Lecture 35 Dermatological Disease with Higher Prevalence in Skin of Colour Flashcards
What are dermatological conditions with higher prevalence/impact in skin of colour?
pseudofolliculitis barbae
acne keloidalis nuchae
actinic prurigo
melasma
vitiligo
traction alopecia
What is pseudofolliculitis barbae (S&S, Tx)?
aka razor bumps
S&S: papules and pustules after shaving or plucking (tightly curled hair), can be painful and tender, secondary infection possibly
Tx: topical steroids, benzoyl peroxide, topical retinoids, topical antibiotics for infection
changing hair removal techs such as suggesting clippers, single blade razor, avoid plucking
What is acne keloidalis nuchae (S&S, Tx)?
S&S: tender papules, pustules and plaques on posterior of scalp, unknown etiology, results in hair loss
Tx: avoid friction in area, topical antibiotics, potent topical steroids, oral antibiotics for infection, laser, surgical excision
What is actinic prurigo (S&S, Tx)?
prevalent in Indigenous populations, likely due to genetic variation in HLADR4, DRB1*0407 gene and UV exposure, commonly arises in childhood, worse in summer but can present year-round
S&S: sun-exposed skin develops eczematous eruptions, crusting, hemorrhage and pitted scars
can also develop conjunctivitis and cheilitis
Tx: sun protection, topical corticosteroids, calcineurin inhibitors, antimalarials, azathioprine, cyclosporine
What is melasma (S&S, risk fx, Tx)
people with SoC at elevated risk of developing this
S&S: darkening on skin, distribution is usually bilateral on face (cheek, forehead, upper lip), sun-exposed areas
Risk Fx: females, sun exposure, hormonal changes due to pregnancy or oral contraceptives
Tx: sun protection year-round is CRITICAL, must be high SPF at least 30 and be BROAD-SPECTRUM, covering UVA and UVB and preferably visible light (Zinc oxide and titanium dioxide will block visible light)
hydroquinone 4% remains GOLD STANDARD (sometimes combo’d with topical retinoid),, oral or topical tranexamic acid ⇒ ensure pt doesn’t have hx of PEs, DVT or coagulation issues
azelaic acid, kojic acid, topical retinoids, alpha arbutin (found in some OTCs)
What is vitiligo (S&S, Tx)?
S&S: white depigmented patches on skin, can be solitary, segmental or widespread
associated with autoimmune comorbidities
mental and emotional burden is worse in patients with SoC
Tx: no cure and tx often unsatisfactory, goal is stop progression
sun protection measures, camouflage makeup, topical steroids, calcineurin inhibitors, new agents like ruxolitinib
What is acanthosis nigricans (S&S, Tx)?
S&S: irregularly defined hyperpigmented velvety patches on skin
most commonly on neck, axilla, groin
Tx: manage comorbidities (can represent insulin deficiency/sensitivity), topical or oral retinoids, Vit D analogues, referral for laser tx
What is traction alopecia (S&S, Tx)?
S&S: form of acquired hair loss that results from prolonged or repetitive tension on scalp hair
chronic wearing of hair extensions, weaves, braids, use of chemical relaxers, tightly worn head coverings
mostly affects front and sides of scalp, is tension dependent
Tx: loosen hair style or head covering, avoid scalp exposure to chemical and heat, minoxidil, topical or intralesional steroids, hair replacement surgery
What is central centrifugal cicatricial alopecia (CCCA) (S&S, Tx)?
S&S: permanent destruction of the hair follicle with irreversible hair loss, signs of hair breakage
possibly tenderness, burning, pruritus
hair loss typically begins at vertex or mid-scalp and extends outward
Tx: eliminate aggressive hair practices, topical or intralesional steroids, oral meds (retinoids, immunosuppressants)
