Skin Color Research Articles

Skin colour: A window into human phenotypic evolution and environmental adaptation.

As modern humans ventured out of Africa and dispersed around the world, they faced novel environmental challenges that led to geographic adaptations including skin colour. Over the long history of human evolution, skin colour has changed dramatically, showing tremendous diversity across different geographical regions, for example, the majority of individuals from the expansive lands of Africa have darker skin, whereas the majority of people from Eurasia exhibit lighter skin. What adaptations did lighter skin confer upon modern humans as they migrated from Africa to Eurasia? What genetic mechanisms underlie the diversity of skin colour observed in different populations? In recent years, scientists have gradually gained a deeper understanding of the interactions between pigmentation gene and skin colour through population-based genomic studies of different groups around the world, particularly in East Asia and Africa. In this review, we summarize our current understanding of 26 skin colour-related pigmentation genes and 48 SNPs that influence skin colour. Important pigmentation genes across three major populations are described in detail: MFSD12, SLC24A5, PDPK1 and DDB1/CYB561A3/TMEM138 influence skin colour in African populations; OCA2, KITLG, SLC24A2, GNPAT and PAH are key to the evolution of skin pigmentation in East Asian populations; and SLC24A5, SLC45A2, TYR, TYRP1, ASIP, MC1R and IRF4 significantly contribute to the lightening of skin colour in European populations. We summarized recent findings in genomic studies of skin colour in populations that implicate diverse geographic environments, local adaptation among populations, gene flow and multi-gene interactions as factors influencing skin colour diversity.

Comprehensive Evaluation of the Regulation of Skin Pigment Deposition by Active Ingredients Based on Whitening Products

Comprehensive Evaluation of the Regulation of Skin Pigment Deposition by Active Ingredients Based on Whitening Products

Promoter replication of grape MYB transcription factor is associated with a new red flesh phenotype.

In our study, we discovered a fragment duplication autoregulation mechanism in 'ZS-HY', which may be the reason for the phenotype of red foliage and red flesh in grapes. In grapes, MYBA1 and MYBA2 are the main genetic factors responsible for skin coloration which are located at the color loci on chromosome 2, but the exact genes responsible for color have not been identified in the flesh. We used a new teinturier grape germplasm 'ZhongShan-HongYu' (ZS-HY) which accumulate anthocyanin both in skin and flesh as experimental materials. All tissues of 'ZS-HY' contained cyanidin 3-O-(6″-p-coumaroyl glucoside), and pelargonidins were detected in skin, flesh, and tendril. Through gene expression analysis at different stage of flesh, significant differences in the expression levels of VvMYBA1 were found. Gene amplification analysis showed that the VvMYBA1 promoter is composed of two alleles, VvMYBA1a and 'VvMYBA1c-like'. An insertion of a 408bp repetitive fragment was detected in the allele 'VvMYBA1c-like'. In this process, we found the 408bp repetitive fragment was co-segregated with red flesh and foliage phenotype. Our results revealed that the 408bp fragment replication insertion in promoter of 'VvMYBA1c-like' was the target of its protein, and the number of repeat fragments was related to the increase of trans-activation of VvMYBA1 protein. The activation of promoter by VvMYBA1 was enhanced by the addition of VvMYC1. In addition, VvMYBA1 interacted with VvMYC1 to promote the expression of VvGT1 and VvGST4 genes in 'ZS-HY'. The discovery of this mutation event provides new insights into the regulation of VvMYBA1 on anthocyanin accumulation in red-fleshed grape, which is of great significance for molecular breeding of red-fleshed table grapes.

Effects of EGFR-TKI on epidermal melanin unit integrity: Therapeutic implications for hypopigmented skin disorders.

