INTRODUCTION
Recent data show that basal cell carcinoma (BCC) is the most common cutaneous malignancy in all races.1,2 Though BCC is most often studied in Fitzpatrick skin types (FST) I-III, BCC in skin of color (SOC) is characterized by unique clinical features and a propensity toward pigmentation. Herein, we present a systematic review of pigmented basal cell carcinoma (pBCC) in individuals with SOC.
SOC is defined as FST IV, V, or VI in individuals of Latinx, Black, or Asian descent.3,4 While skin cancer occurs with a decreased frequency in individuals with skin of color, the diagnosis is generally associated with disproportionately high morbidity and mortality.5,6 Poor outcomes in individuals with skin of color are often attributed to delayed diagnosis and more advanced disease in the setting of atypical clinical presentations.5,6 Socioeconomic disparities, environmental factors, as well as explicit and implicit bias within the healthcare system, play decisive roles as well. Dermatologists need to recognize clinical presentations of skin cancer in individuals with skin of color to improve outcomes and mitigate gaps in care.
SOC is defined as FST IV, V, or VI in individuals of Latinx, Black, or Asian descent.3,4 While skin cancer occurs with a decreased frequency in individuals with skin of color, the diagnosis is generally associated with disproportionately high morbidity and mortality.5,6 Poor outcomes in individuals with skin of color are often attributed to delayed diagnosis and more advanced disease in the setting of atypical clinical presentations.5,6 Socioeconomic disparities, environmental factors, as well as explicit and implicit bias within the healthcare system, play decisive roles as well. Dermatologists need to recognize clinical presentations of skin cancer in individuals with skin of color to improve outcomes and mitigate gaps in care.
MATERIALS AND METHODS
A systematic review was completed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search for peer-reviewed articles was conducted on PubMed/MEDLINE with no publication date restriction. The terms "pigmented basal cell carcinoma" and "pBCC" were independently combined with "Asian," "Black," "Hispanic," "Latinx," "skin of color," and "SOC" using the Boolean operator "AND."
Human studies and studies written in the English language were included. In vitro, cadaver, and animal studies were excluded, as well as duplicates and articles for which the complete text was unavailable. Additional studies addressing skin cancer in men and women with skin of color were included per a discriminant review of article references. Data extraction was performed following a full-text review of eligible articles (Figure 1).
Human studies and studies written in the English language were included. In vitro, cadaver, and animal studies were excluded, as well as duplicates and articles for which the complete text was unavailable. Additional studies addressing skin cancer in men and women with skin of color were included per a discriminant review of article references. Data extraction was performed following a full-text review of eligible articles (Figure 1).
