Dermatology Book


Skin Cancer in Skin of Color

Aka: Skin Cancer in Skin of Color, Skin Cancer in Black Patients, Skin Cancer in African American Patients, Skin Cancer in Asian Patients, Skin Cancer in Native American Patients, Skin Cancer in Middle Eastern Patients, Skin Cancer in Hispanic Patients
  1. See Also
    1. Skin of Color
    2. Nonmelanoma Skin Cancer
    3. Basal Cell Skin Cancer
    4. Squamous Cell Skin Cancer
    5. Melanoma
  2. Approach: Basal Cell Skin Cancer (BCC)
    1. Most common skin cancer in white, asian and hispanic patients (second most common Skin Cancer in Black Patients)
    2. Characteristics in Skin of Color
      1. Pigmented Basal Cell Carcinomas represent 50% of lesions (contrast with 6% in white patients)
      2. Typical translucent lesions with Telangiectases and central ulceration are often difficult to diagnose on darker skin
      3. Brown to glossy black, pearly appearance in asian patients
    3. Distribution
      1. Form in sun-exposed areas on the head and neck especially in areas of scars and irradiated sites
    4. Prevention
      1. Sun screen and other sun protection is imperative (despite the lack of Sun Burn risk in darker skinned patients)
  3. Approach: Squamous Cell Skin Cancer (SCC)
    1. Ethnicities with SCC as most common skin cancer
      1. Native Americans
      2. Black patients
        1. Peak Incidence at ages 40-49
        2. Especially common in scars, chronic ulcers and Discoid Lupus lesions
    2. Ethnicities with SCC as second most common skin cancer
      1. Chinese and Japanese (peaks after age 60 years old)
      2. Hispanic patients
    3. Common presenting locations in Skin of Color
      1. Non-sun-exposed areas (e.g. legs, anogenital, scalp)
  4. Approach: Melanoma
    1. Patients with Skin of Color present with Melanoma at a later, more advanced stage with worse outcomes
    2. Patient Education about Melanoma risk and Self Skin Exam is important
    3. Common presenting locations in Skin of Color
      1. Non-sun-exposed sites
      2. Mucous membranes
      3. Palmar, plantar and subungual (Acral Lentiginous Melanoma) more common in asian and black patients
  5. References
    1. Kundu (2013) Am Fam Physician 87(12): 850-6 [PubMed]
    2. Gloster (2006) Acad Dermatol 55(5): 741-60 [PubMed]
    3. Taylor (2002) J Am Acad Dermatol 46: S41-S62 [PubMed]

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