1. Why is it important?
   1. 2050
      1. Hispanic
         1. 25%
      2. Blacks
         1. 14%
      3. White
         1. 52%
2. Benefits
   1. Dark
      1. protected from cancer
   2. Light
      1. inc. conversion of D
3. Terms
   1. Mongoloid
      1. Asian
         1. Indian
   2. Astraloid
      1. Aborigenes
   3. Congoid/Negroid
   4. Capoid
      1. Southern Africa
         1. coppery yellow skin
            1. orange hair
         2. Botswana, Angola, Mosanbiue
   5. Caucasoid
4. Biology of Pigementation
   1. ALL skin types have the same # of melanocytes
      1. 1 melanocyte
         1. has
            1. 36 keratinocytes
            2. go between cells
            3. melanosome
            4. organelle
            5. makes melanin
            6. more in DARK SKIN
            7. Melasma
            8. hormonal
            9. think
            10. pregnancy
            11. birth control pills
            12. high estrogen states
            13. trt
            14. B-3 (niacinamide)
            15. less effective than creams
            16. less side effects
   2. Types of Melanin
      1. African
         1. Eumelanine
            1. 90%
            2. protects against UV damage
            3. "Eu-" means normal
         2. larger granules
      2. Oriental
      3. Caucasian
         1. Pheomalanine
            1. 90%
            2. INC free radical production
   3. Tyrosine
      1. Dopamine
   4. Black stratum corneum
      1. higher lipid content
      2. mb lower Na+ in sweat
      3. more compact
5. Racial differences in the dermis
   1. Fibroblasts
      1. black females
      2. multi-nucleated
      3. highly reactive
      4. low in collagenase
      5. keloid scars
6. Hair
   1. Type VI
      1. Black
         1. thick
            1. esp. at tips
         2. cross-section
            1. elipse
         3. pulls out easily
            1. not anchored well
            2. few elastic fibers
         4. low density
            1. fewer follicles
            2. less eslasticity
            3. knots, fizzyres and splits
   2. Asian
      1. round
         1. cross-section
   3. Native American
      1. round
         1. largest diameter
   4. White
      1. smallest
7. Cultural Practices Linked to Skin/Hair Dz
   1. Facial lightening Agents
      1. cause
         1. steroid induced atrophy
            1. stretch marks
   2. Henna
      1. Lawsonia alba
         1. oxidizing agent
            1. contact dermatitis
8. Conditions unique/common on Type V & VI Skin
   1. Dermatosis papulosa nigra
      1. Gross Morphology
         1. small deeply pigmented verrucose lesions
         2. malar area
      2. Histopathology
         1. hyperkeratosis
         2. sheets of basal-like cells containing melanin
      3. DD
         1. seborrheic keratosis
   2. Pseduofolliculitis barbae
      1. shaved, curved hairs penetrate the skin and setup a foreign body rxn
      2. Morphology
         1. papules/pustules
         2. post-inflammatory
            1. hyperpigmentation
   3. Traction alopecia
      1. hair thins out
         1. from pulling
            1. braids
   4. Keloid
      1. Histopathology
         1. collagen nodule
            1. high density of fibroblasts
            2. highly vascularized
            3. thickened epidermal layer
      2. Epidemiology
         1. age
            1. 10-30
         2. females
         3. Polynesian and Chinese
         4. 16% of blacks
         5. ear piercing
9. Normal Variations in Type V and VI Skin
   1. Voigt lines
      1. aka
         1. Futcher lines
      2. demarcation between lighter and darker skin
      3. upper arms and sternum area
   2. Melanonychia Striata
      1. refer out
         1. melanoma
   3. Palmar Punctate Keratoses
      1. common
      2. <5 mm
      3. hyperkeratotic pits
         1. firm plugs
            1. sharply defined
            2. translucent
         2. can also be in palmar creases
   4. Mongolian spots
      1. Morphology
         1. collections of melanocytes
         2. brown to blue-black ill-defined macules in infants
         3. buttock and lumbosacral
      2. leave after 7-13 yrs old
      3. DD
         1. child abuse