Skin of Color Disproportionately Affected by Cutaneous Disorders

Many cutaneous disorders disproportionately affect patients with skin of color, according to results of a study published in the Journal of the American Academic Dermatology.

Although census estimates project individuals with skin of color to compose nearly 50% of the US population by 2050, the occurrence of cutaneous diseases across racial and ethnic groups has not been determined. To compare cutaneous disease occurrence in each racial and ethnic group with the general population, data from 6,703,740 patients from the John Hopkins Hospital System were analyzed; 615,048 were diagnosed with skin disorders. Patients ≥18 years of age were included.  

Neoplastic disorders were more commonly observed in White patients, and the majority of follicular-based, alopecia, and scarring disorders were more commonly observed in Black patients and pigmentary disturbances were more commonly observed in Asian and Hispanic patients. Pruritus and several chronic pruritic dermatoses such as prurigo nodalaris and atopic dermatitis were more commonly observed in Black and Asian patients. Hidradenitis suppurativa and folliculitis decalvans were more commonly observed in Black patients. Cutaneous disorders were more commonly observed in women, whereas men presented with higher rates of neoplastic dermatoses.

Central centrifugal cicatricial alopecia most disproportionately affected Black patients ([OR], 729.03; 95% CI, 234.6-2265.43; P <.001). Mycosis fungoides was more commonly observed in Black patients whereas pityriasis alba and melasma were more commonly observed in Hispanic patients.

Limitations to this study include the inconsistent data regarding race and ethnicity and the effect of racial disparities in access to healthcare on data collection. Furthermore, the study observed patients from a single hospital system and may not be generalizable to other regions.

The study results suggest that “cutaneous disorders disproportionately affect skin of color patients,” the investigators wrote, and that “very little is known about the occurrence of skin of color dermatoses in these groups.” These findings indicated significant racial and ethnic differences in the occurrence of many dermatoses, which the researchers believe may affect preventative care measures.

Disclosure: A study author declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of author disclosures.

Reference

Khanna R, Belzberg M, Khanna R, et al. Examining the landscape of skin color dermatoses: A cross-sectional study at an urban tertiary care center. [published online August 8, 2020]. J Am Acad Dermatol. doi:10.1016/j.jaad.2020.07.124

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