Epidermal melanin unit integrity is crucial for skin homeostasis and pigmentation. Epidermal growth factor (EGF) receptor (EGFR) is a pivotal player in cell growth, wound healing, and maintaining skin homeostasis. However, its influence on skin pigmentation is relatively unexplored. This study investigates the impact and underlying mechanisms of EGFR inhibitors on skin pigmentation. We evaluated EGF and EGFR expression in various skin cells using quantitative real-time PCR, Western blot, and immunofluorescence. EGF and EGFR were predominantly expressed in epidermal keratinocytes, and treatment with the EGFR tyrosine kinase inhibitors (EGFR-TKIs) gefitinib and PD153035 significantly increased stem cell factor (SCF) and endothelin-1 (ET-1) expression in cultured keratinocytes. Enhanced melanocyte migration and proliferation were observed in co-culture, as evidenced by time-lapse live imaging and single-cell tracking assays. Furthermore, topical application of gefitinib to guinea pig dorsal skin induced increased pigmentation and demonstrated efficacy in mitigating rhododendrol-induced leukoderma. Suppression of EGF signaling indirectly enhanced skin pigmentation by upregulating SCF and ET-1 in epidermal keratinocytes. This novel mechanism highlights the pivotal role of EGF signaling in regulating skin pigmentation, and topical EGFR-TKI therapy at an appropriate dose may be a promising approach for depigmentation disorder management.

Acceptable dark skinned women and egotistical light skinned women: black women speak on colorism and colorist microaggressions within the black community on campus

ABSTRACT This study focuses on Black undergraduate women’s perspectives and experiences with colorism and colorist microaggressions in Black communities at a Historically Predominantly White University (HPWI). Previous studies demonstrate that Black undergraduate women’s experiences are shaped by their race and gender together. Our study highlights how their skin tone, colorism, and colorist microaggressions also shape their college experiences. Twenty-five Black undergraduate women were interviewed about their experiences with discrimination on campus. The perspectives on colorism from dark and light skinned Black women show that colorist ideals are present within the campus’ Black Community and impact Black student interactions. Colorist microaggressions experienced by light-skinned Black women were rooted in objectification and fetishization; whereas the colorist microaggressions endured by dark-skinned Black women were enmeshed in anti-Black constructions of darkness with masculinity and deviance. This study demonstrates the importance of centering skin tone when exploring and analyzing Black undergraduate women’s experiences with discrimination.

Bridging the Communication Gap - Sign Language Communication System

Now, imagine a world where words are not spoken, and emotions are not expressed. For the Deaf community, this is not a mere thought experiment but a daily reality. Indeed, they are forced to communicate primarily through sign language e, therefore, regularly feel alienated in a society where words are the primary tool for translating thoughts and feelings. Under such circumstances, most Deaf and hard-of-hearing people are struggling to communicate the most effectively. They usually opt for interpreters or their own signaling, but these alternatives are not the most efficient or effective choices. While signaling is the most intuitive and meaningful alternative, its grammar and semantic variations make it impossible to comprehend for those people who are not within the culture. Therefore, we have also developed a software prototype that could interpret sign language automatically. This paper presents a new method to recognize Indian sign language alphabets A-Z and digits (0-9) in a real- time video feed by employing the Bag of Visual Words model (BOVW). Furthermore, it not only predicts the labels of the signs but also gives the output as text and speech. The segmentation process here comprehends skin color detection and background subtraction. Speeded Up Robust FeaturesSurf features have been extracted again from the images, and histograms are built to map the signs to text labels. Furthermore, we have utilized algorithms such as Support Vector Machine (SVM) and Convolutional Neural Networks (CNN) for binary classification. Finally, we have established an interactive Graphical User Interface (GUI to make this process more user-friendly

Efficacy and Safety of Monopolar Radiofrequency for Tightening the Skin of Aged Faces

Background: Monopolar radiofrequency (RF) has emerged as a promising modality for tightening the skin of aged faces. Although many studies have assessed the efficacy of monopolar RF via the clinical evaluation of photographs, few have examined the long-term effectiveness and safety of this therapy using various skin testing devices. Methods: Twenty women with aged faces participated in this study. After a single monopolar RF treatment, three blinded dermatologists who were not involved in the treatment evaluated its clinical efficacy and safety after 4, 12, and 24 weeks. Skin firmness, fine wrinkles, skin pores, and skin tone were also measured using an indentometer (Courage+Khazaka Electronic GmbH, Köln, Germany) and a facial aging measurement device (Mark-Vu; PSI Plus, Suwon-si, Republic of Korea). Results: Skin laxity in the jowls and nasolabial folds showed significant improvement 12 weeks after the single monopolar RF treatment when evaluated by dermatologists, and this improvement lasted 24 weeks (p < 0.05). Moreover, the participants reported improvement at 4 weeks compared to baseline which lasted 24 weeks (p < 0.05). Skin firmness measured in the cheek increased 4 weeks after treatment and continued to improve during 24 weeks of follow-up (p < 0.01). Although there was a gradual increase in improvement in skin pores, fine wrinkles, and skin tones, there were no statistical differences compared to the baseline. No patients experienced pain during the treatment, and no burns, skin breakdown, or scarring occurred after treatment. Conclusions: A single monopolar RF treatment is effective for females with aged face. A significant improvement in the jowls and nasolabial folds and facial skin firmness was observed between the 4- and 24-week follow-ups without adverse effects.

