Dermatologic Disorders in Skin of Color: Moving Toward a Better Understanding

April 2013 | Volume 12 | Issue 4 | Editorials | 394 | Copyright © 2013

Andrew F. Alexis MD MPH

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I am honored to serve as Guest Editor for this Special Topic issue of the Journal of Drugs in Dermatology featuring articles on skin of color. I commend the journal for highlighting this important area in dermatology, which is becoming increasingly relevant given demographic trends in the United States and globally.

Among the numerous dermatologic disorders that present more frequently in darker skin types, keloids, dyschromias, and follicular disorders are among the most therapeutically challenging. Until recently, clinical research studies investigating treatments of these disorders was limited, while coverage in dermatology meetings, text books, and journals was relatively sparse. In addition, the use of lasers and other cosmetic procedures in Fitzpatrick skin types IV to VI was hampered by considerable safety concerns and a paucity of studies that included subjects belonging to nonwhite racial/ethnic groups. Over the past decade, there has been remarkable progress in advancing research, education, and treatment of dermatologic concerns prevalent in populations with darker skin types.

The following milestones exemplify this progress:

  1. The meetings of the American Academy of Dermatology, American Society for Dermatologic Surgery, and other leading national conferences now include numerous lectures providing practical approaches to common disorders in skin of color.
  2. Several textbooks on diagnosis and treatment of dermatologic concerns in darker skin types have recently been published.1-9
  3. Conferences devoted to the management of skin of color are now available, including the Skin of Color Seminar Series (now in its fourth year), the International Ethnic Skin and Hair Conference (held in London, UK for the past 3 years), and the Hampton University Skin of Color Research Institute (HUSCRI) Skin of Color Symposium (now in its third year).
  4. Clinical trials of new dermatologic drugs and devices now enroll a larger number of subjects with Fitzpatrick skin types IV to VI, providing much needed data on the safety and efficacy of these treatments in darker skin types, while basic research into mechanisms of pigmentary disorders, keloids, and scarring alopecias has increased considerably.
  5. Advances in minimally invasive therapies, including laser and light-based technologies, have broadened the range of safe and effective aesthetic treatment options for individuals with darker skin types. According to the American Society for Aesthetic Plastic Surgery 2011 survey, patients belonging to nonwhite racial/ethnic groups underwent 21% of the cosmetic procedures performed in the United States.10
  6. A number of departments of dermatology in the United States have developed centers for research specializing in skin of color and similar trends are emerging globally.
  7. A professional organization dedicated to promoting awareness of and excellence in skin of color—The Skin of Color Society—was founded in 2004 by Susan C. Taylor MD and hosts an annual meeting during which cutting-edge research from residents and fellows is presented. This society also fosters young investigators with an interest in skin of color by providing an annual research award.

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