Dermatology in Skin of Color: Unique Presentations of Common Diseases

Overview / Definition Dermatology in skin of color refers to the study and treatment of skin conditions in individuals with darker skin tones, which may exhibit different clinical features compared to lighter skin. It encompasses a range of skin types, including African, Asian, Hispanic, and Middle Eastern skin, each with unique presentations for common dermatological conditions. Epidemiology Skin of color constitutes a significant proportion of the global population, yet dermatological education has historically focused on lighter skin types. The lack of representation in dermatological literature has implications for misdiagnosis and delayed treatment. Incidence of skin conditions: Certain conditions like keloids, hyperpigmentation disorders, and acne may have higher incidence rates in individuals with darker skin. Access to care: Socioeconomic factors and systemic barriers often limit access to dermatological care for people of color. Pathophysiology / Mechanism The skin color variation is primarily due to the type and amount of melanin produced by melanocytes. Individuals with darker skin have more eumelanin, which provides some protection against UV radiation but also leads to unique pathological responses. Inflammatory responses: Skin of color may respond differently to inflammation, leading to conditions such as post-inflammatory hyperpigmentation (PIH). Genetic factors: Genetic predisposition can influence the severity and presentation of common skin diseases. Clinical Presentation Common dermatological conditions may present differently in skin of color. Recognizing these variations is crucial for accurate diagnosis. Acne: May present as darker lesions and is often associated with PIH. Eczema: Can appear as dark brown or purple patches rather than typical red lesions. Psoriasis: Lesions may be less scaly and more inflammatory in appearance. Keloids: More common in individuals with darker skin, presenting as raised scars at sites of injury. Diagnosis / Worku