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SUMMARY
Although melanoma is predominantly diagnosed in the White population, it has a worse prognosis and survival rate in populations with skin of color.
Clinical characteristics, including location, histological subtype, and stage, differ between melanomas in white skin and skin of color. For example, superficial spreading melanomas on the trunk and legs are more common in White populations, but acral lentiginous melanomas of the extremities are more common in Black and Asian populations.
There is a controversy regarding the role of ultraviolet radiation and genetics and family history in the development of melanomas in skin of color, and more research needs to be done to better understand the risk factors that lead to melanoma development in these populations.
Surgery is the gold standard for melanoma treatment across ethnic groups.
Black patients have significantly worse survival than White patients, even when stratified for melanoma clinicopathological characteristics.
Photoprotection practices differ amongst ethnicities, and clinicians need to emphasize the importance of sun protection in skin of color.
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DON’T FORGET
Acral lentiginous melanomas of the outer extremities and mucosal melanomas are common in skin of color, and physicians should make sure they pay special attention to the palms, soles, subungual regions, interdigital spaces, and mucosal surfaces during total-body skin examinations.
Sun protection is important in skin of color, and physicians should educate patients about proper sun protection practices.
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CLINICAL PEARLS
It is important to educate patients with skin of color about sun protection practices.
When performing skin examinations on white skin and skin of color, pay special attention to the palms, soles, subungual regions, interdigital spaces, and mucosal surfaces, including genitals.
Monitor for lesions following “ABCDE” characteristics, nonhealing ulcers, or Hutchinson sign.
Advise vitamin D supplementation if needed.
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PATIENT EDUCATION POINTS
You can develop melanoma no matter what color your skin is.
Although people with skin of color have a lower risk of developing melanoma than white patients, melanomas in skin of color are often found at a late stage.
Sun protection and early detection of melanoma are extremely important.
It is important to wear sunscreen that has a sun-protection factor of 30 or higher, wear sun-protective clothing, seek shade, avoid tanning beds, and perform skin self-examinations to look for any changing marks on the body.
Consult a dermatologist immediately if a lesion changes.
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Cutaneous melanoma is the most aggressive form of skin cancer. In 2022, over 99,000 patients were diagnosed with melanoma in the United States alone, and melanoma was responsible for more than 7600 deaths.1 Melanoma is predominately diagnosed in the White population. However, as this chapter demonstrates, melanoma has significantly worse prognoses and survival outcomes in patients with skin of color. Given the lower incidence and additional barriers, significantly less research is conducted on melanoma in patients with skin of color, and physicians are not as knowledgeable about melanoma presentation in these populations, ...