The Asian patient ….., photodamage in the form of pigmentary disorders is common. Melasma, freckles, and lentigines are the epidermal disorders commonly seen, whilst nevus of Ota and acquired bilateral nevus of Ota-like macules are common dermal pigmentary disorders. Post-inflammatory hyperpigmentation (PIH) occurring after cutaneous injury remains a hallmark of skin of color.
The term Asian refers to people having origins from the Far East, southeast Asia, or the Indian subcontinent. They are a diverse group with various skin phototypes ranging from Fitzpatrick type III to V in the Chinese and Japanese to type IV and V in Indians and Pakistanis.
- Significant photodamage in the form of epidermal atypia and atrophy, dermal collagen and elastin damage, and pigmentary disorders can occur in skin of color.
- Both pigmentary changes and wrinkling can be major features of photoaging in Asians. However, moderate-to-severe wrinkling becomes apparent only at about 50 years of age, which is a decade or two later than in age-matched Caucasians.
- Other cutaneous manifestations of aging ethnic skin include the development of benign cutaneous growths such as dermatosis papulosa nigra, seborrheic keratoses, and the development of solar lentigines.
Common Skin Diseases in Asians
Cutaneous Malignancies in Skin of Color
Hypopigmented mycosis fungoides, with ill-defined, often pruritic, hypopigmented macules and patches, tends to present in a younger patient population and only in skin of color. The disorder can often be mistaken for vitiligo, pityriasis alba, tinea versicolor, or post-inflammatory hypopigmentation. Misdiagnosis can delay treatment. There is usually a good response to PUVA, UVB phototherapy, or topical mechlorethamine (chlormethine), but recurrences are common. The overall prognosis is good