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Alchorne MMDA, Conceição KDC, Barraza LL, Milanez Morgado de Abreu MA. Dermatology in black skin. An Bras Dermatol 2024; 99:327-341. [PMID: 38310012 DOI: 10.1016/j.abd.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/25/2023] [Accepted: 10/17/2023] [Indexed: 02/05/2024] Open
Abstract
The vast majority of publications in dermatology refer to lightly pigmented skin, with few addressing the peculiarities of black skin. In addition there is no consensus on what it means to be black in different regions of the world. The lack of knowledge on the subject makes it difficult to recognize and manage dermatoses in this type of skin. This article aims to review the literature on intrinsic characteristics, as well as epidemiological and clinical aspects of the cutaneous manifestations of different dermatoses in black skin. It was found that there are sometimes striking differences, in the structural, biological, and functional aspects when comparing lightly pigmented and black skin. There are also physiological changes that need to be recognized to avoid unnecessary interventions. Some dermatoses have a higher incidence in black skin, such as acne, eczema, dyschromia and dermatophytosis. On the other hand, several dermatoses are more specific to black skin, such as pseudofolliculitis barbae, keloid, dermatosis papulosa nigra, ulcers caused by sickle-cell anemia, dactylolysis spontanea, confluent and reticulated papillomatosis of Gougerot and Carteaud, and some diseases of the hair and scalp (including fragile and brittle hair, traction alopecia, folliculitis keloidalis nuchae, folliculitis dissecans and central centrifugal cicatricial alopecia). A spectrum of peculiar aspects of specific dermatoses, including sarcoidosis, lichen planus (with emphasis on the pigmentosus variant), psoriasis, lupus erythematosus, vitiligo, syphilis, pityriasis versicolor, and neoplasms are highlighted. In the latter, characteristics of basal cell carcinoma, squamous cell carcinoma, and melanoma are compared, in addition to highlighting unusual aspects of primary cutaneous T-cell lymphoma, endemic Kaposi sarcoma, and dermatofibrosarcoma protuberans.
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Affiliation(s)
| | | | - Leonardo Lora Barraza
- Department of Dermatology, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Geisler AN, Taye M, Larrondo J, Mayo TT, Aguh C, McMichael A, MacKelfresh JB, Krueger L. Updates on disorders in curly hair. Int J Dermatol 2024. [PMID: 38622785 DOI: 10.1111/ijd.17184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/17/2024]
Abstract
Hair disorders, including central centrifugal cicatricial alopecia (CCCA), traction alopecia (TA), and acquired trichorrhexis nodosa (ATN), commonly occur in individuals with curly textured hair. Curly textured hair in individuals of African descent has unique properties and can present diagnostic and therapeutic challenges. CCCA has been linked to uterine leiomyoma and type 2 diabetes mellitus, as well as fibroproliferation. TA often presents with a fringe sign and can arise from high-tension hairstyles presumed to be protective. Trichoscopy is useful in establishing a diagnosis; perifollicular halos are more commonly seen than perifollicular erythema or scale in CCCA. In TA, miniaturized follicles, hair casts, and "flambeau sign" can be seen. Hairstyling practices likely contribute to TA and ATN; however, the data are mixed on the role of chemical relaxers and heat styling in CCCA. Unique considerations in the presentation of frontal fibrosing alopecia in curly textured hair have also been published recently. This review provides a comprehensive, up-to-date summary of these disorders with an emphasis on their unique properties, as well as considerations in hair care for curly textured hair.
