As simple as black and white?
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Black or African American↗
Biomedical subjects
Susan C Taylor
Publications and source records attributed to Susan C Taylor.
Postinflammatory hyperpigmentation: evolving combination treatment strategies.
Postinflammatory hyperpigmentation (PIH) is a common acquired excess of pigment in the epidermal and/or dermal layers of the skin. Lesions persist for extended periods if untreated, thus therapy is warranted. Topical monotherapies include the standard bleaching agent hydroquinone (HQ) as well as retinoids. Recently, several fixed-dose combination products were introduced to the armamentarium: HQ 4%-retinol 0.15% in a microsponge formulation; HQ 4%-retinol 0.3%; mequinol 2%-tretinoin (RA) 0.01%; and fluocinolone acetonide (FA) 0.01%, HQ 4%, and RA 0.05%. Recent findings have suggested that mequinol 2%-RA 0.01% solution is a promising alternative for the treatment of PIH.
Adolescent↗
Enhancing the care and treatment of skin of color, part 1: The broad scope of pigmentary disorders.
Scientific research and technologies related to skin pigmentation and dyschromias, which are often key skin concerns for patients of color, have led to recent developments in skin care and treatment. Differences and similarities between skin of color and white skin and current issues in the treatment of ethnic skin are reviewed. Recent research findings, such as the elucidation of the protease-activated receptor 2 (PAR-2) pathway and its role in pigmentation, and areas for further investigation, such as the pathogenesis of pseudofolliculitis barbae (PFB), also are discussed. Awareness of this information within the wider community of dermatologists, primary healthcare providers, and the media will help to accomplish the objective of stimulating new prospective research.
Humans↗
The Taylor Hyperpigmentation Scale: a new visual assessment tool for the evaluation of skin color and pigmentation.
The Taylor Hyperpigmentation Scale is a new visual scale developed to provide an inexpensive and convenient method to assess skin color and monitor the improvement of hyperpigmentation following therapy. The tool consists of 15 uniquely colored plastic cards spanning the full range of skin hues and is applicable to individuals with Fitzpatrick skin types I to VI. Each card contains 10 bands of increasingly darker gradations of skin hue that represent progressive levels of hyperpigmentation. This article describes the ongoing development of the Taylor Hyperpigmentation Scale and reports the results of a recent validation study of the use of this newly developed chart in individuals with skin of color. In the study, skin color and an area of hyperpigmentation in 30 subjects of white, African American, Asian, or Hispanic ancestry (approximately 5 from each of the 6 skin types) were evaluated by 10 investigators. The results of the study revealed significant variation among intraindividual and interindividual ratings by investigators of skin hue (P < .0001) and hyperpigmentation (P = .0008); however, most investigators rated the scale as useful and easy to use, and 60% stated they would use it in clinical practice to document the response of hyperpigmentation to therapeutic agents. A heuristic evaluation of the results of this study provided insight into essential considerations for the continued effort to develop a useful and simple scale for assessing skin color and pigmentation.
Adult↗
Acne and your pediatric patient: a roundtable discussion of treatment modalities and other factors.
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Acne Vulgaris↗
Enhancing the care and treatment of skin of color, part 2: understanding skin physiology.
Cutaneous diseases in patients with skin of color frequently present differently than in individuals with white skin. Increased understanding of skin physiology including skin lipids and barrier function, as well as documentation of common issues such as ashy skin, has been the focus of researchers. New insights into the effects of UV radiation in skin of color and the increasing incidence of malignant melanoma heighten awareness of the need for new initiatives directed at education and further research, despite previous views about photoprotection for this population.
Black People↗
Topical antimicrobial agents in dermatology.
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Administration, Topical↗
Epidemiology of skin diseases in ethnic populations.
The spectrum of cutaneous disease occurring in ethnic populations is as broad and diverse as the ethnic populations themselves. Many skin diseases are seemingly common to most of the ethnic populations, however, including blacks, Hispanics, Asians, and Native Americans. These diseases include acne vulgaris; pigmentary disorders; eczematous dermatitis; and infection caused by bacteria, fungi, and viruses. Diseases of a more cosmetic nature have emerged over recent years and include the pigmentary disorders melasma and postinflammatory pigmentation, acne keloidalis nuchae, scalp and facial folliculitis, keloidal scarring, alopecia, and photoaging. The identification of cutaneous diseases affecting the rapidly increasing ethnic populations serves to focus resources both research and clinical in these areas.
