Dermatological Issues in People with Brown Skin

Question 1

What are important histological differences between people with darker skin and people with lighter skin?

Answer 1

• Everyone has the same number of melanocytes
• Skin color differentiation comes from differening amounts of the pigment melanin made by those melanosomes
• Darker skin has more melanin and melanosomes
• Melanin in darker skin is degarded more slowly than melanin in lighter skin
• Melanin in darker skin is present in more layers of the epidermis than in lighter skin

Question 2

• Darker skin has [increased or decreased] tyrosinase activity, leading to [increased or decreased] melanin content.
• What is the clinical implication of the above statement?

Answer 2

• Increased; increased
• Greater photo protection, lower incidence of skin cancer, less pronounced photoaging

Question 3

• Darker skin has [larger or smaller] melanosomes
• What are the clinical implications of the above statement

Answer 3

• Larger
• Greater photoprotection, lower incidence of skin cancer, less photo aging

Question 4

• Darker skin has [slower or faster] melanin degradation
• What are the clinical implications of the above statement?

Answer 4

• Slower
• Although this confers greater photoprotection, lower incidence of skin cancer, and less photo aging, it also confers increased dyschromias (melasma = patches on skin, hyperpigmentation)

Question 5

• The dermis of people with darker skin is [thicker or thinner] than that of people with light skin.
• What are the clinical implications of this statement?

Answer 5

• Thicker
• Preserved skin elasticity, less pronounced photoaging, more likely to keloid

Question 6

• People with darker skin have [larger or smaller] and [more or less] numerous fibroblasts
• What are the clinical implications of the above statement?

Answer 6

• Larger; more
• Preserved skin elasticity, greater prevalence of hypertrophic scarring and keloids

Question 7

If a person with darker skin has acne, they are more at risk for what complication?

Answer 7

Post Inflammatory Hyperpigmentation

Question 8

Melasma is patchy scarring. People with darker skin are more at risk for this condition due to having more melanin that lasts longer. Treatments for this condition target what biological pathway?

Answer 8

Tyrosinase blockers –> reduce amount of eumelanin made

Question 9

When chosing a sunscreen, what is the best type to buy and why?

Answer 9

A mineral sunscreen (preferrably one that contains iron oxide) because mineral sunscreens are the only kind that protect against radiation from the sun as well as “hidden” sources

Question 10

How does aging differ between light and dark skin?

Answer 10

Dark skin ages more slowly, signs of aging that are typically seen in light skin are seen about 10 years later in darker skin

Question 11

How can inflammation on dark skin look different than inflammation on light skin?

Answer 11

Darker skin it can appear grey, dry and patchy