Dark-skinned Individuals Research Articles

Tinea capitis with kerion complicated by keloid formation in a 34-year-old man: A case report

A kerion, also known as a dermatophyte, is a type of inflammatory tinea capitis caused by an exaggerated immune response to a fungal ringworm infection primarily affecting the scalp. A keloid is an abnormal scar tissue proliferation occurring at the site of tissue injury or spontaneously. It occurs more commonly in darker-skinned individuals. The coexistence of kerion and keloid is rare. This case involves a 34-year-old man who presented with a four-year history of scalp swelling, itching, and occasional fluid discharge. There is a history of keloids in multiple parts of the body. Examination revealed multiple keloids on the scalp alongside a purulent, oozing rash with satellite nodules. Skin scraping for KOH microscopy was positive for fungal spores and hyphae. This case highlights the rare complication of keloid formation in kerion which can hinder effective treatment of the underlying fungal infection.

Sunscreens prescribed to patients with skin of color and/or with melasma: A survey of 221 dermatologists and dermatology residents in Spain.

Dark-skinned individuals (DSI) present high rates of melasma and post-inflammatory hyperpigmentation. The use of sunscreens with mineral filters is essential for prevention and treatment. Our objective was to determine the preferences of dermatologists and dermatology residents in the prescription of sunscreens for DSI. An anonymous survey of attendees at an online photoprotection event held on March 31, 2022, in Spain. The survey was answered by 66.6% (221/332) of the attendees: 159 dermatologists (71.9%) and 62 dermatology residents (28.1%). Respondents reported recommending the use of sunscreen to a median of 80% of DSI [interquartile range (IQR), 50-90]. Physicians reported prescribing tinted sunscreens to a median percentage of 60% (IQR, 25-90) of DSI with acne; and to a median percentage of 90% (IQR, 58-99) of DSI with melasma. The most prescribed photoprotectors to DSI with melasma were organic broad-spectrum sunscreens with antioxidants: 102/220 (46.4%) and mineral broad-spectrum sunscreens (with iron oxides): 45/220 (20.4%). In DSI with melasma or other pigmentary disorders, the most preferred features of sunscreens were as follows: sun protection factor ≥ 30: 217/221 (98.2%), UVA protection: 214/221 (96.8%), color for camouflage: 150/220 (68.2%) and mineral filters such as titanium dioxide and zinc oxide: 151/220 (68.6%) or iron oxides: 131/220 (59.5%). Online survey, potential inclusion bias. Respondents reported to prescribe sunscreens to the majority of DSI, and tinted sunscreens for the majority of DSI with pigmentary disorders. However, the most frequently recommended sunscreens for DSI were organic broad-spectrum sunscreens with antioxidants.

The prevalence of vitamin D deficiency among different population groups and its impact on health outcomes

Background: Vitamin D is an essential nutrient involved in various bodily functions such as bone health, immune system regulation, and cell growth. Despite its importance, vitamin D deficiency is a widespread issue globally, affecting individuals across different age groups and backgrounds. The deficiency's prevalence and impact on health outcomes vary among populations due to factors like sun exposure, dietary habits, skin pigmentation, and geographic location. This study reviews the recent advancements in understanding the prevalence of vitamin D deficiency among different population groups and its impact on health outcomes. Methods and Materials: A comprehensive literature review was conducted using databases such as PubMed, Google Scholar, and others from 2014 to 2024. Keywords like "Vitamin D," "Vitamin D Deficiency," and "evidence-based medicine" guided the search. The inclusion criteria focused on studies written in English and covered a wide range of research articles, clinical trials, and meta-analyses to ensure a thorough understanding of the topic. Results: The review revealed that vitamin D deficiency is prevalent across various demographic groups, with significant variations based on factors like skin pigmentation, age, geographic location, and lifestyle. Darker-skinned individuals, older adults, and those living in high-latitude regions are particularly at risk. The deficiency is linked to several adverse health outcomes, including osteoporosis, cardiovascular diseases, autoimmune disorders, and mood disorders like depression. Conclusion: Addressing vitamin D deficiency is crucial for improving public health. Tailored interventions considering demographic and geographic differences are necessary to mitigate the deficiency's impact. Public health strategies should promote sun exposure, dietary adjustments, and supplementation to enhance vitamin D levels, ultimately improving health outcomes and reducing healthcare disparities.