The Impact of Ambon Banana (Musa Accuminata Colla) Puree Addition to Banana Bread Making on Physical Quality and Consumer Acceptance

The objective of this study was to analyze the impact of the addition of ambon banana puree in banana bread on physical quality and consumer acceptance. The method used was an experimental method with three types of treatments, namely banana bread adding 25%, 50%, and 75% ambon banana puree, conducted at the Pastry & Bakery Laboratory of Culinary Art Education, State University of Jakarta. The validity test was conducted using the organoleptic test to five lecturers of Culinary Art Education, State University of Jakarta, consisting of four external aspects and eight internal aspects, showing that banana bread adding 25% and 50% ambon banana puree excelled in various aspects. The physical quality test was conducted by measuring the volume of each product for three repetitions. The test results using the ANOVA test showed that there was no impact of the addition of banana puree on the quality of bread volume. The consumer acceptance test was conducted using the Friedman test, and data collection was done using the hedonic test for 30 panelists. The Friedman test results showed that there was an impact of the addition of ambon banana puree in banana bread on consumer acceptance in the aspects of volume, skin color, bread crust, skin characteristics, crumb color, crumb pores, crumb texture, and chewing quality. Furthermore, the results of Tuckey's test showed that banana bread adding 25% ambon banana puree was most preferred in terms of volume and chewing quality, banana bread adding 25% and 50% ambon banana puree was most preferred in terms of bread crust color, bread crust thickness, bread crust characteristics, crumb color, crumb pores, and crumb texture. Based on the results of this study, it is recommended that banana bread add 50% of banana puree products for further utilization of banana ambon.

Intra-Individual Paired Mass Spectrometry Dataset for Decoding Solar-Induced Proteomic Changes in Facial Skin

Photoaging is the premature aging of the skin caused by prolonged exposure to solar radiation. The visual alterations manifest as wrinkles, reduced skin elasticity, uneven skin tone, as well as other signs that surpass the expected outcomes of natural aging. Beyond these surface changes, there is a complex interplay of molecular alterations, encompassing shifts in cellular function, DNA damage, and protein composition disruptions. This data descriptor introduces a unique dataset derived from ten individuals, each with a minimum of 18 years of professional experience as a driver, who are asymmetrically and chronically exposed to solar radiation due to their driving orientation. Skin samples were independently collected from each side of the face using a microdermabrasion-like procedure and analyzed on an Exploris 240 mass spectrometer. Our adapted proteomic statistical framework leverages the sample pairing to provide robust insights. This dataset delves into the molecular differences in exposed skin and serves as a foundational resource for interdisciplinary research in photodermatology, targeted skincare treatments, and computational modelling of skin health.

Anatomy's missing faces: An assessment of representation gaps in atlas and textbook imagery.

Previous research suggests that underrepresentation in medical curricula perpetuates inequities in healthcare. This study aimed to quantify the prevalence of human phenotypic diversity (e.g., skin tone, sex, body size, and age) across 11 commonly used anatomy atlases and textbooks in pre-clerkship medical education, published from 2015 to 2020. A systematic visual content analysis was conducted on 5001 images in which at least one phenotypic attribute was quantifiable. Anatomy images most prevalently portrayed light skin tones, males, persons with intermediate body sizes, and young to middle-aged adults. Of the 3883 images in which there was a codable skin tone, 81.2% (n = 3154) depicted light, 14.3% (n = 554) depicted intermediate, and 4.5% (n = 175) depicted dark skin tones. Of the 2384 images that could be categorized into a sex binary, 38.4% (n = 915) depicted females and 61.6% (n = 1469) depicted males. A male bias persisted across all whole-body and regional-body images, including those showing sex organs or those showing characteristics commonly associated with a specific sex (e.g. for males, facial hair and/or muscle hypertrophy). Within sex-specific contexts, darker skin was underrepresented, but male depictions displayed greater overall skin tone variation. Although most images could not be assigned to a body size or age category, when codable, these images overwhelmingly depicted adults (85.0%; 482 of 567) with smaller (34.7%; 93 of 268) or intermediate (64.6%; 173 of 268) body sizes. Ultimately, these outcomes provide reference metrics for monitoring ongoing and future efforts to address representation inequalities portrayed in anatomical imagery.

