Skip to main content
SpringerLink
Log in

Racial and Gender Influences on Skin Disease

  • Chapter
  • First Online:
Gender and Dermatology

  • 894 Accesses

Abstract

Skin disorders are often multifactorial in nature, as both intrinsic factors such as genetics and extrinsic factors such as differing cultural practices can be implicated in disease pathogenesis. For this reason, there are a number of diseases that affect individuals with skin of color at a higher rate compared to Caucasians, and there are a number of diseases that affect males and females within these populations disproportionately. In this chapter, we discuss specific diseases that are more common in different genders and ethnicities, specifically follicular and scarring disorders and disorders of pigmentation. The follicular and scarring disorders include central centrifugal cicatricial alopecia, traction alopecia, acne keloidalis nuchae, pseudofolliculitis barbae and dissecting cellulitis. The disorders of pigmentation include nevus of Ota and melasma. Beyond exploring the clinical features, histology and treatment of these disorders, this chapter also highlights the epidemiology and pathogenesis of these diseases in an effort to explain why they may be more common in a certain ethnic group or gender.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 279.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 379.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Colby SL, Ortman JM. Projections of the size and composition of the US population: 2014 to 2060; 2015. P25-1143.

    Google Scholar 

  2. Taylor SC. Skin of color: Biology, structure, function, and implications for dermatologic disease. J Am Acad Dermatol. 2002;46(2). https://doi.org/10.1067/mjd.2002.120790.

  3. Kaidbey KH, Agin PP, Sayre RM, Kligman a M. Photoprotection by melanin—a comparison of black and Caucasian skin. J Am Acad Dermatol. 1979;1(3):249–60. https://doi.org/10.1016/S0190-9622(79)70018-1.

    Article  CAS  PubMed  Google Scholar 

  4. Zaidi Z. Skin of colour: characteristics and disease. J Pak Med Assoc. 2017;67(2):292–9.

    PubMed  Google Scholar 

  5. Montagna W, Carlisle K. The architecture of black and white facial skin. J Am Acad Dermatol. 1991;24(6):929–37. https://doi.org/10.1016/0190-9622(91)70148-U.

    Article  CAS  PubMed  Google Scholar 

  6. Lindelöf B, Forslind B, Hedblad MA, Kaveus U. Human hair form. Morphology revealed by light and scanning electron microscopy and computer aided three-dimensional reconstruction. Arch Dermatol. 1988;124(9):1359–63. https://doi.org/10.1001/archderm.1988.01670090015003.

    Article  PubMed  Google Scholar 

  7. Lewallen R, Francis S, Fisher B, et al. Hair care practices and structural evaluation of scalp and hair shaft parameters in African American and Caucasian women. J Cosmet Dermatol. 2015;14(3):216–23. https://doi.org/10.1111/jocd.12157.

    Article  PubMed  Google Scholar 

  8. Loussouarn G, Lozano I, Panhard S, Collaudin C, El Rawadi C, Genain G. Diversity in human hair growth, diameter, colour and shape. An in vivo study on young adults from 24 different ethnic groups observed in the five continents. Eur J Dermatol. 2016;26(2):144–54.

    CAS  PubMed  Google Scholar 

  9. Olsen EA, Callender V, McMichael A, et al. Central hair loss in African American women: incidence and potential risk factors. J Am Acad Dermatol. 2011;64(2):245–52. https://doi.org/10.1016/j.jaad.2009.11.693.

    Article  PubMed  Google Scholar 

  10. Davis EC, Reid SD, Callender VD, Sperling LC. Differentiating central centrifugal cicatricial alopecia and androgenetic alopecia in African American men report of three cases. J Clin Aesthet Dermatol. 2012;5(6):37–40.

    PubMed  PubMed Central  Google Scholar 

  11. Kyei A. Medical and environmental risk factors for the development of central centrifugal cicatricial alopecia. Arch Dermatol. 2011;147(8):909. https://doi.org/10.1001/archdermatol.2011.66.

