(Last Updated On: November 9, 2018)

Putting the spotlight on skin of color

Editorial, November 2017, November 2017 Editorial

My fascination with pigmentary disorders started in 2015 when I gave a lecture titled “Controversial 50 shades of grey”, in one of the pre-congress sessions during the World Congress of Dermatology in Vancouver. The special meeting was a global consensus forum on conditions that are considered rare but may be found on pigmented skin such as ashy dermatosis, erythema dyschromicum perstans, lichen planus pigmentosus, Riehl’s melanosis and idiopathic eruptive macular pigmentation. After a series of discussions and E-mail communications among members of the group, a consensus on terminologies was formulated and the report is now awaiting publication.
The year 2016 was even more memorable when I was invited to write book chapters on the “histopathology of melasma and vitiligo in brown skin” and “macular pigmentation of uncertain etiology” by Dr Evangeline Handog and Prof Prasad Kumarasinghe, respectively. Through this experience, my differential diagnoses of hyperpigmentation have extended beyond the common pigmentary diseases such as melasma and post-inflammatory hyperpigmentation. With the aid of Dermoscopy and Dermatopathology, the diagnoses of dyschromias such as lichen planus pigmentosus, idiopathic eruptive macular pigmentation, Riehl’s melanosis, confluent reticulated papillomatosis, ashy dermatosis, and atypical forms of acanthosis nigricans have become more challenging and exciting. These dyschromias may be manifestations of genetic or systemic diseases or limited only to the skin. Sadly, some of these diseases are cosmetically disfiguring and have greatly affected the quality of life of patients. It has become apparent why our colleagues Dr Evangeline Handog, Dr Vermen Verallo-Rowell, Dr Sylvia Jacinto have devoted much of their time to study and publish books on how skin diseases and pigmentary disorders uniquely present in brown skin.
In recent years, pigmentary disease has become one of the most common and troublesome conditions in the Asian population. Because of this, studies on pigmentary disorders are currently being conducted and which have also led to the discovery of several pathogenetic pathways. In melasma, for example, many melanin biosynthesis-related genes such as tyrosinase, tyrosinase-related protein (TYRP1), TYRP2 and Microphthalmia-associated transcription factor (MITF) have been shown to be upregulated in lesional skin. A scientific understanding of the dyschromias and a more rational approach to using skin-lightening cosmeceuticals should be the advocacy for each of the PDS members. In my opinion, we should be able to generate an array of articles in the form of original studies, review articles, case reports and letters to the editor in both local and international publication since our forte in terms of clinical knowledge are pigmentary disorders in brown skin.
I would like to thank all the contributors who shared their knowledge in this issue of the JPDS, especially those who I personally requested to write about melasma, photoprotection, and rare pigmentary disorders. I am especially delighted that some of the associate editors and several residents have made significant contributions to the journal in the form of systematic review, clinical trial, observational studies and case reports. I hope that these simple accomplishments encourage them to be more academically productive in the future.
Johannes F. Dayrit, MD, FPDS
Journal of the Philippine Dermatological Society