Top

Published in:

01-12-2022 | Hyperpigmentation | REVIEW

Dermatologic conditions in skin of color compared to white patients: similarities, differences, and special considerations

Authors: Sheena Chatrath, Laurence Bradley, Joshua Kentosh

Published in: Archives of Dermatological Research | Issue 5/2023

Abstract

The US population is becoming increasingly diverse, yet patients of color remain underrepresented in dermatology. The lack of diverse images in dermatologic learning materials can lead to discomfort in treating patients of color, delayed, and missed diagnoses. In this review, we compare and contrast the clinical presentation, management, and special considerations of common skin conditions between patients of color and white patients as well as provide a visual representation of these differences.

Lester JC, Taylor SC, Chren M-M (2019) Under-representation of skin of colour in dermatology images: not just an educational issue. Br J Dermatol 180(6):1521–1522. https://doi.org/10.1111/bjd.17608CrossRefPubMed

Adelekun A, Onyekaba G, Lipoff JB (2021) Skin color in dermatology textbooks: an updated evaluation and analysis. J Am Acad Dermatol 84(1):194–196. https://doi.org/10.1016/j.jaad.2020.04.084CrossRefPubMed

Amuzie AU, Jia JL, Taylor SC, Lester JC (2021) Skin-of-color article representation in dermatology literature 2009–2019: higher citation counts and opportunities for inclusion. J Am Acad Dermatol. https://doi.org/10.1016/j.jaad.2021.03.063CrossRefPubMed

Militello M et al (2021) A quantitative analysis of research publications focused on skin of color: representation in academic dermatology journals. J Am Acad Dermatol 85(3):e189–e192. https://doi.org/10.1016/j.jaad.2021.04.053CrossRefPubMed

Nusbaum KB, Adame S, Shipp D, Trinidad JC (2021) Skin of color in dermatology: analysis of representation in dermatologic journals. Int J Dermatol. https://doi.org/10.1111/ijd.15828CrossRefPubMed

Kurtti A, Austin E, Jagdeo J (2022) Representation of skin color in dermatology-related google image searches. J Am Acad Dermatol 86(3):705–708. https://doi.org/10.1016/j.jaad.2021.03.036CrossRefPubMed

Buster KJ, Stevens EI, Elmets CA (2012) Dermatologic health disparities, (in eng). Dermatol Clin 30(1):53–viii. https://doi.org/10.1016/j.det.2011.08.002CrossRefPubMedCentral

Heng AHS, Chew FT (2020) Systematic review of the epidemiology of acne vulgaris, (in eng). Sci Rep 10(1):5754. https://doi.org/10.1038/s41598-020-62715-3CrossRefPubMedPubMedCentral

Perkins AC, Cheng CE, Hillebrand GG, Miyamoto K, Kimball AB (2011) Comparison of the epidemiology of acne vulgaris among Caucasian, Asian, Continental Indian and African American women, (in eng). J Eur Acad Dermatol Venereol 25(9):1054–1060. https://doi.org/10.1111/j.1468-3083.2010.03919.xCrossRefPubMed

10.

Oge LK, Broussard A, Marshall MD (2019) Acne vulgaris: diagnosis and treatment, (in eng). Am Fam Physician 100(8):475–484PubMed

11.

Maruthappu T, Taylor M (2022) Acne and rosacea in skin of colour. Clin Exp Dermatol 47(2):259–263. https://doi.org/10.1111/ced.14994CrossRefPubMed

12.

Madu P, Kundu RV (2014) Follicular and scarring disorders in skin of color: presentation and management, (in eng). Am J Clin Dermatol 15(4):307–321. https://doi.org/10.1007/s40257-014-0072-xCrossRefPubMed

13.

Alexis AF, Barbosa VH (2012) Skin of color: a practical guide to dermatologic diagnosis and treatment. Springer, New York

14.