Adult↗
Epidemiology of skin diseases in people of color.
The epidemiology of skin diseases in people of color has not been extensively studied. Many skin diseases (eg, acne vulgaris; eczematous dermatitis; infections caused by bacteria, fungi, or viruses) are common to most people of color--blacks, Asians, Hispanics/Latinos, and Native Americans. Diseases of more cosmetic concern (eg, melasma, postinflammatory pigmentation, acne keloidalis nuchae, scalp and facial folliculitis, keloids, alopecias) occur more in skin of color than in white skin.
Asian People↗
Efficacy and safety of a new triple-combination agent for the treatment of facial melasma.
Treatment of melasma, a hyperpigmentation disorder, remains a challenge. The primary objective of two 8-week, multicenter, randomized, investigator-blind studies was to compare the efficacy and safety of a hydrophilic cream formulation containing tretinoin 0.05%, hydroquinone 4.0%, and fluocinolone acetonide 0.01% (RA+HQ+FA) with the dual-combination agents tretinoin plus hydroquinone (RA+HQ), tretinoin plus fluocinolone acetonide (RA+FA), and hydroquinone plus fluocinolone acetonide (HQ+FA). All agents had the same drug concentration and vehicle. A total of 641 adult patients, predominantly female, with moderate to severe melasma and Fitzpatrick skin types I through IV, were randomized to the various treatment groups. Due to the similarity of the study designs, the results of the 2 studies were combined and are reported here. The primary efficacy analysis involved the proportion of intent-to-treat patients in each treatment group whose condition had completely cleared by week 8. The results of the combined clinical trials demonstrated that significantly more of the patients treated with RA+HQ+FA (26.1%) experienced complete clearing compared with the other treatment groups (4.6%) at the end of week 8 (P<.0001). In addition, at week 8, a 75% reduction in melasma/pigmentation was observed in more than 70% of patients treated with RA+HQ+FA compared with 30% in patients treated with the dual-combination agents. The most common adverse reactions seen with all treatment groups were erythema, skin peeling, burning, and/or stinging sensation. The majority of treatment-related adverse events were of mild severity.
Administration, Topical↗
Keloidal scars: a review with a critical look at therapeutic options.
Keloidal scars are abnormal scars of uncertain etiology with a predilection for certain racial groups. Although many articles have been published on the management of these scars, there are no definitive treatment protocols. Our objective was to examine the scientific quality of the literature on therapy for keloidal scars. There are many problems with the study designs of existing keloidal scar research. These include lack of consistent disease definitions and outcome measures, inadequate follow-up, and inconsistent therapeutic interventions. Suggestions are given for future studies.
Cicatrix, Hypertrophic↗
Defining pseudofolliculitis barbae in 2001: a review of the literature and current trends.
Pseudofolliculitis barbae (PFB) is a chronic inflammatory and potentially disfiguring condition most often seen in men and women of African American and Hispanic origin who have tightly curled hair and who shave or tweeze hairs frequently. The etiology is multifactorial. The shape of the hair follicle, hair cuticle, and the direction of hair growth each play a role in the inflammatory response once the hair is shaven or plucked and left to grow. This reaction often produces painful, pruritic, and sometimes hyperpigmented papules in the beard distribution. The result is an unappealing cosmetic appearance, often with emotionally distressing consequences for affected individuals. The diagnosis is made clinically. Currently, prevention and early intervention are the mainstays of therapy. Many treatment options are available; however, none has been completely curative. In this review, the history, incidence, pathogenesis, clinical manifestations, dermatopathology, prevention, and treatment of PFB, including the most current surgical options, will be discussed. In addition, new data on patients with PFB from the Skin of Color Center will be presented.
Black People↗
Skin of color: biology, structure, function, and implications for dermatologic disease.
People with skin of color constitute a wide range of racial and ethnic groups-including Africans, African Americans, African Caribbeans, Chinese and Japanese, Native American Navajo Indians, and certain groups of fair-skinned persons (eg, Indians, Pakistanis, Arabs), and Hispanics. It has been predicted that people with skin of color will constitute a majority of the United States and international populations in the 21st century. There is not a wealth of data on racial and ethnic differences in skin and hair structure, physiology, and function. What studies do exist involve small patient populations and often have methodologic flaws. Consequently, few definitive conclusions can be made. The literature does support a racial differential in epidermal melanin content and melanosome dispersion in people of color compared with fair-skinned persons. Other studies have demonstrated differences in hair structure and fibroblast size and structure between black and fair-skinned persons. These differences could at least in part account for the lower incidence of skin cancer in certain people of color compared with fair-skinned persons; a lower incidence and different presentation of photo aging; pigmentation disorders in people with skin of color; and a higher incidence of certain types of alopecia in Africans and African Americans compared with those of other ancestry. However, biologic or genetic factors are not the only ones impacting on these differences in dermatologic disorders. Cultural practices also can have a significant impact. Further studies are needed to help dermatologists optimally treat people with skin of color.
