While there is a common perception that skin pigmentation is protective against skin cancer, even individuals with the most pigmented skin can still develop these conditions, said Edmonton-based dermatologist Dr. Jaggi Rao. The incidence and relative risk of specific sub-types and their presentations differ in different ethnic groups from those of Caucasians, however, he said.
Dr. Rao is a clinical professor of medicine at the University of Alberta, and is a member of the board of directors of the Canadian Association of Aesthetics Medicine (CAAM). He spoke about the incidence and presentation of skin cancer in skin of colour at the third annual Skin Spectrum Summit in Vancouver on May 27, 2017.
“Skin cancer in ethnic skin, compared to Caucasian patients, is not as common,” said Dr. Rao. “We do not see it as often [in darkly pigmented skin], but when we do see it, it often presents quite atypically. We also see that they present at a more advanced stage.”
Patients of skin of colour may be using over-the-counter (OTC) skin lightening products that contain hydroquinone, corticosteroids, and mercury, according to Dr. Jonathan Shapero. He spoke about issues and the potential toxic effects of some skin lightening procedures during the 3rd annual Skin Spectrum Summit in Toronto on Apr. 8, 2017.
Dr. Shapero, a Toronto-based dermatologist at Shapero Dermatology, said that he and his colleagues Drs. Nisha Mistry, Roopal Kundu, and Harvey Shapero, reported the first cases of skin lightening complications in Canada.
The first case involved a 28-year-old black female who developed dark areas on her skin after pregnancy. She purchased an OTC cream at a Caribbean health food store. While the cream lightened her skin, she developed lesions. It turned out that the cream contained clobetasol ointment.
He said his office sees a patient every couple of months who presents with complications from skin lightening agents.
Combination therapy with a range of lightening agents—and possibly oral agents for photoprotection—may become the new gold standard for treating hyperpigmentation in skin of colour. That development is in response to a growing need for an alternative to hydroquinone (HQ), according to Dr. Heather Woolery-Lloyd, director of Ethnic Skin Care, and voluntary assistant professor at the Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine in Miami.
She spoke during the third annual Skin Spectrum Summit in Toronto on Apr. 8, 2017 and addressed some of the challenges in treating hyperpigmentation in darker-skinned individuals using HQ. She also outlined some of the alternative approaches that can be utilized to reduce the usage of HQ and improve patient outcomes.
While HQ is a highly effective bleaching agent, and 2 to 4% formulations are commercially available, compounded formulations of up to 6 to 10% may be needed in darker-skinned patients, said Dr....
Early diagnosis and aggressive treatment of hidradenitis suppurativa (HS) is important and can make a significant difference in the lives of these patients, according to Toronto-based dermatologist Dr. Afsaneh Alavi.
“HS is a chronic and debilitating disease that commonly [occurs] in the young population of patients after puberty. HS is three times more common in female patients,” said Dr. Alavi, speaking at the 3rd annual Skin Spectrum Summit in Toronto on Apr. 8, 2017.
Dr. Alavi reviewed the epidemiology and clinical presentations of HS. In a case-based discussion, she also shared with the delegates some of her experience treating and managing HS patients.
Prevalence of HS uncertain
“There is considerable uncertainty regarding the prevalence of HS. The prevalence over recent decades has been associated with a significant degree of unexplained discrepancy ranging from 0.05 per cent to four per cent,” said Dr. Alavi, assistant professor of dermatology, Department of Medicine (Dermatology),...
The treatment paradigm for the management of acne is similar when treating skin of colour versus Caucasian patients, Dr. Sam Hanna reported during a presentation at the 2nd annual Skin Spectrum Summit in Toronto on Apr. 16.
“There are many options available for the management of acne sequelae, but when treating skin of colour patients every single [acne treatment] carries different risks than when we treat patients with lighter skin,” Dr. Hanna, a dermatologist in Toronto, said.
“Acne is common across all skin types. I like to initiate therapy for acne early—so that I am not a year, five or 10 years down the road behind the eight ball trying to [treat acne scarring], which we might have been able to prevent,” he said. He emphasized that preventing acne scars is easier than treating acne scars.
“Scar treatment is available, but it is difficult, expensive and has risks,” he said.
Dr. Hanna said during his presentation that topical retinoids remain the mainstay of early topical therapy. He no...
The practice of gluing hair extensions onto the scalp of women of African ancestry should be avoided to prevent the occurrence of alopecia, said dermatologist Dr. Heather Woolery-Lloyd, who presented at the second annual Skin Spectrum Summit in Toronto.
“I am extremely opposed to the use of hair glue,” said Dr. Woolery-Lloyd, dermatologist and director of Ethnic Skin Care in the Department of Dermatology and Cutaneous Surgery at the University of Miami. “I recommend to all my patients to avoid glue because it can put them at risk for permanent alopecia.”
Dr. Woolery Lloyd added that the glue used to apply hair extensions is toxic and contains ingredients such as natural rubber, latex, ammonium hydroxide and colour.
Hair glue has been found to be associated with an anaphylactic reaction, said Dr. Woolery-Lloyd.
Presently, there seems to be a movement toward more natural hairstyle practices among women of African ancestry, said Dr. Woolery-Lloyd.
Pseudofolliculitis barbae (PFB) and acne keloidalis nuchae (AKN) are both conditions that are primarily seen in men of African ancestry and can be a therapeutic challenge, according to a New York City-based dermatologist who presented during a morning session at the second annual Skin Spectrum Summit in Toronto.
"Thankfully through behavioural modification, topical and oral therapies, and newer in office procedures including laser hair removal, if done safely, can really transform patients lives and improve the bumps and disfigurement from both of these conditions," says Dr. Andrew F. Alexis, the chair of the Department of Dermatology and the director of Skin of Color Center at Mount Sinai St. Luke'-Roosevelt Hospital and an associate professor at the Icahn School of Medicine at Mount Sinai.
Dr. Alexis says PFB can be managed through total discontinuation of shaving and growing a beard, chemical depilatory (barium sulfide and calcium thioglycolate), and modifyin...
Early treatment of atopic dermatitis (AD) reduces the flaring frequency and intensity of this condition regardless of a patient’s skin colour, said Dr. Leon H. Kircik, during a presentation at the Skin Spectrum Summit in Montreal on May 14, 2016.
Awareness of the triggers of AD is an important part of treatment and prevention, said Dr. Kircik, who spoke about strategies for managing AD in young patients with skin of colour.
Weather is one trigger of AD, and ethnicity can make a difference in terms of how this environmental factor impacts the skin, said Dr. Kircik, clinical associate professor of dermatology at Indiana University School of Medicine and Mount Sinai Medical Center in Louisville, Ky.
“In the case of Caucasian people, cold weather makes the skin of these patients dry and [the condition] worse. It is different for African Americans—their skin tends to get worse in the summer, because sweating make these patients worse,” he said.