Davis EC, Callender VD (2010) A review of acne in ethnic skin: pathogenesis, clinical manifestations, and management strategies, (in eng). J Clin Aesthet Dermatol 3(4):24–38PubMedPubMedCentral

15.

Kundu RV, Patterson S (2013) Dermatologic conditions in skin of color: part I. Special considerations for common skin disorders, (in eng). Am Fam Physician 87(12):850–856PubMed

16.

Shah SK, Alexis AF (2010) Acne in skin of color: practical approaches to treatment, (in eng). J Dermatolog Treat 21(3):206–211. https://doi.org/10.3109/09546630903401496CrossRefPubMed

17.

Embil K, Nacht S (1996) The microsponge delivery system (MDS): a topical delivery system with reduced irritancy incorporating multiple triggering mechanisms for the release of actives, (in eng). J Microencapsul 13(5):575–88. https://doi.org/10.3109/02652049609026042CrossRefPubMed

18.

Yin NC, McMichael AJ (2014) Acne in patients with skin of color: practical management, (in eng). Am J Clin Dermatol 15(1):7–16. https://doi.org/10.1007/s40257-013-0049-1CrossRefPubMed

19.

Abdel Hay R et al (2016) Interventions for acne scars, (in eng). Cochrane Database Syst Rev 4(4):Cd011946. https://doi.org/10.1002/14651858.CD011946.pub2CrossRefPubMed

20.

Leasure AC, Cohen JM (2022) Prevalence of eczema among adults in the United States: a cross-sectional study in the all of US research program. Arch Dermatol Res. https://doi.org/10.1007/s00403-022-02328-0CrossRefPubMed

21.

Kaufman BP, Guttman-Yassky E, Alexis AF (2018) Atopic dermatitis in diverse racial and ethnic groups—variations in epidemiology, genetics, clinical presentation and treatment. Exp Dermatol 27(4):340–357. https://doi.org/10.1111/exd.13514CrossRefPubMed

22.

Berke R, Singh A, Guralnick M (2012) Atopic dermatitis: an overview, (in eng). Am Fam Physician 86(1):35–42PubMed

23.

Chovatiya R, Silverberg JI (2022) The heterogeneity of atopic dermatitis, (in eng). J Drugs Dermatol 21(2):172–176. https://doi.org/10.36849/jdd.6408CrossRefPubMedPubMedCentral

24.

Chan CX, Zug KA (2021) Diagnosis and management of dermatitis, including atopic, contact, and hand eczemas, (in eng). Med Clin North Am 105(4):611–626. https://doi.org/10.1016/j.mcna.2021.04.003CrossRefPubMed

25.

Eichenfield LF et al (2014) Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis, (in eng). J Am Acad Dermatol 70(2):338–351. https://doi.org/10.1016/j.jaad.2013.10.010CrossRefPubMed

26.

Sachdeva M, Joseph M (2022) Dermatology: how to manage atopic dermatitis in patients with skin of colour, (in eng). Drugs Context. https://doi.org/10.7573/dic.2021-12-1CrossRefPubMedPubMedCentral

27.

Grim KD, Rosen T (2013) Inflammatory disorders with unique clinical features. In: Alexis AF, Barbosa VH (eds) Skin of color: a practical guide to dermatologic diagnosis and treatment. Springer, New York, pp 45–90CrossRef

28.

Alexis A et al (2022) Insights in skin of color patients with atopic dermatitis and the role of skincare in improving outcomes, (in eng). J Drugs Dermatol 21(5):462–470. https://doi.org/10.36849/jdd.6609CrossRefPubMed

29.

Brunner PM, Guttman-Yassky E (2019) Racial differences in atopic dermatitis, (in eng). Ann Allergy Asthma Immunol 122(5):449–455. https://doi.org/10.1016/j.anai.2018.11.015CrossRefPubMed

30.

Sangha AM (2021) Dermatological conditions in SKIN OF COLOR-: managing atopic dermatitis, (in eng). J Clin Aesthet Dermatol 14(3 Suppl 1):S20-s22PubMedPubMedCentral

31.