Humans↗
Acne vulgaris in skin of color.
In the 21st century, individuals with skin of color, including those of Hispanic, Asian, and African American descent, will account for more than half of the US population. Consequently, those individuals will constitute a significant patient population for the dermatology community. Dermatologists in major metropolitan centers as well as those in rural communities need to meet the diagnostic and therapeutic challenges posed by these patients by becoming familiar with dermatologic disease prevalence and presentation in skin of color. Commonly occurring cutaneous diseases, such as acne vulgaris, display histological and clinical differences in people with skin of color compared with Caucasians (whites). Additionally, the response to therapeutic agents may vary in people with skin of color. This article reviews data derived from a survey of skin of color patients with acne vulgaris seen at the Skin of Color Center, Department of Dermatology, St. Luke's-Roosevelt Hospital, in New York City. This information should help clinicians in their diagnosis and treatment of acne vulgaris for these patients.
Female↗
The effect of race and ethnicity on patch test results.
BACKGROUND: Allergic contact dermatitis is a condition that may be affected by differences in genetic and environmental factors. Race and ethnicity are possible examples of the former. OBJECTIVE: The objective of this study was to examine the differences in patch test results between white and black individuals tested by the members of the North American Contact Dermatitis Group from July 1, 1992, to June 30, 1998. METHODS: Patients evaluated in our patch test clinics were exposed to a standardized patch testing technique involving a standard series of 41 allergens in total. The standard series we used varied over the 6 years of the study in 2-year cycles. The series was the same at all centers during each of these 2-year cycles: 1992-94, 1994-96, and 1996-98. Over a 6-year period, our group tested 9624 patients. Of those individuals, 8610 (89.5%) were white and 1014 (10.5%) were black. RESULTS: Allergic contact dermatitis and irritant contact dermatitis were the final diagnoses assigned by the investigators to individuals of the 2 races: 49% and 16%, respectively, for the white patients and 46% and 15%, respectively, for the black patients. In at least one of the three 2-year periods, testing in white patients revealed higher rates of sensitization to formaldehyde, glutaraldehyde, and a number of the formaldehyde-releasing preservatives, as well as lanolin, epoxy resin, thioureas, and balsam of Peru. Black patients exhibited higher rates of sensitization to para-phenylenediamine, cobalt chloride, thioureas, and p-tert-butylphenol formaldehyde resin in at least one of the 2-year periods. CONCLUSION: In this test population, we found no differences in the overall response rate to allergens. There were some differences between white and black patients in their response to specific allergens. These differences, although possibly related to genetic factors based on race, are more likely related to differences in allergen exposure determined by ethnicity.
Allergens↗
Health disparities in arthritis and musculoskeletal and skin diseases-the dermatology session: National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, Maryland, December 15-16, 2000.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases hosted a diverse group of physicians and scientists to discuss health disparities in arthritis, musculoskeletal, and skin diseases. This article discusses the cutaneous disease portion of the conference. Speakers described a history of scarce information on cutaneous diseases in skin of color, problems with the data that do exist, and inappropriate use of dermatologic data. Basic descriptive data on the structure and function of skin in people of color is needed. For specific cutaneous diseases, information must be collected on their epidemiology, clinical presentation, natural history, complications, and therapeutics. Researchers are standardizing methods for studying keloidal scars, and are developing and validating measurement tools for cutaneous diseases in skin of color, such as atypical nevi, psoriasis, and hand dermatitis, but more is needed.
Acne Vulgaris↗
Defining skin of color.
In the past few years, increasing attention has been given to skin disease in individuals with skin of color (also termed ethnic skin, racial skin, black skin, or pigmented skin). We will attempt to identify those individuals with skin of color. We use this article as an introduction to a recurring series that will address cutaneous disease affecting these individuals.
Humans↗
Topical antimicrobial agents in dermatology.
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Administration, Cutaneous↗