Skin of Color: Clinical Pearls

Seemal Desai, MD

Here are some important takeaway messages from Dr Desai’s presentation on skin of color at Maui Derm Summer NP+PA:

1. Erythema can be difficult to distinguish in patients with skin of color. Don’t be fooled by areas of violaceous hue, brownish discoloration, and bluish brown discoloration that can actually represent erythema and thus active inflammation. For example, in patients with psoriasis
2. Progressive Macular Hypomelanosis is a condition commonly on the trunk, and can be seen in the distribution of tinea versicolor
3. Treat acne vulgaris in patients with skin of color aggressively. These patients are more prone to post-inflammatory hyperpigmentation, which can be difficult to treat
4. Inflammatory disorders such as sarcoidosis, cutaneous lupus, and infectious pathologies can mimic psoriasis in skin of color and vice-versa. Biopsy when in doubt
5. First line therapy in the treatment of melasma consists of triple combination topical therapy, but second line therapy, including chemical peels should be considered for recalcitrant cases