    Article  PubMed  Google Scholar 

  12. Dlova NC, Jordaan FH, Sarig O, Sprecher E. Autosomal dominant inheritance of central centrifugal cicatricial alopecia in black South Africans. J Am Acad Dermatol. 2014;70(4):679–82. https://doi.org/10.1016/j.jaad.2013.11.035.

    Article  PubMed  Google Scholar 

  13. Herskovitz I, Miteva M. Central centrifugal cicatricial alopecia: challenges and solutions. Clin Cosmet Investig Dermatol. 2016;9:175–81.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Miteva M, Tosti A. Dermatoscopic features of central centrifugal cicatricial alopecia. J Am Acad Dermatol. 2014;71(3):443–9. https://doi.org/10.1016/j.jaad.2014.04.069.

    Article  PubMed  Google Scholar 

  15. Callender VD, Lawson CN, Onwudiwe OC. Hair transplantation in the surgical treatment of central centrifugal cicatricial alopecia. Dermatol Surg. 2014;40(10):1125–31. https://doi.org/10.1097/dss.0000000000000127.

    Article  CAS  PubMed  Google Scholar 

  16. Samrao A, Price VH, Zedek D, Mirmirani P. The “fringe sign” - a useful clinical finding in traction alopecia of the marginal hair line. Dermatol Online J. 2011;17(11):1.

    PubMed  Google Scholar 

  17. James J, Saladi RN, Fox JL. Traction alopecia in Sikh male patients. J Am Board Fam Med. 2007;20(5):497–8. https://doi.org/10.3122/jabfm.2007.05.070076.

    Article  PubMed  Google Scholar 

  18. Khumalo NP, Jessop S, Gumedze F, Ehrlich R. Hairdressing and the prevalence of scalp disease in African adults. Br J Dermatol. 2007;157(5):981–8. https://doi.org/10.1111/j.1365-2133.2007.08146.x.

    Article  CAS  PubMed  Google Scholar 

  19. Khumalo NP, Jessop S, Gumedze F, Ehrlich R. Determinants of marginal traction alopecia in African girls and women. J Am Acad Dermatol. 2008;59(3):432–8. https://doi.org/10.1016/j.jaad.2008.05.036.

    Article  PubMed  Google Scholar 

  20. Donovan JC, Mirmirani P. Transversely sectioned biopsies in the diagnosis of end-stage traction alopecia. Dermatol Online J. 2013;19(4):11.

    PubMed  Google Scholar 

  21. Madu P, Kundu RV. Follicular and scarring disorders in skin of color: presentation and management. Am J Clin Dermatol. 2014;15(4):307–21. https://doi.org/10.1007/s40257-014-0072-x.

    Article  PubMed  Google Scholar 

  22. Callender VD, McMichael AJ, Cohen GF. Medical and surgical therapies for alopecias in black women. Dermatol Ther. 2004;17(2):164–76. https://doi.org/10.1111/j.1396-0296.2004.04017.x.

    Article  PubMed  Google Scholar 

  23. Kundu RV, Patterson S. Dermatologic conditions in skin of color: part II. Disorders occurring predominately in skin of color. Am Fam Physician. 2013;87(12):859–65. http://www.ncbi.nlm.nih.gov/pubmed/23939568

    PubMed  Google Scholar 

  24. Knable ALJ, Hanke CW, Gonin R. Prevalence of acne keloidalis nuchae in football players. J Am Acad Dermatol. 1997;37(4):570–4. https://doi.org/10.1016/S0190-9622(97)70173-7.

    Article  PubMed  Google Scholar 

  25. Kelly AP. Pseudofolliculitis barbae and acne keloidalis nuchae. Dermatol Clin. 2003;21(4):645–53. https://doi.org/10.1016/S0733-8635(03)00079-2.

    Article  PubMed  Google Scholar 

  26. Maranda EL, Simmons BJ, Nguyen AH, Lim VM, Keri JE. Treatment of acne keloidalis nuchae: a systematic review of the literature. Dermatol Ther (Heidelb). 2016;6(3):363–78. https://doi.org/10.1007/s13555-016-0134-5.

