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Special Considerations in Skin of Color

»	What is “skin of color”?
»	What accounts for differences in color between ethnic and racial groups?
»	Do any physiologic differences exist between black skin and that of other racial/ethnic groups?
»	Are the brown streaks on the nails of people with skin of color always a cause for concern?
»	Is pigmentation of the oral mucosa in people with skin of color invariably concerning?
»	Are there other areas of the body where hyperpigmentation represents a normal racial variant?
»	What are Futcher’s lines?
»	What causes postinflammatory hyperpigmentation?
»	What causes postinflammatory hypopigmentation?
»	Is pityriasis alba the same thing as postinflammatory hypopigmentation?
»	Is vitiligo more common in patients with darker skin?
»	Why does tinea versicolor cause hypopigmented spots on dark skin?
»	Why is it more difficult to appreciate erythema in darker skin?
»	Can any other generalizations be made about common cutaneous reaction patterns in skin of color?
»	What is the significance of multiple brown papules often seen on the periorbital area, cheeks, and nose?
»	What is cutaneous sarcoidosis?
»	What are keloids?
»	What are “razor bumps”?
»	How is pseudofolliculitis barbae treated?
»	Are there other racial differences that may affect the treatment of hair or scalp conditions in blacks?
»	Are patients with skin of color particularly susceptible to any life-threatening illnesses?
»	Do any special considerations exist when performing skin surgery on patients with skin of color?
»	Why is skin cancer less common in skin of color?
»	Are there any unique presentations of skin cancer when it does occur in patients with darker skin?
»	List skin diseases or conditions that are often considered more common in persons with skin of color.

Is pigmentation of the oral mucosa in people with skin of color invariably concerning?

No. Pigmentation of the oral mucosa is often subdivided into conditions related to melanin (including racial differences in pigmentation), and non–melanin-associated conditions, such as metabolic conditions or pigmentation related to drugs. Therefore, oral pigmentation in people with skin of color is neither uncommon, nor necessarily indicative of a serious condition. Idiopathic, racially related pigmentation of the oral mucosa often involves the gingiva, hard palate, buccal mucosa, or tongue. The color may vary, but it often has a blue or gray appearance. Symmetry is frequently observed. As always, obtaining an appropriate medical history is important, particularly with respect to the length of time present and any associated symptoms.

Meleti M, Vescovi P, Mooi WJ, van der Waal I: Pigmented lesions of the oral mucosa and perioral tissues: a flow-chart for the diagnosis and some recommendations for the management, Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105:606–616, 2008.