++
KEY POINTS
It is expected that children with skin of color will constitute about 15% of all dermatology visits by the year 2050.
Children with skin of color are more susceptible to keloid and hypertrophic scar development, and many will develop a pigmentary alteration in response to inflammatory skin conditions.
African American children are more susceptible to dry scalp, traction related hair loss, and tinea capitis.
++
Children of color are often underserved in their needs, because the majority of dermatology textbooks have been written about Caucasian children and most prescription drugs have been tested primarily in Caucasian children. Currently there is only one atlas1 in print that describes children of color. Children of color have several unique concerns that affect their development of illness and response to therapy.
++
Ten percent of visits to pediatricians are for skin issues, and 30% of all dermatology appointments are made for children.2 By the year 2050, almost half of the U.S. population will be non-Caucasian.3 Thus it is expected that children of color will constitute about 15% of all dermatology visits by the year 2050.4
++
Children of color have specific reactions to injury. They are more susceptible to keloid and hypertrophic scar development.2 Most darkly pigmented children will develop a pigmentary alteration in response to inflammatory skin conditions, including atopic dermatitis, pityriasis rosea, and acne.3 In fact, pigmentation, both hyperpigmentation and hypopigmentation, may be more noticeable and consequently more disturbing to children, especially adolescents of color. Furthermore lichenoid dermatologic responses are more common in children of color, resulting in cases of lichenoid atopic dermatitis, hypertrophic lichen planus, and lichenoid contact dermatitis.
++
Immunologic and metabolic reaction patterns in children of color are different as well. Higher rates of diabetes, poor vitamin D levels due to melanin-related sun protection, and alterations in enzymes such as low levels of glucose-6-phsophate dehydrogenase (G6PD) may all serve to contribute to skin disease development and ability to tolerate standard dermatologic therapeutics (eg, dapsone).
++
Other concerns include curved hair follicles and reduced flow of sebum on the hair shaft,4 leaving the African American child more susceptible to dry scalp, traction-related hair loss, tinea capitis, and as an adult, central centrifugal cicatricial alopecia.
++
This chapter is meant to provide an overview of skin conditions seen in children of color and includes 10 sections: newborn skin conditions, dermatitis, papulosquamous disorders, acneiform skin conditions, autoimmune and collagen vascular diseases, vascular birthmarks, pigmentary diseases, traumatic, hair disorders, and infections. The sections will be limited to conditions not covered elsewhere in the text or will provide added information pertinent to pediatric patients supplemental to other chapters. Due to the complexity of the topic, only a limited number of conditions are covered in depth. The readers are encouraged to contribute to the literature regarding children of color, as it is limited in nature at ...