    Article  Google Scholar 

  27. Herzberg AJ, Dinehart SM, Kerns BJ, Pollack SV. Acne keloidalis. Transverse microscopy, immunohistochemistry, and electron microscopy. Am J Dermatopathol. 1990;12(2):109–21. http://www.ncbi.nlm.nih.gov/pubmed/2331046

    Article  CAS  PubMed  Google Scholar 

  28. Sperling LC, Homoky C, Pratt L, et al. Acne keloidalis is a form of primary scarring alopecia. Arch Dermatol. 2016;136(4):479–84. https://doi.org/10.1001/archderm.136.4.479.

    Article  Google Scholar 

  29. Lee A, Cho S, Yam T, Harris K, Ardern-Jones M. Staphylococcus aureus and chronic folliculocentric pustuloses of the scalp - cause or association? Br J Dermatol. 2016;175(2):410–3.

    Article  CAS  PubMed  Google Scholar 

  30. Ogunbiyi A. Acne keloidalis nuchae: prevalence, impact, and management challenges. Clin Cosmet Investig Dermatol. 2016;14(9):483–9.

    Article  Google Scholar 

  31. Salami T, Omeife H, Samuel S. Prevalence of acne keloidalis nuchae in Nigerians. Int J Dermatol. 2007;46(5):482–4. https://doi.org/10.1111/j.1365-4632.2007.03069.x.

    Article  PubMed  Google Scholar 

  32. Alexis A, Heath CR, Halder RM. Folliculitis keloidalis nuchae and pseudofolliculitis barbae: are prevention and effective treatment within reach? Dermatol Clin. 2014;32(2):183–91. https://doi.org/10.1016/j.det.2013.12.001.

    Article  CAS  PubMed  Google Scholar 

  33. Winter H, Schissel D, Parry DAD, et al. An unusual Ala12Thr polymorphism in the 1A alpha-helical segment of the companion layer-specific keratin K6hf: evidence for a risk factor in the etiology of the common hair disorder pseudofolliculitis barbae. J Invest Dermatol. 2004;122(3):652–7. https://doi.org/10.1111/j.0022-202X.2004.22309.x.

    Article  CAS  PubMed  Google Scholar 

  34. Nguyen TA, Patel PS, Viola KV, Friedman AJ. Pseudofolliculitis barbae in women: a clinical perspective. Br J Dermatol. 2015;173(1):279–80. https://doi.org/10.1111/bjd.13644.

    Article  CAS  PubMed  Google Scholar 

  35. Gray J, McMichael AJ. Pseudofolliculitis barbae: understanding the condition and the role of facial grooming. Int J Cosmet Sci. 2016;38:24–7. https://doi.org/10.1111/ics.12331.

    Article  PubMed  Google Scholar 

  36. Conte M, Lawrence J. Pseudofolliculitis barbae. No “pseudoproblem”. JAMA. 1979;241(1):53–4.

    Article  CAS  PubMed  Google Scholar 

  37. Mundi J, Marmon S, Fischer M, Kamino H, Patel R, Shapiro J. Dissecting cellulitis of the scalp. Dermatol Online J. 2012;18(12):8.

    PubMed  Google Scholar 

  38. Badaoui A, Reygagne P, Cavelier-Balloy B, et al. Dissecting cellulitis of the scalp: a retrospective study of 51 patients and review of literature. Br J Dermatol. 2016;174(2):421–3. https://doi.org/10.1111/bjd.13999.

    Article  CAS  PubMed  Google Scholar 

  39. Powers M, Mehta D, Ozog D. Cutting out the tracts: staged excisions for dissecting cellulitis of the scalp. Dermatol Surg. 2017;43:738.

    Article  CAS  PubMed  Google Scholar 

  40. Bjellerup M, Wallengren J. Familial perifolliculitis capitis abscedens et suffodiens in two brothers successfully treated with isotretinoin. J Am Acad Dermatol. 1990;23(4 Pt 1):742–3.

    Google Scholar 

  41. Segurado-Miravalles G, Camacho-Martínez FM, Arias-Santiago S, et al. Epidemiology, clinical presentation and therapeutic approach in a multicentre series of dissecting cellulitis of the scalp. J Eur Acad Dermatol Venereol. 2016;31:e199–200. https://doi.org/10.1111/jdv.13948.

