Black Skin Disease in South East London

ABSTRACT

Skin disease in black patients can present a diagnostic challenge both because of variations in clinical appearance and because certain disorders appear unique to black skin. The majority of dermatology text books and atlases concentrate mainly on white skinned patients. Our hospital serves a cosmopolitan local community in whom 40 percent of the population is black. We recorded the diagnosis made in 461 consecutive black (African, Afro-Caribbean and mixed-race) patients who attended a general dermatology new patient clinic in South East London. The aim of the study was to document the spectrum of skin disease seen in black patients and to highlight these disorders. 187 children and 274 adults were studied. In the black children atopic eczema was diagnosed in 38 percent, tinea capitis 26.7 percent, pityriasis alba 3.7 percent, viral warts 3.2 percent, keloids 2.7 percent, others 25.7 percent. Diseases recorded which are not seen in the white children included Facial Afro-Caribbean Childhood Eruption (FACE) and infantile acropustulosis. Of the 274 adults assessed, acne was diagnosed in 14.6 percent, eczema 10.2 percent, psoriasis 5.1 percent, pityriasis versicolor 4.0 percent, alopecia areata 3.3 percent, dermatofibroma 2.9 percent, urticaria 1.8 percent, pityriasis rosea 1.8 percent, cutaneous sarcoid 1.5 percent, discoid lupus 1.1 percent. Diseases more commonly seen in black skin were acne nuchae keloidalis/scalp folliculitis 14.6 percent, keloids 4.4 percent, post inflammatory pigmentation 3.6 percent and traction alopecia 1.1 percent; other disorders were seen in 30 percent. Normal variants recorded were dermatosis papulosa nigra, linear nail pigmentation and palmar pits. As the UK population becomes increasingly cosmopolitan, familiarity with skin disorders in both black and white skin is increasingly relevant to our practice. (AU)