Assessing GPT-4's Diagnostic Accuracy with Darker Skin Tones: Underperformance and Implications.

This study aimed to assess the accuracy of GPT-4 in generating appropriate differential diagnoses and arriving at the correct diagnoses for common skin lesions. Additionally, we investigated any differences in its diagnostic accuracy between darker and lighter skin tones. GPT-4 exhibited better performance in providing the correct diagnosis for lighter skin tones (44%, n = 11/25) compared to darker skin tones (12%, n = 3/25), and this was statistically significant (p-value < 0.05). Furthermore, with each unit increase in the Fitzpatrick scale, GPT-4’s performance decreased by 11.4% in accurately providing a differential diagnosis and by 7.1% in accurately providing the correct diagnosis.

Twelve Steps to Optimize Scar Outcomes in External Rhinoplasty.

A well-healed scar extends beyond a mere superficial concern, reflecting the precision and care underlying the surgery. This study addresses the lack of recent literature on the complete closure technique for external rhinoplasty scars, emphasizing its potential impact on patient satisfaction and overall aesthetic quality. The main purpose of this article is to introduce and assess the efficacy of a novel closing suture technique for external rhinoplasty and emphasize on twelve specific steps for wound closure. A cohort of 104 patients, who underwent external rhinoplasty utilizing the proposed closing suture technique were evaluated. Standardized photographic documentation and scar assessment were performed using the Vancouver-Manchester scale, considering notching, skin level differences, pigmentation, and overall appearance. The surgical approach involved a combination of vertical mattress and interrupted simple sutures, creating an effective closure framework. Analysis revealed an absence of poor scars, with 83.6% classified as good. 65.5% of the good scars achieved a perfect 6-point score. While one moderate scar scored 3 points, the majority demonstrated optimal outcomes. Clinical photographs further illustrated the technique's success, showcasing imperceptible scars and reinforcing the efficacy of the complete closure approach. Our study introduces and assesses the efficacy of the complete closure technique for external rhinoplasty scars. The approach consistently yields positive outcomes, with an emphasis on almost imperceptible scars. While not achieving a 100% imperceptible scar rate, this study underscores the need for ongoing research to refine techniques and enhance patient satisfaction in external rhinoplasty. The proposed technique contributes significantly to scar management practices and encourages further exploration within the evolving landscape of rhinoplasty.

Abstract PO5-09-12: Unraveling the Intricacies of Racial Disparities in Breast Cancer in Brazil