Pitiriasis Versikolor

Pityriasis versicolor is an infectious disease that arises due to decreased immunity and is chronic. This disease is caused by the fungus Malassezia sp. which is characterized by hypopigmented or hyperpigmented macules, which can even be accompanied by erythematous and smooth scales. Infection occurs more often in areas with relatively higher temperatures and humidity. Pityriasis versicolor has a worldwide prevalence of up to 50% in tropical countries and 1.1% in cold climates. The incidence of pityriasis versicolor is the same in all races, but is more frequently seen in dark-skinned individuals due to changes in skin pigmentation. This case report describes a 10 year old girl who came with complaints of white spots appearing on her face for 8 months. The initial appearance of the spots is accompanied by itching when sweating. Dermatological examination revealed multiple hypopigmented macules of lenticular to nummular size with well-defined borders with fine scales. On examination with 20% KOH, grouped spores and short hyphae appear like spaghetti and meatballs. Clustered spores are a sign of colonization, while hyphae indicate infection. Pityriasis versicolor therapy consists of administering antifungals which can be done topically and systemically. Furthermore, patients are educated to always keep their skin dry, reduce activities that cause excessive sweating, and wear clothing that is not tight and absorbs sweat.

Efficacy and Safety of Q-Switched 1064/532 nm Nd:YAG Lasers on Benign Hypermelanosis in Dark-Skinned Individuals-A Preliminary Study.

Background: Facial hypermelanosis is a major cosmetic issue that causes severe social embarrassment and psychological pain, particularly among Asians and dark-skinned individuals. Aim: This study assesses the safety and effectiveness of Q-switched 1064/532 nm nanosecond/picosecond lasers in removing benign hypermelanosis in dark-skinned individuals, evaluating the possible associated side effects. Material and methods: A total of 30 participants (80% females and 20% males) with Fitzpatrick skin types IV-V-VI who presented superficial benign hypermelanoses on the facial and décolleté area were enrolled. All patients underwent to one to two laser treatment sessions with a 1064/532 nm Q-switched laser system. Three months after the final laser session, results were assessed by comparing before- and after-treatment photos and using a quartile scale for lesion clearance (4-point Investigator Global Assessment scale). Results: All patients observed global improvements in their pigmented lesions: 53% of patients achieved excellent clearance, 30% of patients achieved good to moderate clearance, 10% of patients achieved slight clearance, and 7% of patients did not respond to the therapy. No serious adverse event occurred. Photos showed the clinical improvement achieved at 3 months follow-up. Conclusions: The Q-switched 1064/532 nm laser proved to be a key tool for treating benign hypermelanosis in all skin types, including dark-skinned persons.

Improving cosmetic and functional outcome in case of post burn contracture of hand and fingers by using de-epithelized plantar skin graft

Background: Burn scar contractures in the fingers and hand often lead to debilitating functional and cosmetic issues. Various surgical approaches exist, but achieving optimal outcomes remains a challenge. While grafting glabrous split-thickness skin from the foot's plantar aspect is a well-established method, it remains underutilized, with conventional grafts leading to complications, especially in darker-skinned individuals. Method: This study involved 35 patients with McCauley grade II and III hand burn contractures, spanning various age groups and genders. Surgical procedures encompassed scar removal, contracture release, and plantar skin graft application. Post-operatively, patients received dressing, splinting, and physiotherapy. Donor site healing was evaluated at the 3-week mark. Results: Remarkably, all patients exhibited successful donor site healing within 3 weeks. The surgical technique effectively addressed contractures, enhancing range of motion and function. Post-operative care, featuring physiotherapy, coconut oil massages, and pressure garment use for at least 6 months, significantly contributed to post-burn hand and finger contracture management. Conclusions: De-epithelized plantar skin grafts offer a promising avenue for enhancing both aesthetics and function in individuals with post-burn hand and finger contractures. This technique minimizes complications common with traditional grafts while promoting successful donor site healing and improved range of motion. The study underscores the significance of using like-for-like reconstruction to achieve the best possible results in managing post-burn contractures.

