and body types.

Norwegian software company Fotoware, in partnership with Medialogix, provided the image platform, which allows users to locate, filter, download and use images for diagnostics, education, and communication. 

Debbie Hubbard, project lead at the University of the West of England, said: “White skin is presented as the normal – there isn’t a consideration for other skin tones. 

“If we don’t have images that reflect reality, we won’t learn to see it.

“It’s a huge problem – if we don’t have those images it means healthcare professionals may not be able to recognise the signs of disease and illness. 

“Some conditions do present quite differently in different skin tones, for example chickenpox. 

“This causes people to have delayed diagnosis, misdiagnosis and potentially receive incorrect treatment or no treatment. 

“This ultimately contributes to people having a poor experience of healthcare.”

The medical photos in the image bank were taken in collaboration with local communities, GPs and health centres. 

They include images of skin conditions like eczema, psoriasis, impetigo and allergic rashes; wounds; infections; common childhood diseases like chickenpox; and conditions like jaundice, meningitis and anaemia.

Anne Gretland, chief executive of Fotoware, said: “We are proud to contribute our technology to such an important initiative.

“Through the Reframe Project, the NHS is using our product platform to build an inclusive medical image database that better reflects the full diversity of the population.”

The project is now expanding further with new photo sessions and plans to include even more diagnoses and skin types. 

Faisal Mahmood, director at Medialogix, said: “This is a truly unique initiative – one that has the potential to reshape how we think, foster inclusivity, and strengthen understanding between communities. 

“It’s precisely the kind of forward-thinking project we’re proud and honoured to support.”

The image library, hosted on the NHS website, launched in May 2025 and is open access for healthcare workers, educators and students worldwide.

Sarah Todd, senior specialist in education for urgent and emergency care at NHS England in the South West, said: “This is a landmark project to improve care for patients, by supporting healthcare professionals in clinical situations and allowing educators to broaden their teaching for healthcare students. 

“And more directly, anyone will be able to use the images as a source of reference if they’re concerned about their own health.”