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Special Considerations in Skin of Color

»What is “skin of color”?
»What accounts for differences in color between ethnic and racial groups?
»Do any physiologic differences exist between black skin and that of other racial/ethnic groups?
»Are the brown streaks on the nails of people with skin of color always a cause for concern?
»Is pigmentation of the oral mucosa in people with skin of color invariably concerning?
»Are there other areas of the body where hyperpigmentation represents a normal racial variant?
»What are Futcher’s lines?
»What causes postinflammatory hyperpigmentation?
»What causes postinflammatory hypopigmentation?
»Is pityriasis alba the same thing as postinflammatory hypopigmentation?
»Is vitiligo more common in patients with darker skin?
»Why does tinea versicolor cause hypopigmented spots on dark skin?
»Why is it more difficult to appreciate erythema in darker skin?
»Can any other generalizations be made about common cutaneous reaction patterns in skin of color?
»What is the significance of multiple brown papules often seen on the periorbital area, cheeks, and nose?
»What is cutaneous sarcoidosis?
»What are keloids?
»What are “razor bumps”?
»How is pseudofolliculitis barbae treated?
»Are there other racial differences that may affect the treatment of hair or scalp conditions in blacks?
»Are patients with skin of color particularly susceptible to any life-threatening illnesses?
»Do any special considerations exist when performing skin surgery on patients with skin of color?
»Why is skin cancer less common in skin of color?
»Are there any unique presentations of skin cancer when it does occur in patients with darker skin?
»List skin diseases or conditions that are often considered more common in persons with skin of color.

 
 
 

Is pityriasis alba the same thing as postinflammatory hypopigmentation?


Pityriasis alba, demonstrating hypopigmented macules of the face.  (Courtesy of James E. Fitzpatrick, MD.)
Fig. 62.4 Pityriasis alba, demonstrating hypopigmented macules of the face. (Courtesy of James E. Fitzpatrick, MD.)
Pityriasis alba is seen primarily in children with darker skin types, and it manifests as hypopigmented macules on the face and/or upper arms (Fig. 62-4). The lesions lack a distinct border and may have overlying fine scale. Patients often report a history of atopic dermatitis. Some studies show boys may be preferentially affected. While many consider pityriasis alba to be a mild form of postinflammatory hypopigmentation, it is often considered a separate entity. Although the condition typically resolves with time, brief treatment with low-potency topical corticosteroids and/or generous emollients may be helpful.

Blessmann Weber M, Sponchiado de Avila LG, Albaneze R, et al: Pityriasis alba: a study of pathogenic factors, J Eur Acad Dermatol Venereol 16:463–468, 2002.