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A study published in the Journal of Cosmetic Dermatology examined the use of camouflage in individuals with vitiligo, a condition characterized by depigmented areas on the skin. The study found that almost half of the respondents used some form of camouflage, such as makeup or medical tattoos, to conceal their vitiligo. The study also found that age, gender, and race/ethnicity influenced the use of camouflage. The findings suggest that patient education and the use of camouflage can improve the quality of life for individuals with vitiligo, especially those with skin of color. The study highlights the challenges faced by users in finding the correct shade and emphasizes the need for increased patient education and discussions with dermatologists about camouflage options, particularly for younger individuals and those from socially marginalized groups. [Extracted from the article]

The extent to which the Ultraviolet (UV) index is associated with the prevalence of melanoma and keratinocyte cancer in the United States is not clear. We conducted a cross-sectional study using the Center for Disease Control and Prevention's (CDC) 2019 Behavioral Risk Factor Surveillance System (BRFSS) telephone interview survey to investigate the epidemiology of skin cancer in the US including age, household income, education, and marital and employment status. Of non-Hispanic white respondents, 9.6% (N = 29,925) reported a being told of a skin cancer diagnosis. The prevalence of skin cancer was significantly higher in high UV (> / = 8) states (11.8%, N = 36,575) than in medium UV (6–7) (9.0%, N = 27,812) and lower UV (< / = 5) (7.8%, N = 24,083) states (p <.0001). Respondents from a medium UV or high UV state had higher odds (1.21 [1.15–2.27], 1.55[1.47–1.63], respectively) of reporting a skin cancer diagnosis than those from a low UV state. The association of UV index with lifetime skin cancer prevalence reinforces the importance of educating patients on preventive practices such as avoidance of tanning beds and usage of UV protection with clothing and sunscreen. [ABSTRACT FROM AUTHOR]

Vitiligo is characterized by progressive loss of skin pigmentation. The search for aetiologic factors has led to the biochemical, the neurologic and the autoimmune theory. The convergence theory was then proposed several years ago to incorporate existing theories of vitiligo development into a single overview of vitiligo aetiology. The viewpoint that vitiligo is not caused only by predisposing mutations, or only by melanocytes responding to chemical/radiation exposure, or only by hyperreactive T cells, but rather results from a combination of aetiologic factors that impact melanocyte viability, has certainly stood the test of time. New findings have since informed the description of progressive depigmentation. Understanding the relative importance of such aetiologic factors combined with a careful selection of the most targetable pathways will continue to drive the next phase in vitiligo research: the development of effective therapeutics. In that arena, it is likewise important to acknowledge that pathways affected in some patients may not be altered in others. Taken together, the convergence theory continues to provide a comprehensive viewpoint of vitiligo aetiology. The theory serves to intertwine aetiologic pathways and will help to define pathways amenable to disease intervention in individual patients. [ABSTRACT FROM AUTHOR]

Foundational academic medical texts facilitate foundational understanding of disease recognition in medical students. Significant underrepresentation of darker skin tones and overrepresentation of lighter skin tones in dermatologic texts, general medical texts, and scientific literature is observed. This compromises the clinical tools of trainees when it comes to darker skin tones. Text publishers and editors are steadily beginning to address these disparities, but bottom-up change from trainees is necessary to comprehensively address this issue. In this article the authors propose institutional review panels as a framework for building awareness of underrepresentation of darker skin tones and ensuring that faculty intentionally share diverse presentations in didactics. They also propose trainee engagement in building diverse medical image libraries and including texts on skin of color in institutional libraries. Empowering trainees to be advocates and call out any implicit or explicit biases in image selection can engender change in this area of medical education. [ABSTRACT FROM AUTHOR]

Vitiligo is characterized by skin depigmentation, which can lead to profound psychological effects and decreased quality of life, especially for those with skin of color. Individuals with vitiligo may utilize complementary and alternative medicine (CAM) due to limited treatment options with varying efficacy. An anonymous, multiple-choice, cross-sectional questionnaire was distributed to participants with vitiligo in the United States through online forums. Data on disease characteristics, use of prescription medications, use of topical therapies, supplements, and diets, and perceptions of CAM were collected. In total, 625 respondents completed the survey. Overall, 32.5% of participants (203/625) have tried CAM. Commonly reported CAM include supplements of vitamin D (57.7%, 116/203), vitamin B12 (46.3%, 93/203), vitamin C (27.4%, 55/203), topical Nigella sativa oil (26.4%, 53/203), oral omega-3 fatty acids (24.9%, 50/203), folic acid (22.9%, 46/203), and vitamin E (22.9%, 46/203). Frequently cited reasons for CAM use include desire to try “new” (40.4%, 82/203) or “more natural” (26.6%, 54/203) therapies, “frustration with conventional medicine” (24.6%, 50/203), and fear of “adverse side effects of conventional medicine” (23.6%, 48/203). Non-White participants were more likely than their White counterparts to report CAM use and have more positive perceptions of CAM therapies. Less than half (43.3%, 88/203) of CAM users reported that they disclosed their use of CAM with their physician. Dermatologists should be mindful of CAM and ask patients about their use. Further investigation of the role of CAM as adjuvant therapy for vitiligo is warranted to better advise patients. [ABSTRACT FROM AUTHOR]

Foundational academic medical texts facilitate foundational understanding of disease recognition in medical students. Significant underrepresentation of darker skin tones and overrepresentation of lighter skin tones in dermatologic texts, general medical texts, and scientific literature is observed. This compromises the clinical tools of trainees when it comes to darker skin tones. Text publishers and editors are steadily beginning to address these disparities, but bottom-up change from trainees is necessary to comprehensively address this issue. In this article the authors propose institutional review panels as a framework for building awareness of underrepresentation of darker skin tones and ensuring that faculty intentionally share diverse presentations in didactics. They also propose trainee engagement in building diverse medical image libraries and including texts on skin of color in institutional libraries. Empowering trainees to be advocates and call out any implicit or explicit biases in image selection can engender change in this area of medical education. [ABSTRACT FROM AUTHOR]

Although Asian cultural practices, such as acupuncture and threading, are widely used, there is limited medical literature describing their cutaneous effects and complications. This review briefly describes therapeutic cultural practices (traditional Chinese medicine, acupuncture, cupping, moxibustion, coining, Ayurveda, and aromatherapy) and cosmetic cultural practices (hair oils, henna, bindis, saris, and threading), with particular attention to dermatoses secondary to these practices. Traditional Chinese medicine and Ayurveda may cause heavy metal toxicity, severe cutaneous adverse reactions, and contact dermatitis. Cupping, moxibustion, and coining lead to dermatoses that may be mistaken for abuse by people unfamiliar with the practices. Hair oils may cause contact dermatitis and folliculitis. Paraphenylenediamine in black henna and bindi dyes and adhesives can cause severe allergic contact dermatitis. The drawstring in saris causes frictional irritation, which can lead to tinea corporis, koebnerization, and even squamous cell carcinoma. Threading may cause folliculitis, impetigo, and verrucae. The increasing prevalence of Asian cultural practices, which are performed inside and outside of Asia in this era of globalization, demands that dermatologists be familiar with the secondary dermatoses that may develop. [ABSTRACT FROM AUTHOR]

BACKGROUND There is a lack of randomized split-face studies investigating treatments for dermatosis papulosa nigra (DPN) in dark skin. OBJECTIVE To compare the efficacy, safety, and tolerability of potassium-titanyl-phosphate (KTP) laser with efficacy, safety, and tolerability of electrodesiccation in the treatment of DPN in subjects with Fitzpatrick skin phototypes IV to VI. METHODS Fourteen subjects with Fitzpatrick skin phototypes IV to VI were randomized to receive two KTP laser treatments 4 weeks apart to half of the face. The contralateral half received two electrodesiccation treatments 4 weeks apart. Response was evaluated by photography reviewed by blinded dermatologists at 4 weeks after the second treatment. A treatment quality questionnaire about side effects and cosmetic outcome was also administered. RESULTS Difference in improvement of DPN between the KTP side and the electrodesiccation side per each rater ( p=.99, p=.54) and per raters combined ( p=.50) did not reach statistical significance. There was no treatment difference for subjective effectiveness ( p=.06) or subjective confidence improvement ( p=.99), although there was a significant treatment difference for subjective discomfort ( p=.002) in favor of KTP. Both treatments were well tolerated without significant adverse effects. CONCLUSIONS Although treatment of DPN with KTP laser and electrodesiccation are comparable in efficacy, KTP laser is preferable for patient comfort. [ABSTRACT FROM AUTHOR]

Congenital hemihypertrophy is an uncommon condition of unknown etiology characterized by unilateral overgrowth of part or all of one side of the body. Hemihypertrophy is known to be associated with certain childhood tumors, most notably Wilms tumor (or nephroblastoma), and for this reason infants with hemihypertrophy are often followed with serial abdominal ultrasounds. Klippel–Trénaunay syndrome (KTS) is the triad of port-wine stain, venous varicosities, and soft tissue and/or bony hypertrophy. Children with KTS typically have localized rather than generalized hemihypertrophy, but occasionally the hypertrophy is more extensive than the vascular anomaly itself. Information is lacking about whether hemihypertrophy in this setting can also be a risk factor for Wilms tumor. We systematically reviewed the medical literature to determine whether well-documented cases of Wilms tumor in the setting of both hemihypertrophy and vascular anomalies have been described, and if found, whether the association was sufficiently frequent that routine screening for Wilms tumor in this setting should be recommended. A review of case reports and case series in the pediatric population was undertaken using specific inclusion and exclusion criteria. We found 4 of 58 subjects with hemihypertrophy and Wilms tumor had a reported vascular anomaly, but in only one case was a clear-cut diagnosis of KTS confirmed. The relationship of the other three vascular anomalies reported was of uncertain significance. In conclusion, our review suggests that the risk of Wilms tumor in the setting of localized soft-tissue hypertrophy in conjunction with a vascular malformation is quite low. More extensive hemihypertrophy extending to body sites remote from the vascular malformation itself could have a higher risk of Wilms tumor, although the magnitude of this risk is uncertain. Our findings suggest that routine serial abdominal ultrasounds in patients with vascular malformations in association with localized soft-tissue hypertrophy are unwarranted. [ABSTRACT FROM AUTHOR]

Background: Sunscreen use is an important modifiable behavior to protect against skin cancer, photoaging, and sunburn. Product costs and characteristics may influence accessibility and usage of sunscreen. This study aims to determine preferences for sunscreen attributes and willingness to pay (WTP) for an ideal sunscreen product. Methods: Adult volunteers 18 years or older were contacted on ResearchMatch. Of 670 responses, 489 surveys were completed and 2 were excluded based on the inclusion criterion. Online survey responses were collected in REDCap from July–September 2019. The online survey queried sunscreen attribute preferences and then respondent preferences were compiled into individualized descriptions of ideal products. Respondents were then asked to make purchasing decisions on these products. WTP was determined by analyzing product attributes and purchasing decisions. Attribute preferences were reported as numerical ratings of Importance and Desirability. WTP was calculated by linear regression of purchasing decision data. Qualitative comments about sunscreen preferences were also collected. Results: The study involved 487 participants aged 18–85 years (mean 43.6, SD 15.7) and 84.4% (N = 411) female. The most popular attributes included complete prevention of skin cancer and sunburn. WTP for an ideal product was $30.10 ± 2.11 for one month of use. Conclusions: Consumers provide high values in WTP for sunscreen. Dermatologists should consider cost and variability in attribute preferences when recommending sunscreens to patients. Further study is required to determine the effects, if any, of cost and attributes on adherence to sunscreen use in specific populations. [ABSTRACT FROM AUTHOR]

Since extracutaneous melanocytes in the eye may also be affected in vitiligo, a systematic review was conducted to explore the ocular manifestations of vitiligo. Studies point to a higher risk of ocular findings in periorbital vitiligo. Dry eye disease is the most reported ocular abnormality in vitiligo. Additionally, several small studies have found potential links to uveitis and glaucoma. Various other chorioretinal pigmentary changes are also reported, but without accompanying functional consequences or changes in vision. Although there is a need for larger studies to further elucidate these associations, dermatologists should be aware of potential ocular comorbidities in vitiligo and refer to ophthalmology accordingly. [ABSTRACT FROM AUTHOR]

Cross-sectional analysis of skin lightening and skin bleaching practices on social media. By doing so, they can have honest conversations with their patients about perceived and desired skin tones and take a culturally sensitive approach in educating on the risks of skin bleaching practices. [Extracted from the article]