Impact of Skin Pigmentation on Cerebral Regional Saturation of Oxygen Using Near-Infrared Spectroscopy: A Systematic Review.

Near-infrared spectroscopy (NIRS) is used in critical care settings to measure regional cerebral tissue oxygenation (rSo2). However, the accuracy of such measurements has been questioned in darker-skinned individuals due to the confounding effects of light absorption by melanin. In this systematic review, we aim to synthesize the available evidence on the effect of skin pigmentation on rSo2 readings. We systematically searched MEDLINE, Cochrane Database of Systematic Reviews, Embase, and Google Scholar from inception to July 1, 2023. In compliance with our PROSPERO registration (CRD42022347548), we selected articles comparing rSo2 measurements in adults either between racial groups or at different levels of skin pigmentation. Two independent reviewers conducted full-text reviews of all potentially relevant articles. We extracted data on self-reported race or level of skin pigmentation and mean rSo2 values. Of the 11,495 unique records screened, two studies (n = 7,549) met our inclusion criteria for systematic review. Sun et al (2015) yielded significantly lower rSo2 values for African Americans compared with Caucasians, whereas Stannard et al (2021) found little difference between self-reported racial groups. This discrepancy is likely because Stannard et al (2021) used a NIRS platform which specifically purports to control for the effects of melanin. Several other studies that did not meet our inclusion criteria corroborated the notion that skin pigmentation results in lower rSo2 readings. Skin pigmentation likely results in attenuated rSo2 readings. However, the magnitude of this effect may depend on the specific NIRS platform used.

Commentary on “Dermoscopic-Guided Shave Removal of Acquired Facial Melanocytic Nevi in Dark-Skinned Individuals”

Commentary on “Dermoscopic-Guided Shave Removal of Acquired Facial Melanocytic Nevi in Dark-Skinned Individuals”

Dermoscopic-Guided Shave Removal of Acquired Facial Melanocytic Nevi in Dark-Skinned Individuals.

Acquired melanocytic nevi are common benign skin lesions that require removal under certain circumstances. Shave removal is a straightforward treatment modality with a risk of recurrence. To evaluate the outcome of dermoscopy-guided shave removal of acquired melanocytic nevi in the face of dark-skinned individuals who are more liable to postsurgical complications. The study was conducted on 64 patients with acquired facial melanocytic nevi. Serial shave removal using a razor blade guided by dermoscopic examination was done until nevus-free tissue was seen, followed by electrocauterization of the base. Cosmetic outcome, patients' satisfaction, and recurrence rate were evaluated during follow-up. Excellent cosmetic outcome was achieved in 54.69% of patients, while 39.06% had an acceptable outcome, and 6.25% of patients had poor cosmetic outcome. Meanwhile, the recurrence rate was noticed in 5 cases only (7.8%). Dermoscopic-guided shave removal provides an easy procedure of treating common melanocytic nevi with an acceptable cosmetic result and a lower rate of recurrence even in patients with darker skin phenotypes.

Lichen Striatus: An Updated Review.

