SM_265a: Skin of Color Flashcards
Skin of color has ____ number of melanocytes but melanocytes are ____ activated, there is ____ melanization of melanosomes, and melanosomes are dispersed ____ in the epidermis
Skin of color has same number of melanocytes but melanocytes are more activated, there is increased melanization of melanosomes, and melanosomes are dispersed more uniformly in the epidermis
Describe normal variations in skin of color
Normal variations in skin of color
- Pigmentary demarcation lines
- Periorbital hyperpigmentation
- Palmar and plantar hyperpigmentation
- Punctate keratoeses of palmar creases
- Mucous membrane hyperpigmentation
- Melanonchyia striate
- Idiopathic guttate hypomelanosis
- Congenital dermal melanocytosis
- Dermatosis papulosa nigra
If a nailbed is involved, consider ____ rather than melanonychia striata
If a nailbed is involved, consider melanoma rather than melanonychia striata
People of color are less likely to have ____ presentation of acne vulgaris and more likely to have associated ____ and ____
People of color are less likely to have nodulocystic (severe) presentation of acne vulgaris and more likely to have associated post-inflammatory hyperpigmentation and scarring
Atopic dermatitis has more ____ presentation in black individuals, less ____, and resolves with ____
Atopic dermatitis has more papular or follicular presentation in black individuals, less erythema, and resolves with hyper- or hypopigmentation
(difficult to see erythroderma)
Psoriasis has less conspicuous ____, more extensive ____, and ____
Psoriasis has less conspicuous erythema (more violaceous), more extensive disease involvement, and post-inflammatory hyper- or hypopigmentation
Lichen planus is a ___ that affects the ___, ___, ___, or ___ and may be associated with ___ or ___
Lichen planus is an autoimmune inflammatory mucocutaneous condition that affects the skin, oral mucosa, scalp, or nails and may be associated with medication or Hepatitis C infection
Pityriasis rosea manifests as ____, ____, and ____ in skin of color
Pityriasis rosea manifests as violaceous appearance, distal location (extremities), and central scale and necrosis in skin of color
Seborrheic dermatitis may present as ____ and may show ____ in skin of color
Seborrheic dermatitis may present as polycyclic rings and may show less scale in skin of color
Describe conditions common in skin of color
Conditions common in skin of color
- Sarcoidosis
- Discoid lupus erythematosus
- Hidradenitis suppurativa
- Keloids
- Erythema dyschromicum perstans
- Pityriasis alba
- Melasma
- Vitiligo
- Oculocutaneous albinism
Sarcioidosis is ____ common and ____ severe in African Americans, who are more likely to have ____ disease and lesions may be ____ or ____
Sarcioidosis is more common and more severe in African Americans, who are more likely to have cutaneous disease and lesions may be specific (non-caseating granulomas) or non-specific
Regarding sarcoidosis, ____ is more difficult to appreciate in skin of African Americans, and ____ is particularly common in African American women
Regarding sarcoidosis, erythema nodosum is more difficult to appreciate in skin of African Americans, and lupus pernio is particularly common in African American women
(tattoos and piercings are likely to develop papules of sarcoidosis)
Discoid lupus erythematosus is ____
Discoid lupus erythematosus is the most common form of chronic cutaneous lupus
- Commonly affects women
- African Americans and Latino at increased risk
- Typically affects face, scalp, and ears but may be widespread and involve mucous membranes
Hidradenitis suppurativa is ____
Hidradenitis suppurativa is an inflammatory disorder of the follicular epithelium
- More common in women, African Americans, socioeconomically disadvantaged
- Obesity, metabolic syndrome, and cigarette use also associated
- Affects axillae, groin, buttocks, breast
- Papulonodules, abscess, cysts with extensive scarring and drainage
Keloids are ____ and are common in ____
Keloids are overgrowths of scar tissue beyond the site of original injury and are common in African Americans
- Surgical excisions, traumatic wounds, piercings, tattoos, acne
Vitiligo is ____ that affects races and genders equally but is more apparent in ____
Vitiligo is an acquired pigmentary disorder due to abscence of melanocytes that affects all races and genders equally but is particularly apparent in darker skin types
(often associiated with autoimmune disease)
Describe oculocutaneous albinism
Oculocutaneous albinism
- Group of autosomal recessive disorders characterized by dilution of melanin in hair, skin, and eyes
- OCA2 is most common type worldwide and most common in Africa
- Increased risk of skin cancer
- Angulated wrinkles on back of neck
Pseudofolliculitis barbae is ____ that occurs when ____
Pseudofolliculitis barbae is a common inflammatory condition in men of color that occurs when coarse curly hair penetrates dermis and causes inflammatory reaction
(may lead to scarring and keloids)
Acne keloidalis nuchae is ____ that affects ____ and ____ and is common in ____
Acne keloidalis nuchae is a chronic inflammatory condition that affects the nape of the neck and occipital scalp and is common in African American young men
Descibe traction alopecia
Traction alopecia
- Due to tight hairstyles including weaves, braids, cornrows
- Begins with perifollicular papules and may progress to scarring alopecia
- Bitemporal scalp is most common
Describe central centifugal cicatricial alopecia
Central centifugal cicatricial alopecia
- Lymphocytic scarring alopecia
- Occurs in African American women
- Previously termed “hot comb alopecia” but likely multifactorial etiology
- Begins with hair breakage and thinning and scalp erythema
- May progress to smooth bald patches
- May be associated with burning, itching, or be asymptomatic
Describe dissecting cellulitis of the scalp
Dissecting cellulitis of the scalp
- Common in African American and Hispanic men
- Painful, boggy nodules, interconnected abscesses
- Patchy hair loss
- May become superinfected
Describe tinea capitis / kerion
Tinea capitis / kerion
- Fungal infection of scalp
- Intense inflammatory reaction may lead to thick plaque
- Commonly develops on scalp of African American child
- May be associated with lymphadenopathy and secondary bacterial infection
Epidermal melanin provides ____ for people of color, but skin cancer may present at ____ in people of color
Epidermal melanin provides photo-protection for people of color, but skin cancer may present at advanced stage with worse prognosis in people of color
(most common type of malignancy in US population)
____ basal cell carcinoma is common in skin of of color
Pigmented basal cell carcinoma is common in skin of of color
Squamos cell carcinoma is ____ type of skin cancer in African Americans, may leave ____, and often occurs on ____ areas in skin of color
Squamos cell carcinoma is most common type of skin cancer in African Americans, may leave chronic scarring, and often occurs on non-sun exposed areas in skin of color
Describe melanoma in people of color
Melanoma in people of color
- Low incidence but more likely to present with regional and distant metastases
- Lower extremity most common site except for Latino men (trunk)
- Superficial spreading type most common in Latinos and Asians
- Acral lentiginous type most common in African Americans
Cutaneous lymphoma is ____ in African Americans, ____, and ____
Cutaneous lymphoma is most common in African Americans, may gave a more aggressive course, and hypopigmented form is more common