    Article  PubMed  Google Scholar 

  42. Bernárdez C, Molina-Ruiz AM, Requena L. Histologic features of alopecias: part II: scarring alopecias. Actas Dermosifiliogr. 2015;106(4):260–70. https://doi.org/10.1016/j.ad.2014.07.006.

    Article  PubMed  Google Scholar 

  43. Scerri L, Williams H, Allen B. Dissecting cellulitis of the scalp: response to isotretinoin. Br J Dermatol. 1996;134(6):1105–8.

    Article  CAS  PubMed  Google Scholar 

  44. Mansouri Y, Martin-Clavijo A, Newsome P, Kaur MR. Dissecting cellulitis of the scalp treated with tumour necrosis factor-α inhibitors: experience with two agents. Br J Dermatol. 2016;174(4):916–8. https://doi.org/10.1111/bjd.14269.

    Article  CAS  PubMed  Google Scholar 

  45. Sand FL, Thomsen SF. Off-label use of TNF-alpha inhibitors in a dermatological university department: retrospective evaluation of 118 patients. Dermatol Ther. 2015;28(3):158–65. https://doi.org/10.1111/dth.12222.

    Article  PubMed  Google Scholar 

  46. Park JM, Tsao H, Tsao S. Acquired bilateral nevus of Ota-like macules (Hori nevus): etiologic and therapeutic considerations. J Am Acad Dermatol. 2009;61(1):88–93. https://doi.org/10.1016/j.jaad.2008.10.054.

    Article  PubMed  Google Scholar 

  47. Shah VV, Bray FN, Aldahan AS, Mlacker S, Nouri K. Lasers and nevus of Ota: a comprehensive review. Lasers Med Sci. 2016;31(1):179–85. https://doi.org/10.1007/s10103-015-1834-2.

    Article  PubMed  Google Scholar 

  48. Magarasevic L, Abazi Z. Unilateral open-angle glaucoma associated with the ipsilateral nevus of ota. Case Rep Ophthalmol Med. 2013;2013:924937. https://doi.org/10.1155/2013/924937.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Saha A, Bandyopadhyay D. Nevus of Ota. Indian Pediatr. 2014;51(6):510.

    PubMed  Google Scholar 

  50. Hori Y, Kawashima M, Oohara K, Kukita A. Acquired, bilateral nevus of Ota-like macules. J Am Acad Dermatol. 1984;10(6):961–4.

    Article  CAS  PubMed  Google Scholar 

  51. Zhang Q, Tan C, Jiang P, Yang G. Clinical profile and triggering factors for acquired, bilateral nevus of Ota-like macules. Cutan Ocul Toxicol. 2017;36:327–30.

    Article  PubMed  Google Scholar 

  52. Vashi N, Kundu R. Facial hyperpigmentation: causes and treatment. Br J Dermatol. 2013;169(Suppl 3):41–56.

    Article  PubMed  Google Scholar 

  53. Teekhasaenee C, Ritch R, Rutnin U, Leelawongs N. Glaucoma in oculodermal melanocytosis. Ophthalmology. 1990;97(5):562–70.

    Article  CAS  PubMed  Google Scholar 

  54. Tse JY, Walls BE, Pomerantz H, et al. Melanoma arising in a nevus of Ito: novel genetic mutations and a review of the literature on cutaneous malignant transformation of dermal melanocytosis. J Cutan Pathol. 2016;43(1):57–63. https://doi.org/10.1111/cup.12568.

    Article  PubMed  Google Scholar 

  55. Levin MK, Ng E, Bae Y-SC, Brauer JA, Geronemus RG. Treatment of pigmentary disorders in patients with skin of color with a novel 755 nm picosecond, Q-switched ruby, and Q-switched Nd:YAG nanosecond lasers: a retrospective photographic review. Lasers Surg Med. 2016;48(2):181–7. https://doi.org/10.1002/lsm.22454.

