SM 265: Skin of Color Flashcards
What is Skin of Color?
Individuals of racial and ethnic backgrounds with similar cutaneous characteristics and conditions as well as reaction patterns to those conditions
How does Skin of Color compare to White Skin, in terms of number of Melanoycytes, and size/Melanin content/distribution of Melanosomes?
Same number of Melanocytes
More Melanin per Melanosome
Larger Melanosomes
Melanosomes distributed more uniformly in the epidermis
What does the Fitzpatrick Skin type consider?
Natural skin color
Ability to Tan
Reaction to Sun Exposure
When is the Fitzpatrick skin type less accurate?
Fitzpatrick skin type is less accurate in Asians and African Americans
What are PIgmentary Demarcation Lines and who are they common in? Are they pathological?
PDL = abrupt transition in color of skin over a sharply demarcated line
Common in Infants + Adults of Color
Benign
What is this showing?
A Pigmentary Demarcation Line - it’s benign
What is Periorbital Hyperpigmentation, and who is it common in? Is it benign?
Periorbital Hyperpigmentation is dark circles around the lower eyelid, and is common in Patients of Color
Benign
What is this showing?
Periorbital Hyperpigmentation
What is this showing? Who is it common in? Is it Benign?
Palmar/Plantar Hyperpigmentation
Common in African Americans
May be benign or pathologic
What are these? Are they benign?
Punctate Keratoses of Palmar Creases
Benign
Where is Mucous Membrane Hyperpigmentation normal in Skin of Color?
Mucous Membrane Hyperpigmentation is common in the Oral mucosa in skin of color
What is this? Who is it common in? Is it dangerous?
Melanonychia Striata
Common in older patients of color
Single Nail = Dangerous for Melanoma
Multiple Nails = Normal
What is this? Where does it tend to occur? Is it dangerous?
Guttate Hypomelanosis: small white spots on the skin
Common in Upepr extremities and Anterior shin
Benign
What is this? Where does it occur and in who? Is it dangerous?
Congenital Dermal Melanocytosis
Common in Asian/AA infants; blue-green patches around Sacrococyxial area
Benign and resolves on it’s own
What is this? Who is it common in? Is it dangerous?
Dermatosis Papulosa Nigra
Common in adults of color, increasing with age
Not dangerous
What is Dermatosis Papulosa Nigra?
1 -2 benign brown papules with a “stuck-on” appearance that are commonly found in adults of color, and increase in frequency with age
What is this and why?
Acne Vulgaris: Comedone stage since there’s no cysts/papules/pustules
What is this and why?
Acne Vulgaris: Inflammatory stage, due to presence of Papules/Pustules/Cysts
How does Acne Fulminans vary in skin of color?
Less severe in African Americans than Hispanics and Whites
How does Acne Vulgaris resolve differently in skin of color? How does this effect treatment?
Acne vulgaris is more likely to leave behind post-inflammatory hyperpigmentation as well as create scars like Keloids
Need to be more aggressive in treatment
What is Atopic Dermatitis and how does it present on White skin?
Atopic Dermatitis is a symmetric, ill-defined erythematous patch that feels very itchy and leads to Lichenification; commonly found in:
Face/Extensor/Flexor/Head
Infants/Toddlers/Children/Adults
How does Atopic Dermatitis differ in skin of color?
Still itchy, but less erythema is visible due to darker skin and more papular or follicular presentation in patients of color
Also more likely to end in post-inflammatory pigmentation changes
What is this and why?
Atopic Dermatitis: symmetric lesion with lichenification prominent
How does Psoriasis appear in white skin?
Psoriasis is a chronic inflammatory condition that presents as thickened rash with lots of Scale and a red outline on the Elbows and Knees
How does Psoriasis differ in skin of color?
The Erythema looks more violaceous and the disease has more extensive body involvement, which resolves with more hyper/hypo-pigmentation
What is this and why?
Psoriasis; you can see the thick scale and the violaceous inflammatory hue
What is Lichen Planus?
An autoinflammatory skin condition that effects the wrist, ankles, oral mucosa, and scalp/nails and is associated with Hepatitis C
What is this comparing?
Lichen Planus is shown due to the Planar, Polygonal and Pruritic appearance of the rash, with a purple hue
What is this comparing?
Pityriasis Rosea
How is Pityriasis Rosea seen in skin of color?
Folows a viral trigger like M. Pneumo, but has a violaceous appearance and can effect the extremities as well as the trunk; also has a scale
What is this comparing?
Seborrheic Dermatitis, a chronic inflammatory condition that effects the nose and beard area
In skin of color, less patches and scale with more hypopigmentation
How does Seborrheic Dermatitis present in skin of color?
Polycyclic rings around the nose with less scale
What is this and what might it suggest?
Erythema Nodosum suggesting Sarcoidosis
Harder to see the Erythema in skin of color than white skin
What are these and what do they suggest?
Papules and plaques on the face and extremities suggests Sarcoidosis
What is this and what does it suggest?
Red-brown papules on the face, nose, lips or ear are Lupus Pernio, which suggets Sarcoidosis with a bad prognosis
If you see this, what should you consider?
Plaques on nose and face = Lupus Pernio = Sarcoidosis
How does Sarcoidosis alter pigmentation?
Sarcoidosis causes annular hypopigmented plaques
Where can Sarcoidosis granulomas have a tendency to develop outside the face?
Tatoos and scars
Where does Discoid Lupus Erythematous effect?
DLE commonly effects the face and scalp
How can active and inactive DLE be distinguished?
Active DLE causes bright pink patches and allopecia
What is this? Where on the body it common, and in what groups?
Hidradenitis Suppuritiva, an inflammatory disorder of the follicles associated with obesity and smoking
Effects the axillae, groin, buttocks and breast
Common in women of color
What is this?
A keloid, common in african americans and at sites of traumu
What is this and why?
Gray-blue macules on neck and upper body in an adult = Erythema Dyschromicum Perstans
What is this and why?
Hypopigmented patch in skin of color on the face/neck/trunk = Pityriasis Alba
What is Melasma?
A relapsing condition of hyperpigmented patches that effects sun-exposed areas of the face in young women of color
If this is a young woman of color, what is this?
Melasma; recurrent hyperpigmentation on the face
What is this, what causes it, and what does it increase risk for?
Oculocutaneous Albinism, due to a mutation in Melanin that leads to an increased risk of skin cancer
What is Pseudofolliculitis Barbae?
A common inflammatory condition in men of color that involves corse curly hair penetrating the dermis and causing inflammation and scars/keloids
What is this and why?
Curly hairs that circle back and peentrate the skin = Pseudofolliculitis Barbae, as the areas effected by penetration are showing inflammation on skin of color
What is this and why?
Keloid or rash on the back of the neck of skin of color = Acne Keloidis Nuchae
What is Traction Alopecia?
Alopecia due to tight hairstyles commonly seen in skin of color
What is this and why?
Central hair breakage and bald patches = Central Centrifugal Cicatricial Alopecia (CCCA)
May involve burning or itching
What is Dissecting Cellulitis of the Scalp?
Painful boggy nodules + patchy hair loss in AA men
How does Basal Cell Carcinoma present in skin of color?
Most common type of cancer, risk factors include sun exposure + scars + genetic disorders
Preents as a pigmented leion in the head or neck
How does Squamous Cell Carcinoma present in skin of color?
Presents in areas that are not sun exposed may cause chronic scarring
How does Melanoma present in skin of color?
Rare, often shows up as a single effected fingernail
What is this and how does it effect skin of color differently?
Cutaneous Lymphoma; effects african americans more and follows a more aggressive course