Fishbein AB, Silverberg JI, Wilson EJ, Ong PY (2020) Update on atopic dermatitis: diagnosis, severity assessment, and treatment selection, (in eng). J Allergy Clin Immunol Pract 8(1):91–101. https://doi.org/10.1016/j.jaip.2019.06.044CrossRefPubMed

32.

Singh R, Heron CE, Ghamrawi RI, Strowd LC, Feldman SR (2020) Emerging role of Janus kinase inhibitors for the treatment of atopic dermatitis, (in eng). Immunotargets Ther 9:255–272. https://doi.org/10.2147/itt.s229667CrossRefPubMedPubMedCentral

33.

Grayson C, Heath CR (2020) Dupilumab improves atopic dermatitis and post-inflammatory hyperpigmentation in patient with skin of color, (in eng). J Drugs Dermatol 19(7):776–778. https://doi.org/10.36849/jdd.2020.4937CrossRefPubMed

34.

Lin A, Nabatian A, Halverstam CP (2017) Discovering black soap: a survey on the attitudes and practices of black soap users, (in eng). J Clin Aesthet Dermatol 10(7):18–22PubMedPubMedCentral

35.

Griffiths CEM, Armstrong AW, Gudjonsson JE, Barker J (2021) Psoriasis, (in eng). Lancet 397(10281):1301–1315. https://doi.org/10.1016/s0140-6736(20)32549-6CrossRefPubMed

36.

Langley RG, Krueger GG, Griffiths CE (2005) Psoriasis: epidemiology, clinical features, and quality of life, (in eng). Ann Rheum Dis 64(2):ii18–ii23. https://doi.org/10.1136/ard.2004.033217CrossRefPubMedPubMedCentral

37.

Alexis AF, Blackcloud P (2014) Psoriasis in skin of color: epidemiology, genetics, clinical presentation, and treatment nuances, (in eng). J Clin Aesthet Dermatol 7(11):16–24PubMedPubMedCentral

38.

Yan D, Afifi L, Jeon C, Cordoro KM, Liao W (2018) A cross-sectional study of the distribution of psoriasis subtypes in different ethno-racial groups, (in eng). Dermatol Online J. https://doi.org/10.5070/D3247040909CrossRefPubMed

39.

McKenzie S, Brown-Korsah JB, Syder NC, Omar D, Taylor SC, Elbuluk N (2022) Variations in genetics, biology, and phenotype of cutaneous disorders in skin of color. Part II: differences in clinical presentation and disparities in cutaneous disorders in skin of color," (in eng). J Am Acad Dermatol. https://doi.org/10.1016/j.jaad.2022.03.067CrossRefPubMed

40.

Yadav G et al (2022) Unmet need in people with psoriasis and skin of color in Canada and the United States, (in eng). Dermatol Ther (Heidelb) 12(11):2401–2413. https://doi.org/10.1007/s13555-022-00811-0CrossRefPubMed

41.

Armstrong AW, Read C (2020) Pathophysiology, clinical presentation, and treatment of psoriasis: a review, (in eng). JAMA 323(19):1945–1960. https://doi.org/10.1001/jama.2020.4006CrossRefPubMed

42.

Ferguson JE, Seger EW, White J, McMichael A (2022) Racial/ethnic differences in treatment efficacy and safety for moderate-to-severe plaque psoriasis: a systematic review, (in eng). Arch Dermatol Res. https://doi.org/10.1007/s00403-022-02324-4CrossRefPubMed

43.

Takeshita J et al (2019) Racial differences in perceptions of psoriasis therapies: implications for racial disparities in psoriasis treatment, (in eng). J Invest Dermatol 139(8):1672-1679.e1. https://doi.org/10.1016/j.jid.2018.12.032CrossRefPubMedPubMedCentral

44.

Nicholas MN, Chan AR, Hessami-Booshehri M (2020) Psoriasis in patients of color: differences in morphology, clinical presentation, and treatment, (in eng). Cutis 106(2s):7–10. https://doi.org/10.12788/cutis.0038CrossRefPubMed

45.