Lichen striatus is a benign dermatosis that affects mainly children. This condition mimics many other dermatoses. The purpose of this article is to familiarize pediatricians with the clinical manifestations of lichen striatus to avoid misdiagnosis, unnecessary investigations, unnecessary referrals, and mismanagement of lichen striatus. A search was conducted in June 2023 in PubMed Clinical Queries using the key term "Lichen striatus". The search strategy included all observational studies, clinical trials, and reviews published within the past ten years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of this article. Lichen striatus is a benign self-limited T-cell mediated dermatosis characterized by a linear inflammatory papular eruption seen primarily in children. The onset is usually sudden with minimal or absent symptomatology. The eruption in typical lichen striatus consists of discrete, skin- colored, pink, erythematous, or violaceous, flat-topped, slightly elevated, smooth or scaly papules that coalesce to form a dull red, potentially scaly, interrupted or continuous band over days to weeks. Although any part of the body may be involved, the extremities are the sites of predilection. Typically, the rash is solitary, unilateral, and follows Blaschko lines. In dark-skinned individuals, the skin lesions may be hypopigmented at onset. Nails may be affected alone or, more commonly, along with the skin lesions of lichen striatus. The differential diagnoses of lichen striatus are many and the salient features of other conditions are highlighted in the text. Lichen striatus is a self-limited condition that often resolves within one year without residual scarring but may have transient post-inflammatory hypopigmentation or hyperpigmentation. As such, treatment may not be necessary. For patients who desire treatment for cosmesis or for the symptomatic treatment of pruritus, a low- to mid-potency topical corticosteroid or a topical immunomodulator can be used. A fading cream can be used for post-inflammatory hyperpigmentation.

Understanding skin color bias in deep learning-based skin lesion segmentation

Background: The field of dermatological image analysis using deep neural networks includes the semantic segmentation of skin lesions, pivotal for lesion analysis, pathology inference, and diagnoses. While biases in neural network-based dermatoscopic image classification against darker skin tones due to dataset imbalance and contrast disparities are acknowledged, a comprehensive exploration of skin color bias in lesion segmentation models is lacking. It is imperative to address and understand the biases in these models.Methods: Our study comprehensively evaluates skin tone bias within prevalent neural networks for skin lesion segmentation. Since no information about skin color exists in widely used datasets, to quantify the bias we use three distinct skin color estimation methods: Fitzpatrick skin type estimation, Individual Typology Angle estimation as well as manual grouping of images by skin color. We assess bias across common models by training a variety of U-Net-based models on three widely-used datasets with 1758 different dermoscopic and clinical images. We also evaluate commonly suggested methods to mitigate bias.Results: Our findings expose a significant and large correlation between segmentation performance and skin color, revealing consistent challenges in segmenting lesions for darker skin tones across diverse datasets. Using various methods of skin color quantification, we have found significant bias in skin lesion segmentation against darker-skinned individuals when evaluated both in and out-of-sample. We also find that commonly used methods for bias mitigation do not result in any significant reduction in bias.Conclusions: Our findings suggest a pervasive bias in most published lesion segmentation methods, given our use of commonly employed neural network architectures and publicly available datasets. In light of our findings, we propose recommendations for unbiased dataset collection, labeling, and model development. This presents the first comprehensive evaluation of fairness in skin lesion segmentation.

Nodular Malignant Melanoma on the Abdomen of a Lactating Lady

AbstractMalignant melanoma is an uncommon condition in Indian and dark-skinned individuals. Additionally, it is associated with lifetime recurrences and poor prognosis. Its presence on the trunk poses a diagnostic challenge as it can simulate various skin lesions. Furthermore, it raises diagnostic and therapeutic challenges in pregnancy and lactation. Early recognition and appropriate treatment can reduce adverse events in the mother and the baby. Here, we are reporting a case of a 33-year-old lactating mother who presented with a solitary, rapidly growing nodule on the abdomen. Nodular malignant melanoma was diagnosed on further evaluation with histopathology and immunohistochemistry.

Management of Nodular Nasal Basal Cell Carcinoma with Wide Excision, Transpositional Median Forehead Flap, Forehead Split Thickness Skin Graft: Case Report

Introduction: Basal cell carcinoma (BCC) is the most common skin type cancer with an incidence rate of around 75-80%. The most common location is in the head and neck area around 70-80% and followed by other body parts around 25% consist of the penis, vulva or perianal area and 5% on the skin. BCC occurs more frequently in light-skinned individuals compared to dark-skinned individuals. The incidence rate is relatively lower in Asians, blacks ethnic, and Hispanics.
 Case Presentation: A 66 years-old woman complained of scabs on the right side of her nose which had become increasingly widespread for the past 2 years. The wound was initially the size of a mole and was scratched until it spread until the patient was hospitalized. Physical examination showed a wound in the nasal area measuring 4 x 5 x 1 cm, irregular wound edges, cartilaginous wound base with necrotic tissue and pus. The first biopsy examination showed poorly differentiated basal cell carcinoma. The patient was treated with Nasal Reconstruction surgery consisting of wide excision was performed by surgical oncologist, transpositional median forehead Flap and forehead Split Thickness Skin Graft were performed by reconstructive plastic surgeon.
 Discussion: The diagnosis of BCC in this patient was based on regarding history taking, physical examination and histopathological examination. However, for defects with a diameter of more than 1.5 to 2 cm, generally recommended using axial pattern flaps such as forehead flaps, nasolabial flaps and dorsal nose flaps. In this case, the patient was treated with wide excision followed by nasal reconstruction with a transpositional forehead flap and forehead split thickness skin graft.
 Conclusion: Nevertheless, regional flaps remain the recommended procedure for nasal reconstruction after wide excision of the tumor. Accurate analysis of the damage combined with evaluation of the patient's clinical condition is necessary to select the best surgical technique. Thorough knowledge of regional vascular anatomy and a comprehensive multidisciplinary approach are important first steps for proper treatment of nasal skin cancer, so that the procedure for wide excision of nasal basal cell carcinoma followed by nasal reconstruction with transpositional forehead flap and split thickness skin graft, can provide satisfactory result.

Incidence and Survival Outcomes of Dermatofibrosarcoma Protuberans From 2000 to 2020: A Population-Based Retrospective Cohort Analysis.

Recent changes in the incidence and survival of dermatofibrosarcoma protuberans (DFSP) have not been described. To characterize the incidence and survival of DFSP. A retrospective cohort study of patients with DFSP from 2000 to 2020 in the Surveillance, Epidemiology, and End Results database was performed. Cox and Fine-Gray regression models were used to assess overall and DFSP-specific survival. The incidence of DFSP has not changed from 2000 to 2020 with 4.6 cases/million person-years, with higher rates in dark-skinned and middle-age individuals. Factors associated with overall mortality in DFSP patients include advanced age ( p < .0001), male sex (hazard ratio [HR] 1.8, p < .0001), larger tumors (HR 1.002 per millimeter, p < .001), lower household income (HR 1.8, p = .0002), and lower extremity location (HR 1.7, p = .008). Mohs surgery is associated with improved overall survival (HR 0.4, p = .02). Large tumor size (6.0+ cm, HR 6.7, p = .01) and advanced age (age 80+ years, HR 21.3, p = .003) were associated with worse DFSP-specific mortality. Dermatofibrosarcoma protuberans incidence has remained constant from 2000 to 2020. Increasing age and tumor size, decreased income, male sex, and lower extremity location are associated with worsened survival. Mohs surgery is associated with improved overall survival. Increased age and tumor size are associated with worsened DFSP-specific mortality.

Cumulative Colorism in Criminal Courts

A growing literature documents skin color stratification in punishment, whereby darker-skinned individuals fare worse than their lighter-skinned counterparts. Virtually all of this research has focused on colorism operating through direct channels. Utilizing a novel dataset linking the mugshots and court records of 6931 felony defendants from Miami-Dade County (Florida) from 2012 to 2015, we show that colorism in punishment, particularly for Hispanics, operates through indirect mechanisms – in addition to direct channels. We argue that colorism in punishment is sustained through a cumulative (dis)advantage process, highlighting how skin color stratification is institutionalized in the criminal justice system.

Disparities in Acute Radiation-Related Pain and Dermatitis between Black and White Patients with Early-Stage Breast Cancer Receiving Adjuvant Radiation Following Breast Conserving Surgery

Historically, black patients with cancer experience poor clinical outcomes and low quality of life due to inadequate screening and management of cancer-related treatment toxicities. There are limited data documenting racial disparities in acute radiation-related toxicities (ARRTs) for patients with early-stage breast cancer. Therefore, we compared ARRTs between Black (B) and White (W) patients receiving adjuvant radiation following breast conserving surgery (BCS). This retrospective analysis included 317 patients with stage 0/1 breast cancer treated with adjuvant radiation between October 2019 and February 2022. 29% (N = 81) were B and 71% (N = 236) were W, with an average age of 65 (range: 32-88) for both. We abstracted weekly on-treatment-visit clinical notes (OTVs) completed by a nurse and radiation oncologist who utilized the Common Terminology Criteria for Adverse (CTCAE) v4.0 to evaluate each patient's pain score (scaled 0-10, 0 = no pain and 10 = worst), radiation dermatitis (RD; Grade 0-4), as well as non-CTCAE descriptors of pain and presence of hyperpigmentation or pruritus. We compared onset and severity of pain and rates of RD and pruritus between B and W patients. The proportion reporting pain was significantly lower among B vs. W patients (43.8% vs. 63.6%; P = 0.002). Of patients qualitatively reporting pain, B patients were significantly more likely to have their pain scored as 0 than W patients (24.3% vs. 11.7%; P = 0.024). B patients had significantly lower median pain scores than W patients (P = 0.010), with a median score of 3 (interquartile range [IQR]: 0-5.5) vs. 5 (IQR: 4-8). B patients had a significantly longer time to pain identification than W patients (P = 0.027), with median time to pain of 10th fraction (IQR: 4-13.5) vs. 8th fraction (IQR: 4-11). Radiation dermatitis was graded as 0 (50.6% vs 8.5%; P<0.001), 1 (44.4% vs 82.6%; P<0.001), 2 (14.8% vs 15.3%, P = NS), and 3 (3.7% vs 0.4%; P = 0.023), with no grade 4 RD, amongst B and W patients, respectively. Of note, B patients experiencing mild hyperpigmentation were graded as 0. We found no statistically significant differences in incidence of pruritus. Qualitative and quantitative analyses of ARRTs based on CTCAE v4.0 show discordance in pain scores and radiation dermatitis. The underscoring of pain amongst B patients suggests possible cultural hesitancy to report pain or implicit biases in evaluating pain suggesting the need for alternative ways to discuss and score pain in B patients. Our data suggests that CTCAE does not effectively assess radiation dermatitis in B patients. There are no descriptors of hyperpigmentation in grading of radiation dermatitis in CTCAE, which may lead to underreporting in dark-skinned individuals. Better assessment tools are needed to document ARRTs to ensure appropriate evaluation and treatment across all racial groups.

Using infrared to improve face recognition of individuals with highly pigmented skin

Face recognition is widely used for security and access control. Its performance is limited when working with highly pigmented skin tones due to training bias caused by the under-representation of darker-skinned individuals in existing datasets and the fact that darker skin absorbs more light and therefore reflects less discernible detail in the visible spectrum. To improve performance, this work incorporated the infrared (IR) spectrum, which is perceived by electronic sensors. We augmented existing datasets with images of highly pigmented individuals captured using the visible, IR, and full spectra and fine-tuned existing face recognition systems to compare the performance of these three. We found a marked improvement in accuracy and AUC values of the receiver operating characteristic (ROC) curves when including the IR spectrum, increasing performance from 97.5% to 99.0% for highly pigmented faces. Different facial orientations and narrow cropping also improved performance, and the nose region was the most important feature for recognition.

A review of treatment of port-wine stains with pulsed dye laser in fitzpatrick skin type IV-VI.

