Care in Skin Care

Skin Cancer

People with brown skin often have a false sense of security when it comes to skin cancer. We tend to believe that our darker skin exempts us from this potential danger. It is true that people of color, those with increased skin pigmentation, have added protection against the UV rays of the sun. However, it is also true that those from African-American, Asian, Latino and Native American backgrounds usually have higher morbidity and mortality rates for several types of skin cancer than their white counterparts. This lower survival rate is a direct result of late detection or misdiagnosis. Because there is a dearth of research on brown skin, there is little literature available to healthcare professionals to help educate them on the different ways skin cancer can manifest itself in darker skin. For this reason, it is of the utmost importance that you choose physicians who are familiar with the unique characteristics of darker skin and ethnic skin care. This can literally make the difference between life and death.
In addition to choosing an informed physician, it is also very important for each individual to be self-educated about the different ways in which cancer affects brown skin. There are three types of skin cancer: malignant melanoma (MM) squamous cell carcinomas (SCC) and basal cell carcinomas (BCC). In general, persons with brown skin are less likely to develop BCC than their white counterparts. SCC (especially those that develop from scars or burns) and melanomas are more common in ethnic skin. However, melanoma remains the most deadly form of skin cancer in brown skin, due mainly to its potential for rapid spread, and to late diagnosis.


Malignant Melanoma
Malignant melanoma is the most dangerous and deadly form of skin cancer in people of color. Although it is often curable if discovered early, many cases aren’t discovered until it is too late to effectively treat the disease. Unlike other skin cancers, melanoma has great potential for metastasizing (spreading), and once it reaches other parts of the body, it is very difficult to treat. There are two main reasons for late detection: 1) the melanomas on brown skin often occur on less sun-exposed areas—feet, palms, nails; and 2) they are sometimes misdiagnosed as plantar warts (foot wart), tinea nigra palmaris (fungus on the palm), or talon noir (dark nail). Melanoma in non sun-exposed skin especially the feet, palms, nails) is the most common seen in Asians, Native Americans, African and African-Americans. In Hispanics, melanoma malignancies occur most frequently on the legs.

Melanoma skin cancer is especially unique due to the fact that it is one of the only forms of cancer where the cause is felt to be known. This cancer most often develops due to an individual’s overexposure to the sun and other forms of ultraviolet rays (i.e. artificial light). Despite myths that claim otherwise, people with brown skin do not have absolute protection from the sun. Lighter-skinned Hispanics are particularly vulnerable, as they have less melanin than their darker counterparts to protect them from the sun. However, Hispanics often do not consider themselves at risk for skin cancer and, because of their decreased tendency to sunburn, remain in the sun for dangerously long periods of time without adequate protection.

Melanoma tumors are malignant and originate in the pigment producing cells within your skin (melanocytes). Because of their location, melanoma tumors tend to be black or brown. They do, however, occasionally cause cells to stop producing pigment, which results in the appearance of a dark, pinkish, skin-colored growth. Usually the tumors appear as multi-colored patches or bumps with irregular outlines. These areas often begin to crust and bleed with time and many develop on the sites of pre-existing moles. Melanomas can be either in situ (a localized tumor usually located in one spot on the outer layers of your skin) or invasive (cancer cells that penetrate further into the skin and have begun to invade other parts of the body). If you spot irregularities in your skin, it is always advisable to consult a physician, since she will be able to provide an informed diagnosis.

There are four basic categories of melanomas: Acral Lentiginous, Superficial Spreading, Lentigo Maligna and Nodular Melanoma. The first three are in situ in the beginning, later advancing to the invasive stage. The last is invasive from the beginning.

Acral Lentiginous is one of the most common forms of melanoma in people with brown skin, Asians and African Americans especially. This form of melanoma tends not to affect Caucasians. It is usually seen as a black or brown discoloration on the palms of hands and feet, or under the surface of nails, and is one of the least diagnosed because of its odd location. Acral Lentiginous spreads superficially before tumors begin penetrating deeper organs.

Superficial Spreading melanoma is the most common type and accounts for about 70% of all melanoma cases. Usually it is located on the top layer of the skin and is slow to penetrate into the lower layers. This type of skin cancer often begins as a flat patch of discoloration with irregular borders. It is usually somewhat geometrical and ranges in color, with areas of tan, brown, black, red, blue, or white. These tumors usually start in old moles, and begin to change form over time. Although they can occur anywhere, they are usually found on the legs and upper backs.

Lentigo Maligna melanoma is very similar to the superficially spreading form. It begins as a slightly elevated area of discoloration, usually a mottled patch, ranging from tan to dark brown. The non-spreading form of this cancer is usually found in the elderly, or on people with chronic sun exposure. This form is usually found on the face, upper trunk, arms and the ears.

As mentioned, Nodular melanoma is invasive from the start and is the most aggressive form of the melanomas. One usually will notice this type of tumor when the spreading forms a lump in the skin. It is most often blackish in color, but can also develop in browns, or as a gray, white, red, or pink bump. Nodular Melanoma is found most often on the trunk and limbs of patients and is most common in the elderly. Fortunately, however, it is also the least common form of melanoma, accounting for only 10-15% of patient cases.