Abstract Abstract Background: Over the past three decades, numerous countries have experienced a substantial decrease in breast cancer (BC) fatality, attributed to heightened consciousness, widened and earlier screening, and enhanced therapeutic interventions. However, these advancements have not eradicated the disparity in BC treatment across different racial and ethnic groups. In Brazil, the causes of these disparities are diverse and intricate, resembling health inequalities among ethnic communities observed in other countries. This study aimed to investigate the trends in BC incidence and mortality rates in Brazil, considering clinicopathological and sociodemographic variations, and placing particular emphasis on the severity of racial disparity concerning race/skin color. Patients and methods: Incidence trends for women with BC were analyzed using data from 13 Brazilian Population-Based Cancer Registries covering the period 2010-2015. Crude incidence ratios (CIRs) and the annual average percent change (AAPC) were calculated. Clinical and sociodemographic information from 348 Hospital-Based Cancer Registries spanning from 2000 to 2019 was also utilized. Meanwhile, mortality data for the years 2000-2020 were obtained from the National Mortality Information System. Racial and skin color data were collected through a self-declaration process, following the classification proposed by the Brazilian Institute of Geography and Statistics, which included categories such as white, black, and brown/mixed race. In the analysis, black and brown/mixed race categories were combined as black. Yellow and indigenous categories were excluded. Statistical significance was defined as a p-value less than 0.05. To determine clinically relevant differences, a threshold of more than 5% disparity in proportional values was used as an arbitrary criterion. Results: Between 2010 and 2015, a total of 70,896 newly diagnosed cases of BC were recorded. Mean CIRs were 83.9/100,000 for the overall population, 101.3/100,000 for white women, and 59.7/100,000 for black women. Neither the group of white women (AAPC -1.7; 95% CI: -7.9 to 4.9; p = 0.506) nor the group of black women (AAPC -0.4; 95% CI: -5.0 to 4.5; p = 0.831) exhibited any significant changes in the incidence rate. Black women predominantly originated from underdeveloped regions (56.4%, p < 0.001), were referred by the public healthcare system in Brazil (79.0%, p < 0.001), had ≤ 8 years of schooling (68.7%, p < 0.001), were unmarried (50.9%, p< 0.001), reported alcohol consumption (20.9%, p < 0.001), and were diagnosed with advanced stage disease (60.1%, p < 0.001). The escalation in mortality rates among black women exhibited a notable difference, amounting to 3.8 times the increase observed among white women (AAPC + 2.3; 95% CI: 2.1 to 2.5; p < 0.001) (AAPC + 0.6; 95% CI: 0.5 to 0.7; p < 0.001). Conclusion: Despite the lower incidence of BC in black women compared to their white counterparts, there is a concerning rise in BC-related mortality rates among black women. This group exhibits a significantly unfavorable sociodemographic and clinicopathological profile. These results highlight the pressing need to address the multifaceted factors contributing to these disparities, encompassing socioeconomic disparities and unequal healthcare access. Keywords: Breast cancer; racial disparities; incidence; mortality. Citation Format: Jesse Lopes da Silva, Andreia Cristina De Melo, Mariana Espirito Santo Rodrigues, Lucas Zanetti de Albuquerque, Luiz Claudio Santos Thuler. Unraveling the Intricacies of Racial Disparities in Breast Cancer in Brazil [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-09-12.

Abstract PO3-28-02: BODY-IMAGE DISTRESS IN BREAST CANCER SURVIVORS AND THEIR EVALUATION OF MEDICAL TATTOOING FOLLOWING SURGERY

Abstract A review of the literature reveals a high incidence of body-image distress among breast cancer survivors who have undergone surgery, which is a natural response to the significant changes in their appearance. Reconstructive surgery, utilizing implants or flaps, may be employed to restore breast size and shape. Medical tattooing can recreate the nipple-areola complex and decorative appliques can conceal scars and skin color variations. Both reconstructive surgery and medical tattoos are associated with patient-reported satisfaction, yet further research is necessary to understand their combined impact on body-image distress. To investigate this, a survey was distributed among national breast cancer support groups and advocacy organizations, yielding 207 responses from individuals meeting the study's criteria. The participants were categorized into two groups: those who received post-surgical medical tattoos (n = 61) and those who did not (n = 146). The study also examined how participants evaluated the cosmetic and decision satisfaction of patients who made various surgical and cosmetic intervention choices. This was accomplished by having participants rate images of patients who had received three types of intervention: mastectomy and reconstruction only, mastectomy and medical tattooing only, and mastectomy, reconstruction, and medical tattooing. Using linear regression and multilevel modeling that controlled for demographic and clinical factors associated with body-image distress, the findings demonstrated that participants with medical tattoos reported significantly lower levels of body-image distress, depressive symptoms, and perceived stress compared to those without medical tattoos. Furthermore, participants rated images of patients who underwent both reconstruction and medical tattooing post-mastectomy as having significantly higher cosmetic and decision satisfaction ratings than images of patients who received reconstruction or medical tattooing alone. This research expands on our understanding of body-image distress in survivors as a multidimensional construct and may serve to indicate potential means for intervention. Enhancing our understanding of how breast cancer treatment and surgery affects survivors' body-image distress may aid healthcare professionals in offering additional psychoeducation and recommendations. Furthermore, presenting information about medical tattooing as a complementary cosmetic option early in the treatment process allows patients the opportunity to consider it within the context of their overall treatment plan. Table. Linear regression results using BIBCQ as the outcome variable and medical tattoo group as the predictor variable with covariates included. Note. PHQ9 = Patient Health Questionnaire-9. PSS = Perceived Stress Scale. Citation Format: Miranda Proctor, Jeffrey Cassisi. BODY-IMAGE DISTRESS IN BREAST CANCER SURVIVORS AND THEIR EVALUATION OF MEDICAL TATTOOING FOLLOWING SURGERY [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-28-02.

