SkinCancerNet Article
Skin Cancer: A Fact of Life in Skin of Color
Knowing what it looks like could save a life

People of all races and colors get skin cancer. This common cancer develops in people of African, Asian, Latino, and Native American descent. Even Aboriginal Australians have heard the diagnosis, “You have skin cancer.”

When skin cancer develops in skin of color, the cancer is more often advanced by the time it is diagnosed. Researchers are not sure why. It could be that the cancer is not recognized until the later stages in skin of color. Another possibility is that skin cancer tends to be more aggressive in skin of color. Either way, dermatologists agree that people with skin of color should learn:

It does not take long to learn these things, and the benefit is real. Knowing the warning signs of skin cancer and how to perform a skin self-exam can mean that skin cancer gets diagnosed at an earlier stage when the cure rate averages 95% with proper treatment. In advanced stages, skin cancer spreads. This can be fatal.

How to Recognize Signs of Skin Cancer
Skin cancer tends to develop differently in skin of color than in paler skin. Acral lentiginous melanoma (ALM) is a potentially aggressive melanoma, which makes up the majority of melanomas found in skin of color.

What makes ALM unique is that it is does not look like the typical skin cancer. In the early stages, it often resembles a bruise on the skin or pigmented streak under a nail. ALM also does not appear in the usual places that would make one suspect skin cancer. ALM only develops beneath nails, on the soles of the feet and palms of the hands, and on mucous membranes — inside the mouth and nose, anus, urinary tract, and female genitals. This makes ALM more difficult to recognize.

Warning signs of ALM and other skin cancers in skin of color include:

  • Bruise or sore that does not heal. It also may heal and then re-appear. If this happens, see a dermatologist, especially if the area was injured years ago.

  • Stripe beneath a nail. This can be a sign of skin cancer, especially when the stripe extends into the surrounding skin.

  • Mole that is changing. Melanoma often develops in a mole. The melanoma can be black, brown, or any color. Sometimes it is pink, colorless, or the same color as the surrounding skin.

  • Scar (new or changing). Skin cancer can develop in or near a scar, especially if the scar was caused by a burn or other traumatic injury. Sometimes skin cancer resembles a new keloid or other type of scar. If a scar appears on skin that has not been injured, see a dermatologist.

  • Flat patch of discolored skin. This patch usually has an irregular border, and the discolored skin may be tan, brown, black, red, blue, white, or a variation of colors.

  • Scaly patch with thickened skin and a well-defined border. The patch may be reddish or darker than the surrounding skin. It may feel velvety or resemble a wart. If it looks like a wart, it may crust over and bleed. The patch also may be mistaken for eczema or psoriasis. Sometimes it grows into the shape of a horn.

  • White patch on tongue or inside mouth. Skin cancer can begin in the mouth.

  • Blotchy skin, especially on the legs. African-American women who warmed their bare legs by standing next to a fire or stove when they were young may develop skin cancer on their legs in their senior years.

That can be a lot to remember. To simplify this when performing a skin self-exam, remember to look for change. Is there a change in or near a scar or mole? Did a stripe develop beneath a nail? Is something growing quickly? These changes should be examined by a dermatologist.

How to Perform a Skin Self-Exam
A few things are needed to perform this exam — a full-length mirror, handheld mirror, and well-lit room that offers privacy. Probably the easiest way to learn how to perform this exam is to look at the illustrated guide found on this page:

Skin Examinations
5 illustrations show how to perform a skin self-exam

When performing a skin self-exam, it is important to look at the entire body. Skin cancer can develop anywhere.

If performing a skin self-exam feels awkward, having a skin cancer screening may be the best way to start. This is a great way to find out what is involved and ask questions.

The Importance of Having a Skin Cancer Screening
Dermatologists encourage everyone to have this potentially lifesaving screening. Each year in the United States, more than 1 million new cases of skin cancer are diagnosed, which makes skin cancer the most common cancer in the nation. With early detection and proper treatment, skin cancer can be successfully treated.

The purpose of a skin cancer screening is to visually examine the body for signs of skin cancer. A dermatologist, a dermatologist’s physician assistant, or a nurse in a dermatologist’s practice should perform this screening. Specialized training in diagnosing and treating skin conditions is important. There can be a tendency to overlook dark lesions on skin of color.

Free Skin Cancer Screenings
To encourage everyone to get screened for skin cancer, the American Academy of Dermatology offers free skin cancer screenings across the United States. Many of these screenings take place during May, which is Skin Cancer Awareness and Detection Month. To find a local screening, visit:

Free Skin Cancer Screening Program

References:
1 American Academy of Dermatology. "Melanoma in African Americans." News release issued May 3, 2004.

2 Bellows CF, Belafsky P, Fortgang IS et al. "Melanoma in African-Americans: trends in biological behavior and clinical characteristics over two decades." J Surg Oncol 2001; 78: 10-6.

3 Gloster HM, Jr., Neal K. "Skin cancer in skin of color." J Am Acad Dermatol 2006; 55: 741-60; quiz 61-4.

4 Harper A. "New Research Shows Cancer Prevalent in Darker Skin." Academic Health Center Finding issued by University of Cincinnati, August 2006, http://healthnews.uc.edu/publications/findings/?/2981/2983/. Last accessed April 24, 2008.

5 McCall CO, Chen SC. "Squamous cell carcinoma of the legs in African Americans." J Am Acad Dermatol 2002; 47: 524-9.

6 Mora RG, Perniciaro C. "Cancer of the skin in blacks. I. A review of 163 black patients with cutaneous squamous cell carcinoma." J Am Acad Dermatol 1981; 5: 535-43.

7 Pipitone M, Robinson JK, Camara C et al. "Skin cancer awareness in suburban employees: a Hispanic perspective." J Am Acad Dermatol 2002; 47: 118-23.

8 Taylor SC. Dr. Susan Taylor's Brownskin.net. In: Skin Cancer, www.brownskin.net/cancer.html. Last accessed April 24, 2008.


All content solely developed by the American Academy of Dermatology

The reddish spot on this Asian man's nose is basal cell carcinoma, a type of skin cancer.



In skin of color, melanoma often develops on the sole of the foot. Early treatment is needed to prevent melanoma from spreading.

Photo courtesy of dermatologist Calvon O. McCall, MD, FAAD



Early stage skin cancer, Bowen's disease, appears on this woman's finger.

Photo courtesy of dermatologist Carl. V. Washington, Jr., MD, FAAD



This Latina woman has skin cancer on her nose.

Photo courtesy of dermatologist Miguel R. Sanchez, MD, FAAD



Skin cancer developed on the nose of this Asian Indian man.



The lesion on this man's lower leg is squamous cell carcinoma (SCC). SCC is the most common skin cancer in Asian Indians and blacks.

Photo courtesy of dermatologist Carl V. Washington, Jr., MD, FAAD


Photographs used with permission of the Journal of the American Academy of Dermatology.

All photographs were published in the Journal of the American Academy of Dermatology, Vol. # 55, Gloster HM and Neal K, “Skin cancer in skin of color,” 741-60. Copyright Elsevier (2006).

 

 
 
 
 

 

 

 

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