II. Approach: Basal Cell Skin Cancer (BCC)
- Most common Skin Cancer in white, asian and hispanic patients (second most common Skin Cancer in Black Patients)
- Characteristics in Skin of Color
- Pigmented Basal Cell Carcinomas represent 50% of lesions (contrast with 6% in white patients)
- Typical translucent lesions with Telangiectases and central ulceration are often difficult to diagnose on darker skin
- Brown to glossy black, pearly appearance in asian patients
- Distribution
- Form in sun-exposed areas on the head and neck especially in areas of scars and irradiated sites
- Prevention
- Sun screen and other sun protection is imperative (despite the lack of Sun Burn risk in darker skinned patients)
III. Approach: Squamous Cell Skin Cancer (SCC)
- Ethnicities with SCC as most common Skin Cancer
- Native Americans
- Black patients
- Peak Incidence at ages 40-49
- Especially common in scars, chronic ulcers and Discoid Lupus lesions
- Ethnicities with SCC as second most common Skin Cancer
- Chinese and Japanese (peaks after age 60 years old)
- Hispanic patients
- Common presenting locations in Skin of Color
- Non-sun-exposed areas (e.g. legs, anogenital, scalp)
IV. Approach: Melanoma
- Patients with Skin of Color present with Melanoma at a later, more advanced stage with worse outcomes
- Patient Education about Melanoma risk and Self Skin Exam is important
- Common presenting locations in Skin of Color
- Non-sun-exposed sites
- Mucous membranes
- Palmar, plantar and subungual (Acral Lentiginous Melanoma) more common in asian and black patients