Vitiligo Causes and Treatment: A Review

Vitiligo is a chronic autoimmune disorder characterized by patches of skin losing pigment due to the destruction of melanocytes, the cells responsible for producing pigment. The condition can affect people of all ages and ethnicities, with symptoms including milky-white patches on the skin, premature graying of hair, and color loss in mucous membranes like the mouth or nose. Among the main causes of vitiligo are; Autoimmune Response: Vitiligo is primarily an autoimmune disease where the immune system mistakenly attacks melanocytes, leading to depigmentation. Factors like family history, genetic predisposition, and immune system disorders contribute to its development, Triggers: Events such as sunburn, emotional distress, or exposure to certain chemicals can trigger or exacerbate vitiligo. The treatment options are; Medications: Treatments include light therapy (phototherapy), oral medications like psoralen combined with UVA light (PUVA), and depigmentation therapy using monobenzone to match skin tones Surgery: Surgical options are available for some cases of vitiligo and Psychological Support: Counseling and mental health services can help individuals cope with the emotional impact of vitiligo, in conclusion, v is a multifaceted skin condition lacking a conclusive remedy, many types of vitiligo, but the most common one is Non-segmental Vitiligo (NSV), honmental and genetic are the most important causes of vitiligo. Important symptoms of vitiligo are; depigmented patches, hair discoloration, sensitivity to sunlight, treatment of vitiligo have many approach, among them are; topical Corticosteroids, phototherapy and Cosmetic Camouflage.

Storying My Body in Bits and Bytes

ABSTRACT This study shows how cyberautoethnography can be used to critically interrogate and make sense of how technology and attendant artifacts shape our understanding of embodiment. Specifically, this goal is achieved by applying cyberautoethnography to study Bitmoji avatars, a digital artifact, as a type of digital embodiment. Users can personalize Bitmoji avatars by choosing from a variety of skin tones, body sizes, and other physical characteristics. Thus, similar to the creation of other avatars (such as those in social media and gaming environments), creating and circulating these digital artifacts can be understood as acts of strategic digital (re)presentation and embodiment. Here, I reflect on the process of creating my Bitmoji avatar and analyze conversations using Bitmojis to discuss how I use my Bitmoji to make my body hypervisible in a context that’s typically understood as disembodied. I conclude that the seemingly mundane use of Bitmojis can be understood as a feminist practice that marginalized individuals might engage with in order to extend the political dimensions of everyday, lived experiences into the digital realm. Thus, this critical cyberautoethnography showcases the value of autoethnography for understanding how agency is claimed and limited by contemporary forms of technology-mediated embodiment.

Comparative Effectiveness of 20% Azelaic Acid with 1064-nm Nd:YAG Picosecond Laser vs Azelaic Acid Alone for Melasma Treatment in Thai Female Patients: A Split-Face Study

Melasma is one of the most concerning pigmented skin conditions, especially in females. It can be influenced by sunlight, occupation, gender, and drug use, which can aggravate the disease. This split-face clinical trial assesses the effectiveness of picosecond laser in melasma treatment combined with topical azelaic acid compared with azelaic alone. The primary outcome of this study is the Hemi-MASI score, while the secondary outcome is demographic data, physicians' global assessment, patient satisfaction score, and adverse events. The study recruited twenty Thai females aged between 18 and 65 diagnosed with bilateral symmetrical malar-type melasma. The patients were treated with low fluence 1064-nm Nd:YAG picosecond laser three sessions every two weeks combined with topical azelaic acid twice daily on the right side of the face, whereas the left side was treated with topical azelaic acid twice daily alone for 16 weeks. The mean Hemi-MASI decrease is 3.52%, 9.38%, and 19.94% on the combination side, while there are 1.93%, 7.89%, and 16.73% at the 8th, 12th, and 16th, respectively in the topical azelaic alone side. There were no severe side effects from both picosecond laser and azelaic acid, and they can be relieved without treatment. Thus, the overall clinical result demonstrates the improvement as the patient satisfaction score is satisfied. Still, the mean Hemi-MASI score between the two sides is not statistically significantly different (p>0.05). In conclusion, combining the picosecond laser with azelaic acid alone in melasma treatment results in a better overall general outcome than the azelaic alone.

