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INTRODUCTION

KEY POINTS

  • Latin America has the largest skin of color population outside of the countries of Africa and Asia. Currently, Brazil and other Latin American countries have diverse populations composed of descendants from Europe, Africa, and Asia, along with Brazilian indigenous people.

  • Brazilian and other Latin American skin of color populations experience cutaneous problems specific to or more common in people with skin of color. Problems that are due to skin color assume different characteristics from those found in Caucasians.

  • Dry skin is a frequent complaint among Latin Americans with skin of color, and large amounts of emollients are often necessary.

  • Tropical diseases such as scabies, syphilis, pityriasis versicolor, and tinea corporis may have a different clinical expression in Latin Americans than in other populations.

  • Acral lentiginous melanoma is much more common in Latin American skin of color patients and older age groups compared with Caucasian patients and younger age groups.

South America is as varied climatically as it is linguistically and racially [Figure 94-1]. Its history as a whole is one that has been affected by indigenous movements as well as colonial influences, and no country reflects this as colorfully as Brazil. Therefore, in this chapter, Brazil has been highlighted as a reflection and representation of South America as a whole.

FIGURE 94-1.

Map of the racial and ethnic composition of the Americas.

It is estimated that approximately 2.5 million Amerindians were living in Brazil when the Portuguese first arrived in the country in 1500 and that Portuguese-Amerindian admixing began almost immediately.1 Brazil originally had a population made up of countless indigenous tribes, and many of these tribes exist even today. The native population was small and dispersed compared to the indigenous population of the Spanish-dominated American regions, which included the Mayans, Incas, and Aztecs. Due to factors resulting from colonization, such as slavery, ethnic cleansing, newly introduced diseases, hunger, and marginalization, the native population has since been reduced to some 200,000 individuals.2

After 1550, many Africans were shipped to Brazil as slaves. It is uncertain how many arrived at Brazilian ports, with estimates ranging from 3 to 18 million. Due to the great number of slaves and their widespread miscegenation, Brazil is presently the country with the largest darker skin of color population outside of any country in Africa. As Father Antonio Vieira said in the seventeenth century, “Brazil’s body is in America, but its soul is in Africa.”3 Additionally, Brazil experienced a great influx of immigrants from many diverse regions of the world during the nineteenth and twentieth centuries.

Brazilians today can trace their origins from four main sources—Amerindians, Europeans (mostly of Portuguese/Spanish origin), Africans, and Asians—but it is difficult to think of any racial or ethnic groups on Earth whose genetic heritage is not represented in ...

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