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Affiliation(s)
- Amaris N Geisler
- Department of Dermatology, Emory University School of Medicine, Atlanta, USA
| | - Marta Taye
- Department of Dermatology, Emory University School of Medicine, Atlanta, USA
| | - Jorge Larrondo
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Tiffany T Mayo
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, USA
| | - Crystal Aguh
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, USA
| | - Amy McMichael
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Jamie B MacKelfresh
- Department of Dermatology, Emory University School of Medicine, Atlanta, USA
| | - Loren Krueger
- Department of Dermatology, Emory University School of Medicine, Atlanta, USA
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Sharquie KE, Schwartz RA, Aljanabi WK, Janniger CK. Traction Alopecia: Clinical and Cultural Patterns. Indian J Dermatol 2021; 66:445. [PMID: 34759419 PMCID: PMC8530059 DOI: 10.4103/ijd.ijd_648_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Traction alopecia is common and preventable but frequently overlooked disorder. Objective: To evaluate patients with traction alopecia. Patients and Methods: This study was conducted at the Dermatology Center, Medical City, Baghdad, Iraq, during the period from November 2005 to October 2019. Demographic features like age, gender, disease duration and special hair styling practices and accessories were recorded. Clinical patterns were studied. Results: Thirty female patients were included in this study. Their ages ranged from 6 to 47 years with mean age ± SD was 15.63 ± 9.806. Twenty-one (70%) were below the age of 16 years. No patient had tightly curled hair. All cases were asymptomatic apart from hair loss. The fringe sign was observed in 27 (90%) of cases. The response to therapy was poor. Conclusion: Traction alopecia is an important type of pressure-induced hair loss evident in children and adults with or without curly hair due mainly due to cultural hair styling practices with its frequency apparently increasing in recent years. The fringe sign is common and of diagnostic importance. It is a preventable form of hair loss which can be reversed if diagnosed early; otherwise, permanent scarring alopecia results. It represents a pressure phenomenon evident worldwide in both non-Sub-Saharan lineage and Sub-Saharan lineage individuals.
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Affiliation(s)
- Khalifa E Sharquie
- Department Dermatology, University of Baghdad College of Medicine, Baghdad, Iraq and Iraqi and Arab Board for Dermatology and Venereology, Iraq
| | - Robert A Schwartz
- Dermatology, Pathology, and Pediatrics, Rutgers New Jersey Medical School, Newark, New Jersey, US
| | | | - Camila K Janniger
- Dermatology and Pediatrics, Rutgers New Jersey Medical School, Newark, New Jersey, US
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Mitchell KN, Tay YK, Heath CR, Trachtman R, Silverberg NB. Review article: Emerging issues in pediatric skin of color, part 1. Pediatr Dermatol 2021; 38 Suppl 2:20-29. [PMID: 34664330 DOI: 10.1111/pde.14775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Dermatology for the pediatric skin of color population is the application of dermatology to the genetically diverse and distinctive segment of the pediatric population that includes children of non-White racial and ethnic groups with increased pigmentation including individuals of Asian, LatinX, African, Native American, Pacific Island descent, Indigenous Peoples, among others, with overlap in particular individuals, and mixtures thereof. Treating children of color is a unique skill set within the field of pediatric dermatology, requiring knowledge and sensitivity. The discipline of pediatric skin of color can be challenging. Difficulty in diagnosis of common conditions stems from underlying pigmentation, variations in common hairstyling practices, and differences in demographics of cutaneous disease, whereas some conditions are more common in children of color, other conditions have nuances in clinical appearance and/or therapeutics with regard to skin color. This article is the first in a series of two articles looking at recently published skin-related issues of high concern in children of color. Conditions reviewed in Part 1 include (1) hairstyling hair-related concerns (traction alopecia, central centrifugal cicatricial alopecia, endocrine disruption), (2) autoimmune concerns (cutaneous lupus, vitiligo), and (3) infections (tinea capitis, progressive macular hypomelanosis).
