Autoimmune bullous diseases in skin of color |
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| Institution: | 1. Georgetown University School of Medicine, Washington, DC, USA;2. John H. Stroger Jr. Hospital of Cook County Health, Chicago, Illinois, USA;1. McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA;2. Department of Dermatology, University of Texas Health Science Center at Houston, Houston, Texas, USA;3. Department of Dermatology, Kaiser Permanente, Panorama City, California, USA;4. Department of Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA;5. Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA;1. Department of Dermatology, Brigham and Women''s Hospital, Boston, Massachusetts, USA;2. Department of Dermatology, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa;3. Division of Infection and Immunity, Cardiff University, Cardiff, UK;4. Department of Dermatology & Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA;5. Department of Dermatology, University of North Carolina, School of Medicine Chapel Hill, North Carolina, USA;1. Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA;2. University of Florida College of Medicine, Gainesville, Florida, USA;3. Department of Biostatistics, University of Florida College of Public Health and Health Professions, Gainesville, Florida, USA;1. Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy;2. Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy;3. Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy;4. Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy;5. Institute of Dermatology, Università Cattolica–Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy;6. Department of Dermatology, University of Brescia at ASST-Spedali Civili, Brescia, Italy;7. Dermatology, IRCCS S. Orsola-Malpighi Polyclinic, Bologna, Italy;8. Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy;9. Institute of Dermatology, Università Cattolica–Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy;1. Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA;2. Norfolk and Norwich University Hospital, Norwich, United Kingdom;3. Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA;4. Private practice, Pembroke Pines, Florida, USA |
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| Abstract: | Dermatologic health care disparities disproportionately affect patients with skin of color (SoC), defined as Fitzpatrick skin phototypes IV-VI (light brown, brown, and black skin tones), resulting in delayed treatment and increased morbidity and mortality.1 Numerous studies predict that by 2060 the White race will be a minority in the United States. Despite the rising SoC population, there remains a scarcity of peer-reviewed literature depicting skin conditions in SoC. In 2006, autoimmuneBullous pemphigoidBullous pemphigoid (BP) is the most common AIBD, with a reported incidence of 2.4 to 23 cases/1,000,000.5 BP prevalence is an estimated 12/100,000.6 It affects patients 60 to 80 years old with a 1-year mortality of 20%.7BP is characterized by tissue-bound and circulating IgG autoantibodies against hemi-desmosomal anchoring proteins, BP180 and BP230.8 Diagnosis is confirmed via lesional biopsy, showing a subepidermal bulla with eosinophils in the infiltrate, and perilesional directConclusionsAIBD in SoC patients have heterogeneous clinical presentations with features that may not be readily recognized. These can range from the color of erythema on darker skin types to postinflammatory hyperpigmentation, sometimes being confused for other disorders, as commonly observed with BP and PV. In DH, erythema may not be as pronounced in darker skin types, but even when it is, varied histologic features may create confusion about the clinical diagnosis. There may be some genetic associations |
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