II. Definitions
- Skin of Color
- Patients with richly pigmented skin (Fitzpatrick Skin Types 3-6)
- Typically in ethnic backgrounds from Africa, Asia, Middle East, Central and South America, as well as native americans
III. Precautions: Health Disparities
- Most textbook dermatologic condition images and descriptions are on caucasian skin
- Skin Cancers (Melanoma, basal cell and squamous cell cancers) are dianosed at later, more advanced stages in people of color
- Formal dermatologic training is lacking in conditions that affect black skin
IV. Approach: Common skin conditions
- See Skin Cancer in Skin of Color
-
Postinflammatory Hyperpigmentation
- Presents at any age in more than 65% of people of color, irregular hyperpigmented patches in regions of prior skin lesions
-
Acne
- Skin of Color is more susceptible to scarring, Keloids and Postinflammatory Hyperpigmentation
- Many skin and hair products (e.g. cocoa butter, olive oil) used more commonly in Skin of Color communities exacerbate acne
- Start acne Topical Medications at less irritating, lower concentrations and increase slowly to reduce Postinflammatory Hyperpigmentation
- Retin A 0.025% cream every other day (instead of 0.05% gel daily)
- Benzoyl Peroxide 2.5% (instead of 5-10%)
- Azelaic Acid (Azelex, Finacea) may be indicated if Postinflammatory Hyperpigmentation is already present
V. Approach: Conditions More Common in Skin of Color
- See Hair Disorders in Black Patients
- Early Childhood Onset
- Atopic Dermatitis (7 to 19% of people of color)
- Pruritic Eczematous patches
- Traction Alopecia (up to 37%)
- Atopic Dermatitis (7 to 19% of people of color)
- Teen Onset
- Hidradenitis Suppurativa (up to 4% of people of color)
- Nodules and abscesses involving the axillary and inguinal regions
- Acanthosis Nigricans (5 to 34% of people of color)
- Irregular hyperpigmented patches at the neck, axilla and inguinal region
- Dermatosis Papulosa Nigra (33% of people of color)
- Hyperpigmented sessile Papules on the face and neck
- Keloids (up to 8% of people of color)
- Pseudofolliculitis Barbae (45 to 85% of people of color)
- Hidradenitis Suppurativa (up to 4% of people of color)
- Young Adult Onset
- Acne Keloidalis Nuchae (up to 13% of people of color)
- Melasma (9 to 50% of people of color)
- Gray-brown Hyperpigmentation especially on the face, and more prominent in pregnancy
- Prurigo Nodularis (up to 9%)
- Firm, pruritic Nodules, esp. on the arms and legs, forming in response to scratching