Common Benign Skin Conditions and Pigmentary Disorders in Asians and Patients with Darker Skin

Conclusions

• Many dermatologic conditions in Asian and darker-skinned children present with papular or less classic morphologies, so clinicians should adjust their visual expectations.
• Traumatic anserine folliculosis is a benign, friction-induced eruption that is often seen in darker-skinned patients and improves mainly by removing the source of pressure or rubbing.
• Labial melanotic macules are common benign findings in Asian patients, often associated with cheilitis or atopy, and usually do not indicate Peutz-Jeghers syndrome when there is no buccal involvement.
• Labial melanotic macules can be treated cosmetically with light cryotherapy or pigment lasers, but treatment is not medically necessary in most cases.
• Traction alopecia is an important and potentially irreversible cause of frontal hair loss in Sikh patients, and the fringe sign is a useful diagnostic clue.
• Congenital dermal melanocytosis is usually a benign birthmark that is common in Asian infants and commonly fades with age.
• Dermal melanocytosis can be mistaken for bruising or child abuse, so recognition is important to avoid misdiagnosis.
• Persistent, extensive, darker, or progressive dermal melanocytosis should raise concern for an underlying lysosomal storage disorder or other associated syndromes.
• Overall, the key clinical message is to recognize these culturally and ethnically patterned dermatologic presentations so patients can be reassured and unnecessary workup or alarm can be avoided.