AJSP2405 - CME/CMLE - Clinicopathologic correlation of dermatologic diseases in patients with darker pigmentation-Clinicopathologic correlation of dermatologic diseases in patients with darker pigmentation

Clinicopathologic correlation of dermatologic diseases in patients with darker pigmentation

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This review article addresses the clinicopathologic correlation of dermatologic diseases, particularly focusing on those found in patients with darker pigmentation. Historically understudied and often misdiagnosed, these conditions significantly impact the affected individuals due to both medical and psychosocial reasons.<br /><br />The diseases discussed are categorized primarily into hypopigmented disorders, hyperpigmented disorders, scarring disorders, and alopecic disorders. The authors have conducted a thorough literature review to compile a list of common dermatologic diseases in darker skin populations, providing detailed insights into their clinical features, histopathology, and key diagnostic criteria.<br /><br />**Hypopigmented Disorders:**<br />These include conditions such as tinea versicolor, idiopathic guttate hypomelanosis, postinflammatory hypopigmentation, vitiligo, and hypopigmented mycosis fungoides. The article emphasizes the importance of differentiating between a decrease in melanocytes versus their complete absence and highlights the significance of clinical context and special stains for accurate diagnosis.<br /><br />**Hyperpigmented Disorders:**<br />Conditions such as lentigo, nevus of Ota, argyria, exogenous ochronosis, macular amyloidosis, and lichen planus pigmentosus are explored. The histologic characteristics that distinguish these conditions are discussed, including the depth of pigment and associated histologic patterns.<br /><br />**Scarring Disorders:**<br />Keloids and other scarring conditions like morphea and chronic cutaneous lupus erythematosus are examined. Keloids particularly are highlighted as disproportionately affecting individuals with darker pigmentation, with histologic features varying across their development stages.<br /><br />**Alopecic Disorders:**<br />The article reviews central centrifugal cicatricial alopecia (CCCA), traction alopecia, and other forms of scarring alopecias. CCCA, noted as particularly prevalent among women of African descent, is characterized by specific histologic findings like premature desquamation of the inner root sheath and concentric lamellar fibroplasia.<br /><br />The article concludes by stressing the critical need for improved understanding and diagnostic accuracy of these conditions, aiming to decrease healthcare disparities and improve patient outcomes through better clinicopathologic correlation. The authors call for ongoing research into the pathogenesis and management of these skin diseases to address existing knowledge gaps.

Keywords

dermatologic diseases

darker pigmentation

clinicopathologic correlation

hypopigmented disorders

hyperpigmented disorders

scarring disorders

alopecic disorders

histopathology

diagnostic criteria

healthcare disparities