46.

Cheong WK et al (2015) Treatment of seborrhoeic dermatitis in Asia: a consensus guide. Skin Appendage Disord 1(4):187–196. https://doi.org/10.1159/000444682CrossRef

47.

Elgash M, Dlova N, Ogunleye T, Taylor SC (2019) Seborrheic dermatitis in skin of color: clinical considerations, (in eng). J Drugs Dermatol 18(1):24–27PubMed

48.

Raffi J, Suresh R, Agbai O (2019) Clinical recognition and management of alopecia in women of color, (in eng). Int J Womens Dermatol 5(5):314–319. https://doi.org/10.1016/j.ijwd.2019.08.005CrossRefPubMedPubMedCentral

49.

Monselise A, Cohen DE, Wanser R, Shapiro J (2015) What ages hair?, (in eng). Int J Womens Dermatol 1(4):161–166. https://doi.org/10.1016/j.ijwd.2015.07.004CrossRefPubMedPubMedCentral

50.

Clark GW, Pope SM, Jaboori KA (2015) Diagnosis and treatment of seborrheic dermatitis, (in eng). Am Fam Physician 91(3):185–190PubMed

51.

Halder RM, Richards GM (2004) Management of dyschromias in ethnic skin. Dermatol Ther 17(2):151–157. https://doi.org/10.1111/j.1396-0296.2004.04015.xCrossRefPubMed

52.

53.

54.

Kwon OS et al (2003) Seborrheic keratosis in the Korean males: causative role of sunlight, (in eng). Photodermatol Photoimmunol Photomed 19(2):73–80. https://doi.org/10.1034/j.1600-0781.2003.00025.xCrossRefPubMed

55.

Rajesh G, Thappa DM, Jaisankar TJ, Chandrashekar L (2011) Spectrum of seborrheic keratoses in South Indians: a clinical and dermoscopic study, (in eng). Indian J Dermatol Venereol Leprol 77(4):483–488. https://doi.org/10.4103/0378-6323.82408CrossRefPubMed

56.

57.

Tran M, Richer V (2020) Elective treatment of dermatosis papulosa nigra: a review of treatment modalities, (in eng). Skin Therapy Lett 25(4):1–5PubMed

58.

Davis SA, Narahari S, Feldman SR, Huang W, Pichardo-Geisinger RO, McMichael AJ (2012) Top dermatologic conditions in patients of color: an analysis of nationally representative data, (in eng). J Drugs Dermatol 11(4):466–473PubMed

Title: Dermatologic conditions in skin of color compared to white patients: similarities, differences, and special considerations
Authors: Sheena Chatrath
Laurence Bradley
Joshua Kentosh
Publication date: 01-12-2022
Publisher: Springer Berlin Heidelberg
Keywords: Hyperpigmentation
Atopic Dermatitis
Vulgar Psoriasis
Acne
Hypopigmentation
Published in: Archives of Dermatological Research / Issue 5/2023
Print ISSN: 0340-3696
Electronic ISSN: 1432-069X
DOI: https://doi.org/10.1007/s00403-022-02493-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Dermatologic conditions in skin of color compared to white patients: similarities, differences, and special considerations

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2023

Psychiatric comorbidities of Hidradenitis suppurativa in underrepresented groups: a case–control study utilizing the all of us research program

Prospective, randomized, double-blind clinical study of split-body comparison of topical hydroquinone and hexylresorcinol for skin pigment appearance

Intralesional Candida albicans antigen versus intralesional zinc sulfate in treatment of cutaneous warts

The HLA-Cw*06 allele may predict the response to methotrexate (MTX) treatment in Chinese arthritis-free psoriasis patients

Increasing medicare charge-to-payment ratios for dermatologists from 2012 to 2017

Evaluating the research productivity of academic dermatologists based on the NIH-supported relative citation ratio