    Article  PubMed  Google Scholar 

  56. Lee HS, Kim M, Kang HY. Recurrence of nevus of Ota after successful laser treatment: possible role of dermal stem cells. Ann Dermatol. 2016;28(5):647–9.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Handel AC, Miot LDB, Miot HA. Melasma: a clinical and epidemiological review. An Bras Dermatol. 2014;89(5):771–82. https://doi.org/10.1590/abd1806-4841.20143063.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Ishiy P, Silva L, Penha M, Handel A, Miot H. Skin diseases reported by workers from the campus of UNESP Rubião Jr, Botucatu-SP (Brazil). An Bras Dermatol. 2014;89:529–31.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Kang W, Yoon K, Lee E, Kim J, Lee K, Yim H. Melasma: histopathological characteristics in 56 Korean patients. Br J Dermatol. 2002;146:228–37.

    Article  CAS  PubMed  Google Scholar 

  60. Taylor SC. Epidemiology of skin diseases in ethnic populations. Dermatol Clin. 2003;21(4):601–7. https://doi.org/10.1016/S0733-8635(03)00075-5.

    Article  PubMed  Google Scholar 

  61. Sheth VM, Pandya AG. Melasma: a comprehensive update: part I. J Am Acad Dermatol. 2011;65(4):689–97. https://doi.org/10.1016/j.jaad.2010.12.046.

    Article  PubMed  Google Scholar 

  62. Lieberman R, Moy L. Estrogen receptor expression in melasma: results from facial skin of affected patients. J Drugs Dermatol. 2008;7:463.

    PubMed  Google Scholar 

  63. Jang YH, Lee JY, Kang HY. Oestrogen and progesterone receptor expression in melasma: an immunohistochemical analysis. J Eur Acad Dermatol Venereol. 2010;24:1312.

    Article  CAS  PubMed  Google Scholar 

  64. Yalamanchili R, Shastry V, Betkerur J. Clinico-epidemiological study and quality of life assessment in melasma. Indian J Dermatol. 2015;60(5):519.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Maymone M, Neamah H, Wirya S, Patzelt N, Zancanaro P, Vashi N. Sun-protective behaviors in patients with cutaneous hyperpigmentation: a cross-sectional study. J Am Acad Dermatol. 2017;76:841.

    Article  PubMed  Google Scholar 

  66. Rivas S, Pandya AG. Treatment of melasma with topical agents, peels and lasers: an evidence-based review. Am J Clin Dermatol. 2013;14(5):359–76. https://doi.org/10.1007/s40257-013-0038-4.

    Article  PubMed  Google Scholar 

  67. Grimes P. The safety and efficacy of salicylic acid chemical peels in darker racial-ethnic groups. Dermatol Surg. 1999;25:18.

    Article  CAS  PubMed  Google Scholar 

  68. Zhou LL, Baibergenova A. Melasma: systematic review of the systemic treatments. Int J Dermatol. 2017;56(9):902–8. https://doi.org/10.1111/ijd.13578.

    Article  PubMed  Google Scholar 

  69. Lee HC, Thng TGS, Goh CL. Oral tranexamic acid (TA) in the treatment of melasma: a retrospective analysis. J Am Acad Dermatol. 2016;75(2):385–92. https://doi.org/10.1016/j.jaad.2016.03.001.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Boston University Medical Center, Boston, MA, USA

    Daniel Callaghan

  2. Dermatology, Boston University Center for Ethnic Skin, Boston University School of Medicine, Boston, MA, USA

    Neelam A. Vashi

Authors
  1. Daniel Callaghan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Neelam A. Vashi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Neelam A. Vashi .

Editor information

Editors and Affiliations

  1. Tel Aviv University, Tel Aviv, Israel

    Ethel Tur

  2. Department of Dermatology, UCSF Medical Center, San Francisco, California, USA

    Howard I. Maibach

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Callaghan, D., Vashi, N.A. (2018). Racial and Gender Influences on Skin Disease. In: Tur, E., Maibach, H. (eds) Gender and Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-72156-9_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-72156-9_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-72155-2

  • Online ISBN: 978-3-319-72156-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation