Racial Skin Differences

Historical views on racial classification have been largely superseded by the understanding that biological variation does not fall into well‐demarcated categories, but is a continuum. The most obvious difference in the appearance of humans around the world is skin colour. For the most part, melanin determines the colour of the skin. Despite obvious differences in colour, the skin of the various races is remarkably similar in structure and function. Common inflammatory conditions may present differently in darker skinned individuals. Acne in darker skinned patients causes hyperpigmented macules when papules and pustules resolve. Lichen nitidus occurs most commonly in black skin. Patients with darker skin types are more prone to post‐inflammatory pigment alteration. Biopsy shows pigmentary incontinence, with melanin packed into dermal histiocytes. Cultural practices can be associated with specific skin diseases in certain ethnic groups.