Andrew F. Alexis (editor) - Skin of Color: A Practical Guide to Dermatologic Diagnosis and Treatment

Adedamola Adegbenro 1 and Susan Taylor 2

Abstract

Skin of color is defined as non-Caucasian skin types, which by Fitzpatricks classification comprise skin types III-VI. There is great variability in skin pigmentation among distinct racial and ethnic groups, making it difficult to define skin types simply by ethnicity, race, or culture. Individuals with darker skin comprise a wide range of racial and ethnic groups including Africans, African-Americans, African-Caribbean, Japanese, Chinese, Asians, Latinos, Indians, and Pakistanis, to name just a few. Presently, individuals with pigmented skin comprise 80% of the world population. As expected, demand for health care services by individuals with skin of color will grow substantially as this population grows. This demand will also expand as newer technologies and treatment for skin diseases develop. Therefore, the importance of studying the differences that exist in the structure, physiology, function, and culture of ethnic skin cannot be overemphasized. Most of the early literature on pigmented skin has produced conflicting results that are difficult to interpret or generalize. This is as a result of small sample sizes, non-standardized approaches and methodologies, varying anatomic sites, and the use of subjective parameters. This chapter will summarize the current data regarding ethnic skin differences. An understanding of structural, physiological, and functional differences in pigmented skin will lead to a better grasp of the pathophysiologic mechanisms of skin diseases particularly those that disproportionately affect the ethnic population.

Skin of color is defined as non-Caucasian skin types, which by Fitzpatricks classification comprise skin types III-VI. There is great variability in skin pigmentation among distinct racial and ethnic groups, making it difficult to define skin types simply by ethnicity, race, or culture. Individuals with darker skin comprise a wide range of racial and ethnic groups including Africans, African-Americans, African-Caribbean, Japanese, Chinese, Asians, Latinos, Indians, and Pakistanis, to name just a few (Table ].

The US census indicates that by the year 2056, greater than 50% of the US population will be non-Caucasian []. As expected, demand for health care services by individuals with skin of color will grow substantially as this population grows. This demand will also expand as newer technologies and treatment for skin diseases develop. Therefore, the importance of studying the differences that exist in the structure, physiology, function, and culture of ethnic skin cannot be overemphasized.

Most of the early literature on pigmented skin has produced conflicting results that are difficult to interpret or generalize. This is as a result of small sample sizes, non-standardized approaches and methodologies, varying anatomic sites, and the use of subjective parameters. This chapter will summarize the current data regarding ethnic skin differences. An understanding of structural, physiological, and functional differences in pigmented skin will lead to a better grasp of the pathophysiologic mechanisms of skin diseases particularly those that disproportionately affect the ethnic population.