Skin of Color Savvy: Pigmentary Disorders in Skin of Color, with Nada Elbuluk, MD, MSc, and Michelle Rodrigues, MBBS

Welcome to Skin of Color Savvy: The Art and Science of Treating Patients of Color!

In episode 2 of Skin of Color Savvy: The Art and Science of Treating Patients of Color, host Nada Elbuluk, MB, associate professor of dermatology at the University of Southern California and president-elect of the Skin of Color Society, is joined by a leading expert in pigmentary disorders in Michelle Rodrigues, MBBS, the founder and director of the Pigment and Skin of Colour Centre at Chroma Dermatology in Australia. Together, they explore the complexities of diagnosing and managing pigmentary disorders in diverse patient populations.

The conversation begins with an overview of common pigmentary disorders, including post-inflammatory hyperpigmentation, acquired dermal macular hyperpigmentation, nevus of Ota, melasma, and vitiligo. Rodrigues, who also serves as a clinical associate professor at the University of Melbourne, emphasizes the importance of distinguishing between hyperpigmentation, hypopigmentation, and depigmentation, noting that accurate diagnosis relies heavily on assessing lesion location, color, and patient history. Key diagnostic tools highlighted include dermoscopy, Wood’s lamp examination, and, when necessary, skin biopsy.

The experts discuss the role of laboratory workups in specific contexts, such as screening for clotting disorders before initiating oral tranexamic acid for melasma and thyroid function tests in patients with vitiligo. They underscore the systemic associations of pigmentary disorders and the need for comprehensive patient evaluations.

Addressing misconceptions, Elbuluk and Rodrigues clarify that pigmentary disorders are not exclusive to skin of color populations, though their prevalence and presentation may vary. They reference global prevalence data, noting that conditions like vitiligo and melasma affect individuals across all skin types, with certain disorders more common in specific regions and demographics.

Emerging therapies and innovations in the management of pigmentary disorders are a focal point of the latter portions of the discussion. Rodrigues highlights advances such as novel non-hydroquinone lightening agents, such as thiamidol, the evolving use of picosecond lasers for dermal hyperpigmentation, and the potential of JAK inhibitors for vitiligo. They stress the critical role of comprehensive photoprotection, including the use of broad-spectrum sunscreens with UVA1 blockers and visible light protection through tinted formulations containing iron oxide.

The episode concludes with a call for continued education and awareness among dermatologists to ensure accurate diagnosis, effective management, and culturally competent care for patients with pigmentary disorders.

Hosted by Skin of Color Society and produced by HCPLive, Skin of Color Savvy delves into the latest research, clinical insights, and culturally competent care practices in dermatology with leading experts. Whether it’s groundbreaking research, practice-changing insights, or highlights from the SOCS community, this twice-monthly program provides dermatologists and care providers with expert perspectives on treating patients with skin of color.

Relevant disclosures for Elbuluk include Incyte. Rodrigues has no relevant disclosures to report.