Port-Wine Stains are a congenital vascular malformation that affect 0.3-0.5% of newborns. It is a benign capillary malformation that commonly occurs on the head and neck. It is formed by progressive dilation of the post-capillary venules, and as the patient ages it may be associated with hypertrophy and nodularity which can lead to cosmetic disfigurement and psychological aggravation. There are many choices of treatment such as cryosurgery, cosmetic tattooing, and dermabrasion, amongst others. The treatment of choice is pulse dye laser (PDL) because it is both effective and safe to use.In darker skin types (Fitzpatrick skin types IV-VI), treatment is more difficult. Caution when treating darker skin types with PDL comes from the fact that there is an inverse correlation between vessel specificity of the PDL and skin pigmentation. In this review, we will be reviewing the literature and discussing the manuscripts that describe the treatment of PWS on patients with fitzpatrick skin type IV-VI. Authors searched the PubMed Medline in the English language from database inception through December 2022 for eligible articles. The keywords searched included "PDL," "pulse dye laser," "skin of color," "Fitzpatrick skin types IV-VI," "fitzpatrick," "pigmented skin," "Port-wine stain," "PWS", and "pulse dye laser." The articles that were included discussed PDL in the treatment of PWS in patients of skin of color. Any additional similar articles that were cited in our search were also included. Articles that were excluded did not discuss Fitzpatrick skin types IV-VI, darker skin type, or PDL. Data collected from each article included the number of participants, Fitzpatrick skin type, age, and laser parameters. There were 120 articles that were reviewed from our search and a total of nine articles met inclusion criteria with 241 patients that were considered Fitzpatrick skin type IV-VI. The patients were of a wide range of ages from 1month to 74years old. In our review, patients who are treated at a younger age had better results than when treated at an older age. The results show that darker skin individuals have better results when treated at a younger age compared to adults, they can experience complete resolution. Adults who were treated saw a variation of results, from improvements in the appearance to hyperpigmentation/hypopigmentation or scarring of the treated area. Patients who are Fitzpatrick skin type IV-VI are at higher risk of adverse events when treated with PDL for PWS when compared to patients of other skin types. Studies show that PDL can be beneficial for PWS in patients of skin of color; however, there are risks of hyperpigmentation, hypopigmentation, and scarring that are important to take into consideration when treating these patients. Further research is warranted to improve the understanding of PDL for PWS in patients of skin of color.

Q-switched ruby laser is safe and effective in treating primary gingival hyperpigmentation.

Physiologic gingival hyperpigmentation (PGH) is a benign condition that results from increased melanin production and is prevalent among darker skin individuals. Although the use of lasers for PGH has gained popularity in recent years, the lasers being used are mostly ablative, and act through a non-selective tissue damage mechanism. The objective of this study was to evaluate the use of a non-ablative 694-nm Q-switched ruby laser (QSRL) for the depigmentation of PGH. A retrospective single-center study of patients diagnosed with PGH and treated with a QSRL Between March 2019 and November 2020. Four patients were treated with QSRL for 1-3 sessions, until complete depigmentation was achieved. The average follow-up was 11 months (range 7-18 months) with no patient exhibiting re-pigmentation. Adverse events included mild local tenderness and transient erosions in two patients. The 694-nm QSRL is a novel and promising safe and effective method for treating PGH with the advantages of being a non-ablative modality that minimizes tissue damage and optimizes the outcome.

Epidemiological and clinical features of hypertrophic scar and keloid in Chinese college students: A university-based cross-sectional survey

BackgroundHypertrophic scar (HS) and keloid (KD) are common dermal fibroproliferative growth caused by pathological wound healing. HS's prevalence is currently undetermined in China. Though it primarily occurs in dark-skinned individuals, KD can develop in all races, and its prevalence among Chinese people is poorly documented. ObjectiveTo explore the present epidemiological status of them in Chinese college students. MethodsWe conducted a university-based cross-sectional study at one university in Fujian, China. A total of 1785 participants aged 16–34 years (mean age, 20.0 ± 2.0; 58.7% female) were enrolled and statistical analyses were performed. ResultsHS and KD were observed in 5.2% (95% confidence interval [CI]: 4.2–6.2) and 0.6% (95% CI: 0.3–1.0) of the population respectively. There was a significant difference by sex in HS (P < 0.05), but not in KD. The prevalence of HS and KD both showed a significant difference by age (P < 0.05), but not in ethnic and native place distribution. The occurrence of HS and KD were both concentrated in individuals 9–20 years old (HS: 77.2%; KD: 81.8%). They were mainly distributed in the upper limbs (52.1%; 64.3%), and the main cause was trauma (51.0%; 35.7%). In addition, male sex was a risk factor for HS (adjusted P < 0.001), and KD was associated with age ≥22 years and family history (adjusted P < 0.050). ConclusionHS and KD are common in Chinese college students, and more attention and research is warranted.