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Affiliation(s)
- Krystal N Mitchell
- Department of Dermatology, Icahn School of Medicine at Mt Sinai, New York, New York, USA
| | - Yong Kwang Tay
- Department of Dermatology, Changi General Hospital, Singapore, Singapore
| | - Candrice R Heath
- Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Rebecca Trachtman
- Department of Pediatrics, Division of Pediatric Rheumatology, Icahn School of Medicine at Mt Sinai, New York, New York, USA
| | - Nanette B Silverberg
- Department of Dermatology, Icahn School of Medicine at Mt Sinai, New York, New York, USA
- Department of Pediatrics, Icahn School of Medicine at Mt Sinai, New York, New York, USA
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Das A, Toshniwal A, Madke B. Newer Signs in Dermatology [2016-2020]. Indian Dermatol Online J 2021; 12:342-345. [PMID: 33959541 PMCID: PMC8088181 DOI: 10.4103/idoj.idoj_214_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/04/2020] [Accepted: 06/28/2020] [Indexed: 11/06/2022] Open
Affiliation(s)
- Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Anand Toshniwal
- Consultant Dermatologist, Aesthetic Aura Skin and Hair Clinic, Hyderabad, Telangana, India
| | - Bhushan Madke
- Department of Dermatology, Venereology and Leprosy, Jawahar Lal Medical College and Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India
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Molamodi K, Fajuyigbe D, Sewraj P, Gichuri J, Sijako B, Galliano A, Laurent A. Quantifying the impact of braiding and combing on the integrity of natural African hair. Int J Cosmet Sci 2021; 43:321-331. [PMID: 33605448 DOI: 10.1111/ics.12699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/16/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Afro hair breakage is most commonly attributed to grooming practices such as braiding, hair extensions and weaves, both for chemically treated hair and natural Afro hair. These grooming practices are also frequently associated with traction alopecia in clinical studies. However, there is little to no quantitative scientific data on the surface and internal hair fibre damage caused by grooming, including combing, on Afro hair. METHODS Qualitative and quantitative techniques such as scanning electron microscopy, cuticle cohesion and tensile testing were used to determine the effects of frequent braiding on the integrity of female Afro hair in 15 frequent braiders and 15 occasional braiders (control group) in Johannesburg, South Africa. Frequent braiders were women who braided more than 8 times per year, while occasional braiders typically limit braiding to only twice 2 per year. The severity of traction alopecia was quantified in both groups using the standard Marginal Traction Alopecia Scoring system. Surface damage on naturally curly Afro hair, that was combed but not braided, was assessed as another hairstyle option. RESULTS All measurements showed a relationship between surface and internal hair fibre damage and braiding frequency. Frequent braiders had thinner hair, with more cuticle damage as shown by SEM and cuticle cohesion assessments. Their hair fibres were also significantly weaker (p < 0.05), as shown by the tensile testing. In addition, they also had higher traction alopecia severity scores. In the combing impact assessment, a linear trend was observed between surface hair fibre damage and the number of combing strokes. Cuticle damage from 480 combing strokes was more severe than that from frequent braiding. CONCLUSION Frequent braiding and combing damage natural Afro hair. Quantification of damage caused by different grooming practices identifies a need to develop products that could help mitigate specific hair damage associated with grooming practices. The degree of damage and subsequent hair loss could also be minimized by education on best braiding practices to protect the hair fibre and avoid hair follicle miniaturization caused by high traction hairstyles.
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Affiliation(s)
| | | | - Poonam Sewraj
- L'Oreal Research and Innovation, Johannesburg, South Africa
| | - Julia Gichuri
- L'Oreal Research and Innovation, Johannesburg, South Africa
| | - Babalwa Sijako
- L'Oreal Research and Innovation, Johannesburg, South Africa
| | | | - Alice Laurent
- L'Oreal Research and Innovation, Johannesburg, South Africa
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Goren A, Wei L, Tan Y, Kovacevic M, McCoy J, Lotti T. Frontal pattern hair loss among Chinese women is frequently associated with ponytail hairstyle. Dermatol Ther 2018; 32:e12784. [PMID: 30458063 DOI: 10.1111/dth.12784] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 11/18/2018] [Accepted: 11/18/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Andy Goren
- University of Rome (“G. Marconi”); Rome Italy
- Hairmore Hospital Beijing; Beijing China
| | - Liu Wei
- The General Hospital of Air Force, PLA; Beijing China
| | - Yimei Tan
- Skin & Cosmetic Research Department; Shanghai Skin Disease Hospital; Shanghai China
| | - Maja Kovacevic
- Department of Dermatovenereology; "Sestre Milosrdnice" University Hospital Centre; Zagreb Croatia
| | - John McCoy
- Applied Biology, Inc.; Irvine California
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