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INTRODUCTION

Studying the different aspects and manifestations of cutaneous diseases in people with skin of color is an important area of research for many reasons, not just because of the need to provide informed healthcare to all patients. Today, cultural diversity, global migration, and shifting demographic patterns have all contributed to the fact that populations with skin of color are an important and rapidly growing segment of the global community. This second edition of the textbook Dermatology for Skin of Color is an important work of reference that sets out to tackle this vital topic.

This chapter aims to provide clear and succinct information accompanied by high-quality images of a selected range of cutaneous diseases. Definitions, etiologic explanations, clinical perspectives, differential diagnoses, and treatment options are provided for 23 of the most common conditions affecting patients with skin of color. Using the information outlined in this atlas, dermatologists, medical students, and other medical professionals will be able to accurately recognize cutaneous diseases in patients with skin of color and learn appropriate and effective management techniques to treat them. Additionally, the chapter focuses on the distinctive clinical variations and manifestations encountered in patients with skin of color.

One of the most obvious skin changes seen in individuals with skin of color, as well as being one of the most distressing to experience for the patient, is pigmentary alteration. This clinical skin change often takes the form of either hyper- or hypopigmented skin disorders. Many postinflammatory conditions and photosensitive reactions can cause hyperpigmentation, such as melasma. Some of the diseases causing hypopigmentation include leukoderma, idiopathic guttate hypomelanosis, and pityriasis alba. Additionally, lesions that may seem yellowish-brown or red in fairer-skinned individuals, may instead appear in shades ranging from gray to purple in individuals with darker skin of color. This variation and color difference can be seen in several conditions, for instance in pityriasis rosea, psoriasis, and lichen planus.

Patients with skin of color often display distinctive reaction patterns that may manifest in their skin and hair. While there are no biochemical differences among African, Asian, and Caucasian hair types, hair phenotypes vary among the skin of color population, ranging from tightly coiled to very straight. Therefore, the inherent hair properties of certain patients with skin of color may result in their hair being more dry and brittle. As a result, these patients may need to use certain emollient or oil-based hair products to groom their hair without causing breakage of the hair shaft. The use of these products on the hair may sometimes lead to cutaneous disorders.

Various common diseases have different clinical manifestations among individuals in the patient population, for example acne vulgaris. Additionally, skin of color may react differently in relation to the treatment option chosen by the dermatologist. The treatment for skin disorders may need to be adjusted according to the patient and their individual skin type—for example, when using ...

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