Susan C. Taylor

Gaps in the understanding and treatment of skin cancer in people of color

People of color are at significantly higher risk in mortality from skin cancers, such as melanoma, than Caucasians. Around 4,500,000 people of color are affected by skin cancer The five-year survival rates from melanoma are 81.1% for Hispanics, 80.2% for Asians, 72.2% for African- Americans, and 89.6% for Caucasians. For this reason, it is important to ensure the scientific literature reflects the most up to date recommendations and treatment for blacks regarding skin cancer. Therefore the authors conducted a “gap analysis” on the current treatment of skin cancer in people of color. Three major areas of deficiency were identified. The first major gap identified is the lack of a clear definition of people of color in the literature. The vast majority of current studies utilize the terms Hispanic, Asian, and African-American as if they were all-inclusive, homogenous groups. The second gap identified is the widespread false assumption among dermatologists that people of color do not participate in tanning activities or at risk for UV induced skin cancer. The third gap identified is the false belief among people of color that darker pigmentation confers a “total immunity” against skin cancer. Hopefully raising awareness for these issues will eventually lead to appropriate research and solutions from the medical community as well as the population at risk to lead to the closure of these gaps.

Global Epidemiology and Clinical Spectrum of Rosacea, Highlighting Skin of Color: Review and Clinical Practice Experience

Rosacea has been reported less frequently among individuals with skin of color than in those with white skin, but rosacea is not a rare disease in this population. In fact, rosacea might be underreported and underdiagnosed in populations with skin of color because of the difficulty of discerning erythema and telangiectasia in dark skin. The susceptibility of persons with highly pigmented skin to dermatologic conditions like rosacea, whose triggers include sun exposure, is probably underestimated. Many people with skin of color who have rosacea might experience delayed diagnosis, leading to inappropriate or inadequate treatment; greater morbidity; and uncontrolled, progressive disease with disfiguring manifestations, including phymatous rosacea. In this article, we review the epidemiology of rosacea in skin of color and highlight variations in the clinical presentation of rosacea across the diverse spectrum of patient populations affected. We present strategies to aid in the timely diagnosis and effective treatment of rosacea in patients with skin of color, with an aim of promoting increased awareness of rosacea in these patients and reducing disparities in the management of their disease.