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Some things really are just skin deep. Take the skin characteristics of blacks, for example. Researchers are finding that the same skin disorders can take on different appearances in blacks than in whites, on whom most skin research is done.
"There have been (black) families charged with child abuse because of marks on the skin," said Richard Usatine, M.D., who presented "Dermatology in African Americans" Aug. 8 at the National Conference. Usatine, assistant dean of student affairs and associate clinical professor of family medicine at the University of California, Los Angeles, urged physicians who work with black populations to learn the differences in skin characteristics of divergent racial groups.
Skin diseases occur in all types of skin, regardless of the pigment of the skin, said Usatine. But there are skin problems that are more common among blacks than among whites. And there are skin characteristics that are quite natural and harmless in blacks but that would be seen as problems if they occurred in whites.
Usatine said certain types of hyperpigmentation, for example, are quite common in blacks after even minor trauma. An area of the skin may darken after an injury such as a cut or a scrape or after certain skin disorders. Other conditions, such as some forms of dermatosis, are part of the aging process in blacks.
"The dermatosis papulosa nigra disorder seems to have a genetic predisposition," he said, adding that simple excision of the papules with sharp iris scissors may be all the treatment needed.
Vitiligo, which came to the public's attention when entertainer Michael Jackson was diagnosed with it, is a condition in which pigment cells are destroyed and irregular white patches appear on the skin. It has been estimated to affect 1 percent to 2 percent of the total U.S. population and can cause extreme distress to sufferers because of its unusual appearance.
"If you were to touch the skin, it would feel the same as normal skin," Usatine said. "No one knows what causes this condition, but they do make special makeups that can help."
To reach writer J. Michael Brodie, e-mail mbrodie@aafp.org.
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