More than half of the population will belong to a minority group by the year 2044. Further research needs to be done into the perceptions of those with skin of color regarding their dermatologic care. This study assessed the perceptions and preferences of communities of color regarding the care of their skin and hair. An anonymous, cross-sectional, multiple-choice, online survey was administered from August through October 2021. Participants were recruited using ResearchMatch, a national volunteer health registry supported by the US National Institutes of Health. Eligibility criteria included being 18 years or older, identifying with at least one racial/ethnic group within skin of color, and living in the United States. A total of 547 participants completed the survey, 463 women (84.6%) and 84 men (15.4%) with a mean (standard deviation) age of 44.1 (15.4) years. 301 self-identified as Black (55.0%), 84 Latinx (15.4%), 90 Asian (16.5%), and 72 Multiracial (13.2%). Participants did not feel like dermatologists are trained to treat skin of color (69.5%, n = 380) or ethnic hair (75.1%, n = 411). Participants believed that all dermatologists should have training in skin of color (92.3%, n = 505) and would be more likely to see a dermatologist if they had skin of color training (80.1%, n = 438) as they felt dermatologists who have skin of color training are better equipped to treat their conditions (67.1%, n = 367). Participants were more comfortable receiving treatment at clinics that specialize in skin of color (75.1%, n = 411), but overwhelmingly had never heard of skin of color clinics (94.1%, n = 515). Participants were willing to contribute non-identifiable photos (96.3%, n = 527) and stories about skin and hair diseases (94.1%, n = 515) to create skin of color resources to train dermatologists. Overall, perceptions of communities of color on dermatologic care need to be improved. Greater skin of color training including all races/ethnicities and skin tones is imperative, and greater visibility and resources should also be put into skin of color clinics and formal skin of color research. [ABSTRACT FROM AUTHOR]

Background: Keloids are pathologic scars that pose a significant functional and cosmetic burden. They are challenging to treat, despite the multitude of treatment modalities currently available. Objective: The aim of this study was to conduct an evidence-based review of all prospective data regarding keloid treatments published between 2010 and 2020. Methods: A systematic literature search of PubMed (National Library of Medicine), Embase (Elsevier), and Cochrane Library (Wiley) was performed in November of 2020. Search strategies with the keywords "keloid" and "treatment" were performed by a medical librarian. The search was limited to prospective studies that were peer-reviewed, reported on clinical outcomes of keloid therapies, and were published in the English language between January 1, 2010, and November 24, 2020. Results: A total of 3462 unique citations were identified, of which 108 studies met inclusion criteria. Current literature supports silicone gel or sheeting with corticosteroid injections as first-line therapy for keloids. Adjuvant intralesional 5-fluorouracil (5-FU), bleomycin, or verapamil can be considered, although mixed results have been reported with each. Laser therapy can be used in combination with intralesional corticosteroids or topical steroids with occlusion to improve drug penetration. Excision of keloids with immediate post-excision radiation therapy is an effective option for recalcitrant lesions. Finally, silicone sheeting and pressure therapy have evidence for reducing keloid recurrence. Conclusions: This review was limited by heterogeneity of subject characteristics and study outcome measures, small sample sizes, and inconsistent study designs. Larger and more robust controlled studies are necessary to further understand the variety of existing and emerging keloid treatments, including corticosteroids, cryotherapy, intralesional injections, lasers, photodynamic therapy, excision and radiation, pressure dressings, and others. [ABSTRACT FROM AUTHOR]

Knowledge regarding skin tone preferences and their influence on skincare behaviors among people of color is limited. The objective of this study was to determine whether there is a difference between ideal and actual skin tone among people of color and whether this difference is associated with tanning and sunscreen use. This was a one-time, voluntary, anonymous, electronic survey designed in REDCap and delivered through ResearchMatch, a national electronic, recruitment tool. Eligible participants were at least 18 years old and self-identified as Black, Asian, Latinx, American Indian/Alaskan Native or Mixed Race. In total, 548 completed survey results were analyzed using SAS. Only the Latinx population was found to have a significant preference for tanner skin (p < 0.05). The Latinx population had significantly more subjects that participated in outdoor tanning than both the Black (p < 0.0001) and Asian population (p < 0.05). Latinx participants who indicated a preference for tanner skin were 2.8 times more likely to never use sunscreen than those without this preference (OR = 2.821, CI = 1.029–7.732, p < 0.05). Our findings have implications for how dermatologists screen, treat, and educate Latinx and skin of color populations. [ABSTRACT FROM AUTHOR]

Aging is an inevitable and complex process that can be described clinically as features of wrinkles, sunspots, uneven skin color, and sagging skin. These cutaneous effects are influenced by both intrinsic and extrinsic factors and often are varied based on ethnic origin given underlying structural and functional differences. The authors sought to provide updated information on facets of aging and how it relates to ethnic variation given innate differences in skin structure and function. Publications describing structural and functional principles of ethnic and aging skin were primarily found through a PubMed literature search and supplemented with a review of textbook chapters. The most common signs of skin aging despite skin type are dark spots, loss of elasticity, loss of volume, and rhytides. Skin of color has many characteristics that make its aging process unique. Those of Asian, Hispanic, and African American descent have distinct facial structures. Differences in the concentration of epidermal melanin makes darkly pigmented persons more vulnerable to dyspigmentation, while a thicker and more compact dermis makes facial lines less noticeable. Ethnic skin comprises a large portion of the world population. Therefore, it is important to understand the unique structural and functional differences among ethnicities to adequately treat the signs of aging. [ABSTRACT FROM AUTHOR]

The article presents the results of a survey which determines the knowledge and competence of third year dermatology residents on nail surgery. The results shows that few residents performed nail procedures during residency training programs, other only had observational experience, while other lacks the competence in nail surgery.

Background: Vitiligo vulgaris, an acquired disease related to autoimmune activity directed against melanocytes, is a common disorder of pigmentation affecting up to one percent of the population. Several autoimmune disorders are reported to improve during pregnancy-a state of relative immunosuppression. Objectives: To assess self-reported changes in vitiligo disease activity that occurred during pregnancy. Methods: A survey of 24 subjects with vitiligo was conducted by telephone using questions that pertained to vitiligo history, pregnancy history, and vitiligo disease activity prior to, during, and after pregnancy. Additional questions pertained to demographics, history of other autoimmune disease, and family history of vitiligo. Results: 18 of 24 subjects (75%) reported stable or improvement in vitiligo activity during pregnancy. Of these 18 subjects, five (27%) had discontinued vitiligo therapy during their pregnancies. Conclusion: The majority of patients surveyed reported either stable or improved vitiligo activity during pregnancy. These results support a protective effect exerted by the state of pregnancy against changing or progressing depigmentation characteristic of vitiligo vulgaris in the non-pregnant state. [ABSTRACT FROM AUTHOR]

There are numerous skin conditions that occur commonly in children with ethnic skin, including vitiligo, progressive macular hypomelanosis, pityriasis alba, acne keloidalis nuchae, pseudofolliculitis barbae, and keloids. Though these conditions occur in both children and adults, children may have different patterns of clinical presentation and response to therapy. In caring for such patients, important treatment considerations include side effects of systemic medications and tolerability of invasive procedures. Quality of life is an important measure and should not be compromised by either the skin disease or its treatment. [ABSTRACT FROM AUTHOR]

Background: The Global Program to Eliminate Lymphatic Filariasis aims to interrupt transmission of lymphatic filariasis and manage morbidity in people currently living with the disease. A component of morbidity management is improving health-related quality of life (HRQoL) in patients. Measurement of HRQoL in current management programs is varied because of the lack of a standard HRQoL tool for use in the lymphatic filariasis population. Methodology/Principal Findings: In this study, the psychometric properties of three health status measures were compared when used in a group of lymphatic filariasis patients and healthy controls. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), the Dermatology Life Quality Index (DLQI), and the Lymphatic Filariasis Quality of Life Questionnaire (LFSQQ) were administered to 36 stage II and stage III lymphatic filariasis subjects and 36 age and sex matched controls in Kerala, India. All three tools yielded missing value rates lower than 10%, suggesting high feasibility. Highest internal consistency was seen in the LFSQQ (α = 0.97). Discriminant validity analysis demonstrated that HRQoL was significantly lower in the LF group than in controls for the WHODAS 2.0, DLQI, and LFSQQ, but total HRQoL scores did not differ between stage II and stage III lymphedema subjects. The LFSQQ total score correlated most strongly with the WHODAS 2.0 (r = 0.91, p<0.001) and DLQI (r = 0.81, p<0.001). Conclusions/Significance: The WHODAS 2.0, DLQI, and LFSQQ demonstrate acceptable feasibility, internal consistency, discriminate validity, and construct validity. Based on our psychometric analyses, the LFSQQ performs the best and is recommended for use in the lymphatic filariasis population. Author Summary: Lymphatic filariasis affects approximately 120 million people and is the second leading cause of life-long disability worldwide. Because lymphatic filariasis is one of the World Health Organization's six eradicable diseases, much effort has been placed into reducing transmission of the disease and managing morbidity. Novel interventions frequently use health-related quality of life as an outcome measure to monitor efficacy of the intervention. In an effort to delineate the strengths and weaknesses of health status measures and recommend use of a single tool in the lymphatic filariasis population, we compared the use of three health status tools (The World Health Organization Disability Assessment Schedule 2.0, the Dermatology Life Quality Index, and the Lymphatic Filariasis Quality of Life Questionnaire) in lymphatic filariasis subjects and healthy controls in Kerala, India. The Lymphatic Filariasis Quality of Life Questionnaire performed the best by discriminating well between subjects and controls, possessing significant content overlap with the other two tools, yielding a low missing value rate, and being internally consistent. This is the first study to compare health status measures in lymphatic filariasis subjects and provides insight into the use of the tools in quality of life analysis. [ABSTRACT FROM AUTHOR]

Background: The Global Program to Eliminate Lymphatic Filariasis aims to interrupt transmission of lymphatic filariasis and manage morbidity in people currently living with the disease. A component of morbidity management is improving health-related quality of life (HRQoL) in patients. Measurement of HRQoL in current management programs is varied because of the lack of a standard HRQoL tool for use in the lymphatic filariasis population. Methodology/Principal Findings: In this study, the psychometric properties of three health status measures were compared when used in a group of lymphatic filariasis patients and healthy controls. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), the Dermatology Life Quality Index (DLQI), and the Lymphatic Filariasis Quality of Life Questionnaire (LFSQQ) were administered to 36 stage II and stage III lymphatic filariasis subjects and 36 age and sex matched controls in Kerala, India. All three tools yielded missing value rates lower than 10%, suggesting high feasibility. Highest internal consistency was seen in the LFSQQ (α = 0.97). Discriminant validity analysis demonstrated that HRQoL was significantly lower in the LF group than in controls for the WHODAS 2.0, DLQI, and LFSQQ, but total HRQoL scores did not differ between stage II and stage III lymphedema subjects. The LFSQQ total score correlated most strongly with the WHODAS 2.0 (r = 0.91, p<0.001) and DLQI (r = 0.81, p<0.001). Conclusions/Significance: The WHODAS 2.0, DLQI, and LFSQQ demonstrate acceptable feasibility, internal consistency, discriminate validity, and construct validity. Based on our psychometric analyses, the LFSQQ performs the best and is recommended for use in the lymphatic filariasis population. [ABSTRACT FROM AUTHOR]

Objectives: To assess the level of melanoma awareness and risk perception among ethnic minorities and to identify ways to enhance the relevance of melanoma educational materials for ethnic minorities. Methods: Twelve focus groups composed of participants from a single ethnicity [African-American ( n=40), Hispanic ( n=40), and Asian ( n=40)], participated in a 2 h discussion on melanoma and skin cancer and commented on an educational brochure by the American Cancer Society and reacted to photographs of melanoma on ethnic skin. Participants also evaluated the ability to sunburn and tan and the skin cancer risk of images of celebrities before and after the discussion. Additionally, participants assessed the skin tone of celebrities as very fair, fair, olive, light brown, dark brown, and very dark. The audiotape recordings of the 12 focus groups were transcribed and analyzed with the Non-numerical Unstructured Data Indexing Searching and Theorizing software for common themes. Results: The common themes were (1) lack of relevance of skin cancer to ethnic people, (2) understanding of skin cancer risk terminology is based on personal experience and what is acquired from the media, and (3) sources of health information for ethnic minorities are fragmented and physicians are not the primary source of information. Celebrity images representing the six skin tones were selected. Conclusions: Relevance of melanoma education to ethnic people may be improved by using 'melanoma skin cancer', photographs of early melanoma in people with dark skin, and providing guidance on how to inspect hands and feet for suspicious moles. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

BACKGROUND There are no randomized split-face model studies investigating treatments for postinflammatory hyperpigmentation (PIH) in dark skin. OBJECTIVE To assess the efficacy, safety, and effect on quality of life of salicylic acid peels for PIH in dark skin. METHODS Ten subjects with Fitzpatrick skin phototypes IV to VI were randomized to receive two 20% salicylic acid peels followed by three 30% salicylic acid peels to half of the face. The contralateral half remained untreated. Response was evaluated by photography reviewed by three blinded dermatologists. The Visual Analog Scale, Dermatology Life Quality Index (DLQI), and treatment quality questionnaire were administered. RESULTS Improvement of PIH on the treatment side according to each rater ( p=.81, p=.81, p=.42) and according to the raters combined ( p=.11) approached but did not reach statistical significance. Subjects' Visual Analog Scale scores indicated significantly greater improvement of PIH on the treatment side than in the control ( p=.004). Quality of life measured according to the DLQI improved after treatment but not statistically significantly so ( p=.13). Treatment had no significant adverse effects. CONCLUSIONS Salicylic acid peels are safe in this population. Although patients rated them as clinically effective, blinded raters found a brief series of peels to have less efficacy. Measured quality of life improved nominally. [ABSTRACT FROM AUTHOR]