‘Early intervention’ key to improve skin cancer outcomes in women with skin of color

Key takeaways:

• Women with skin of color are more likely to have advanced skin cancer at diagnosis than their white counterparts.
• Early intervention and regular skin checks are recommended for this population.

NEW ORLEANS — Clinicians should be mindful of unique skin cancer presentations and risks in women with skin of color, according to a speaker here.

“We need to make sure we are educating patients to get in to see a physician early,” DiAnne Davis, MD, FAAD, told Healio. “I can’t tell you how many skin of color patients we are diagnosing so late when it comes to their skin cancers, and then their prognosis is usually poor because it’s at a more advanced stage.”

At the Skin of Color Society Scientific Symposium preceding the American Academy of Dermatology Annual Meeting, Davis discussed basal cell carcinoma, squamous cell carcinoma and melanoma in women with skin of color and emphasized the importance of regular skin checks, especially for areas not necessarily exposed to the sun.

Basal cell carcinoma, the second most common type of skin cancer in African American women, often looks much different in this population than it does in their white counterparts.

Instead of curly, translucent borders and telangiectasia, there is often pigmentation, according to Davis.

Additionally, this population has an increased risk of basal cell carcinoma in areas that are not sun exposed.

“Many of our patients don’t think they need routine skin exams, and it can sometimes take up to 3 years to diagnose basal cell carcinoma because it has not been examined,” Davis said during her presentation.

Squamous cell carcinoma is twice as likely to occur in African American women as it is in African American men, and risk factors can include ultraviolet light exposure, as well as having areas of chronic irritation, inflammation and nonhealing wounds.

“For African American women, those skin cancers, those squamous cells that present in non-sun-exposed areas or that have presented in previous scars are more likely to be aggressive with a 20% to 40% rate of metastasis,” Davis said.

Malignant melanoma occurs significantly less often in African American women compared with white women; however, when malignant melanoma does occur in African American women, it is often at a more advanced stage at diagnosis compared with their white counterparts (stage III/IV, 32.1% vs. 12.7%).

Davis concluded by stressing the importance of both regular skin checks and the use of sunscreen in African American women. She added that clinicians should be mindful of checking areas that are often overlooked, as well as recommending sunscreens that will blend into the skin of these patients to improve adherence.

“Early intervention, early detection and early appointments are going to be key,” Davis told Healio.