Dermoscopic features of neoplasms in skin of color: A review

Abstract

Background Dermoscopy is undoubtedly a useful tool to improve diagnostic accuracy and minimize the number of unnecessary biopsies. However, much of the literature on dermoscopy focuses on findings in lighter-skin phototypes, leaving potential gaps of knowledge regarding its use in skin of color (SoC). As the clinical applications of dermoscopy continue to increase, understanding dermoscopic patterns in SoC is imperative. Objective This review discusses the literature on dermoscopic findings of neoplasms in SoC, highlighting unique and characteristic dermoscopic features. Methods A literature review was performed using the PubMed database. Case reports, case series, case-control studies, and systematic reviews were included. Results A total of 8326 studies were identified based on the selected search terms, and 41 were included in this review based on relevance. Conclusion There are specific dermoscopic characteristics in SoC for benign nevi, acral lentiginous melanoma, ethnic melanonychia, and dermatofibroma; however, there is a lack of published data about specific features of cutaneous melanoma, subungual melanoma, pigmented basal cell carcinoma, and pigmented squamous cell carcinoma in SoC. Because pigmented basal cell carcinoma, pigmented squamous cell carcinoma, ethnic melanonychia, and acral lentiginous melanoma are diagnosed at later stages in this population, it is important to understand their dermoscopic features. Further descriptive studies are needed to better characterize unique dermoscopic features in neoplasms in SoC.

Absence of central white patch in dermatofibromas presenting in darker skin

“…The current literature focuses on the dermatoscopic findings of DFs in lighter skin tones, leaving gaps in the recognition of patterns found in individuals with darker skin phenotypes. 2 …”

“…The current literature focuses on the dermatoscopic findings of DFs in lighter skin tones, leaving gaps in the recognition of patterns found in individuals with darker skin phenotypes. 2 The most reproducibly identified dermatoscopic pattern associated with DFs in fair-skinned individuals is one consisting of a central, stellate, white, scar-like area surrounded by a thin peripheral pigment network. 3 However, this pattern may not be the most common pattern seen in darker skin phenotypes.…”

Case Report of a Patient of Black Ethnian With Skin Cancer in a Hospital Downtown in São Paulo

“…These cells are arranged in layers and, depending on the affected layer, the classification of different types of skin cancer is observed (47) . There are two types of skin cancer and non-melanoma: basal cell carcinoma (BCC), which arises in the basal cells, with low lethality and appears more frequently in regions exposed to the sun, and squamous cell carcinoma (SCC), which manifests in squamous cells and can develop in all parts of the body, although it is more common in areas exposed to them, such as BCC (13,47) . In Brazil, these data confirm, as the National Cancer Institute (INCA) records that the non-melanoma type corresponds to 30% of all malignant tumors registered in the country, of which 70% are BCC and 25% are SCC (32) .…”

“…But despite the lower risk of this population, black patients who develop skin cancer are faced with increased morbidity and mortality, as they present with different characteristics from the white population. (2,3,13,18,50) . In addition, mortality is higher when the lesion arises from an inflammatory process, being greater in spinal tumors, making the prognosis of SCC severe and reserved in black patients.…”

“…As with whites, it is mainly related to prolonged and intense exposure to ultraviolet light. Its diagnosis is also clinical and histopathological, with dermoscopy being a tool that can increase diagnostic accuracy and minimize unnecessary biopsies (13) . The complications of BCC arise when there is a delay in the diagnosis, and may present with expansion of the locally aggressive tumor (49) .…”