Recommendations developed for early detection of cancers on skin of color

Melanoma gets much of the publicity, but the incidence of other types of skin cancer is on the increase and often overlooked — especially in people of color. A March 22 session will address challenges in diagnosing cancers and educating patients, and offer AAD recommendations to help overcome these challenges.

“Skin Cancer and Photoprotection in Skin of Color: Recommendations for Prevention, Education and Early Diagnosis” (F048) will be presented from 10 a.m. to noon March 22. Speakers will examine which cancers are most prevalent in ethnic populations and the clinical features of cancers on skin of color. They also will discuss prevention in the form of photoprotection, vitamin D synthesis, and lifestyle choices.

The greatest challenge in treating skin cancers in people of color is that melanoma draws the most attention, and nonwhites are not aware they are more susceptible to other types of skin cancer. Squamous cell carcinoma is most common in African-Americans and basal cell carcinoma is most common in Hispanics and Asian-Americans.

That also means that these cancers are not recognized soon enough for early detection, leading to poorer outcomes, said Susan Taylor, MD, founding director of the Skin of Color Center at St Luke’s-Roosevelt Hospital Center, New York.

“Skin cancer may not be top of mind for people of color or for their physicians,” said Dr. Taylor, who also is an assistant clinical professor of dermatology at Columbia University. “When detected early, skin cancer has a high cure rate, but it can pose a serious health threat if left untreated. This session will remind dermatologists that people of color are indeed at risk for all types of skin cancer.”

New recommendations from the Academy aim to increase awareness and earlier detection. The findings, based on an extensive literature review, appear online in the Journal of the American Academy of Dermatology.

Henry W. Lim, MD

“People of color can develop skin cancer. More commonly, the cancers are pigmented, and can occur in palms, soles, and oral mucosa,” said Henry W. Lim, MD, director of the session and an author of the JAAD paper. “A complete skin exam, especially in people of color, should include examination of oral mucosa, palms and soles.”

A monthly skin self-exam also is a key to early detection, and patients should be directed to pay special attention to the palms of the hands, soles of the feet, the fingernails, toenails, mouth, groin, and buttocks. Moreover, skin cancer may look different on darker skin. The recommendations call for looking for any spots or lesions that are changing, itching, or bleeding, or any ulcers or wounds that won’t heal.

“Education on this topic is now an integral part of many dermatology residency training programs. The younger generation of dermatologists should be familiar with this topic,” said Dr. Lim, the  C.S. Livingood chair and chairman of the department of dermatology at Henry Ford Hospital, Detroit.

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