Assessing the role of race in quantitative measures of skin pigmentation and clinical assessments of photosensitivity.
ABSTRACT Given the increasing demographic diversity in the United States, clarifying relationships between race, color, ethnicity, and disease processes is critical.
We sought to examine the correlation between objective measures of skin pigmentation, racial identification, and physician-diagnosed and self-reported skin phototypes.
A total of 558 participants (76 nonwhite) were evaluated. A subset underwent spectrometric readings and digital photography of the upper aspect of the inner arm. Self-identified race was compared with 7 measures of pigmentation.
Race correlates best with physician-diagnosed skin phototype (r = 0.55, P < .01), whereas self-reported skin phototype, spectrometry, and colorimetry correlate poorly with race (r = 0.28, < 0.40, and r > -0.31, respectively, P < .01). Associations between race and subjective measures strengthen among patients with darker skin.
Objective measures of pigmentation fail to correlate well with race, whereas race correlates moderately with physician-diagnosed skin phototype. Including objective methods of analyzing skin color may reduce subjective influences of race in assessing photosensitivity and potential risk for skin cancer.
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ABSTRACT: To assess the level of melanoma awareness and risk perception among ethnic minorities and to identify ways to enhance the relevance of melanoma educational materials for ethnic minorities. Methods: Twelve focus groups composed of participants from a single ethnicity [African-American (n=40), Hispanic (n=40), and Asian (n=40)], participated in a 2 h discussion on melanoma and skin cancer and commented on an educational brochure by the American Cancer Society and reacted to photographs of melanoma on ethnic skin. Participants also evaluated the ability to sunburn and tan and the skin cancer risk of images of celebrities before and after the discussion. Additionally, participants assessed the skin tone of celebrities as very fair, fair, olive, light brown, dark brown, and very dark. The audiotape recordings of the 12 focus groups were transcribed and analyzed with the Non-numerical Unstructured Data Indexing Searching and Theorizing software for common themes. The common themes were (1) lack of relevance of skin cancer to ethnic people, (2) understanding of skin cancer risk terminology is based on personal experience and what is acquired from the media, and (3) sources of health information for ethnic minorities are fragmented and physicians are not the primary source of information. Celebrity images representing the six skin tones were selected. Relevance of melanoma education to ethnic people may be improved by using 'melanoma skin cancer', photographs of early melanoma in people with dark skin, and providing guidance on how to inspect hands and feet for suspicious moles.Psycho-Oncology 03/2010; 20(3):313-20. · 3.51 Impact Factor
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ABSTRACT: Background: The Ferriman-Gallwey hirsutism score is the currently accepted standard for assessing excess hair growth that may indicate hyperandrogenicity. The score was originally based on 60 Caucasian women, and recent studies suggest that it may need modification to be used in other populations. Objectives: To investigate ethnic, racial, and pigmentary variations in hair growth of the upper lip in diverse multinational populations. Results: Variations in hair growth of the upper lip were significantly related to self-reported ethnicity and race. In a logistic regression with racial groups and skin lightness, all racial groupings (African American, Hispanic, Asian Indian, and East Asian) were predictive of hair growth (all p<0.0001), but skin lightness was not (all p>0.05). Conclusion: The observed differences in constitutive hair growth illustrate the need to develop an ethnically stratified visual scoring method to more accurately characterize the severity of excess hair growth.Journal of Clinical and Aesthetic Dermatology 05/2014; 7(5):24-6.
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ABSTRACT: IMPORTANCE Determining Fitzpatrick skin phototypes (FST) allows physicians to assess a person's risk of developing sunburn and, by extension, the need for sun protection to prevent the development of skin cancer. Reflectance spectrophotometry objectively measures the melanin index and can assist in determining the accuracy of self-report of FST compared with dermatologist-determined FST. OBJECTIVES To assess whether self-reported or dermatologist-determined FST is more accurate in identifying a participant's FST for FST I through VI and to assess the relevance of the burning and tanning measures for a range of skin types among ethnically diverse participants. DESIGN AND SETTING A convenience sample of participants in an observational study from June 2, 2010, through December 15, 2010, at an ambulatory academic dermatologic practice and employee health center in an urban city. PARTICIPANTS Participants, staff, and students of Northwestern University, who self-identified as being non-Hispanic white, Hispanic or Latino, Asian or Pacific Islander, or black. MAIN OUTCOMES AND MEASURES Melanin index as measured with reflectance spectrophotometry compared with dermatologist- and participant-determined FST. RESULTS Forty-two percent (114 of 270) of the participants' responses to the burning and tanning questions could not be classified using standard FST definitions. The spectrophotometry measurements for dermatologist-determined FST were significantly different for FST III and IV (P < .001) and FST IV and V (P < .001). The spectrophotometry measurements for participant-determined FST were significantly different for FST III and IV (P < .001) but not for FST IV and V (P = .90). Participant responses to burning and the dermatologist-determined FST were significantly correlated (Spearman ρ, 0.764; P < .001). Participant responses to tanning and the dermatologist-determined FST were not significantly correlated (Spearman ρ, 0.089; P = .15). Spectrophotometry measurements assessing FST were statistically significantly different for FST III through VI (P < .001). CONCLUSIONS AND RELEVANCE Dermatologist-determined FST is more accurate than self-report for FST III through VI. Rephrasing the questions using specific descriptors that have meaning to people with skin of color, such as skin irritation, tenderness, itching, or skin becoming darker, may allow physicians to more accurately assign a skin phototype and, by inference, assess the risk of these participants developing skin cancer. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01124513.JAMA dermatology (Chicago, Ill.). 09/2013;