Skin Tone Representation on Patient-Facing Skin Cancer Education Websites.

When patients self-detect suspicious skin lesions, they often reference online photos prior to seeking medical evaluation. Online images must be available in the full spectrum of skin tones to provide accurate visualizations of disease, especially given the increased morbidity and mortality from skin cancer in patients with darker skin tones. The purpose of this study was to evaluate the representation of skin tones in photos of skin cancer on patient-facing websites. Six federally-based and organization websites were evaluated, and of the 372 total representations identified only 49 depicted darker skin tones (13.2%). This highlights the need to improve skin tone representation on patient-facing online resources. J Drugs Dermatol. 2024;23(5):e137-e138.     doi:10.36849/JDD.7905e.

Postinflammatory Hyperpigmentation Following Mohs Micrographic Surgery: An Observational Study.

Functional and cosmetic outcomes following Mohs micrographic surgery (MMS) are poorly studied in individuals with skin of color (SOC). Postinflammatory hyperpigmentation (PIH) may be long-lasting and highly distressing. SOC individuals are particularly susceptible to PIH following procedures.  Objective: To characterize factors that contribute to the development of PIH following MMS in SOC. This retrospective study included 72 SOC individuals with 83 cases of keratinocyte carcinoma treated with MMS between August 2020 and August 2021 at a single medical center in the Bronx, New York. Postinflammatory hyperpigmentation following Mohs micrographic surgery was more common in Fitzpatrick skin types (FST) IV to V (48.0%) compared to FST I to III (18.2%; P=0.006). Grafts and granulation resulted in higher rates of PIH compared to linear repairs and flaps (87.5% vs 30.7%; P=0.003). Cases with postoperative complications resulted in higher rates of PIH compared to cases without (81.8% vs 29.2%; P=0.001). In a subset analysis of linear repairs, polyglactin 910 as a subcutaneous suture produced a higher rate of PIH compared to poliglecaprone 25 (46.2% vs 7.1%; P=0.015).  Conclusions and Relevance: Individuals with SOC (FST IV to V) are more likely to develop PIH following MMS. Grafts and granulation lead to PIH more often than linear repairs and flaps. Postoperative complications significantly increase the risk of PIH. Surgeons should consider these risk factors during surgical planning in an effort to mitigate PIH in SOC individuals. Studies with larger sample sizes are indicated.  J Drugs Dermatol. 2024;23(5):316-321. doi:10.36849/JDD.8146.

Understanding therapeutic radiographers’ confidence in assessing, managing & teaching radiation induced skin reactions (RISR): A national survey in the UK

IntroductionThe standard toxicity tools adopted for assessing Radiation Induced Skin Reactions (RISR) do not currently reflect how skin changes occur across all skin tones.A one size fits all approach is adopted currently for RISR assessment. The aim of this study was to understand what evidence-based practice and RISR tools are being used across the therapeutic radiography workforce and the levels of confidence in using these tools. MethodsA survey using Likert scales to assess confidence in RISR assessment and management was made available to 77 departments in the UK between August–November 2021. Descriptive statistics were used to understand respondents' confidence in assessing, managing, and teaching RISR between white, brown, and black skin tones; Fisher's exact test was used to assess the significance of differences between groups. ResultsComplete responses were received from 406 therapeutic radiographers. Radiation Therapy Oncology Group (RTOG) was the most used RISR assessment tool (58% of respondents n = 237). Most respondents (74.2% n = 303) reported use of locally produced patient information on skin care, rather than the Society and College of Radiographers evidence-based patient leaflets. Confidence in assessing and managing RISR in white skin was higher than that in brown and black skin. Similarly, confidence was higher in teaching of appropriate RISR assessment and management in white skin tones when compared to brown and black skin. ConclusionWhite skin tones appear to be more confidently assessed and managed for RISR along with taught appropriate assessment and management, than brown and black skin tones in the sample of the workforce that responded. Implications for practiceA greater understanding of the reasons for these differences is required but this study aims to instigate change and positive growth within this area.