New recommendations aim to increase awareness and earlier detection of skin cancers in people of color. The findings, based on an extensive literature review, appear online in the Journal of the American Academy of Dermatology.

“People of color can develop skin cancer; more commonly, the cancers are pigmented; can occur in palms, soles and oral mucosa,” says study author Henry W. Lim, MD, FAAD, C.S. Livingood Chair and chairman of the department of dermatology at Henry Ford Hospital in Detroit. “A complete skin exam, especially in people of color, should include examination of oral mucosa, palms and soles. “

The bottom of the foot is where 30% to 40% of melanomas are diagnosed in people of color. Nearly 8% of melanomas in Asian Americans occur in the mouth. Squamous cell carcinoma, which is the most commonly diagnosed skin cancer in African-Americans, often develops on the buttocks, hip, legs, and feet.

The disparities in survival are daunting largely because the melanoma is detected at a much later stage in African-Americans and Latinos. The 5-year survival rate for African Americans is 73% compared to 91% in Caucasians, according to the report.

Earlier detection of skin cancer in people of color should include monthly skin self-exams with special attention to the palms of the hands, soles of the feet, the fingernails, toenails, mouth, groin, and buttocks. Moreover, skin cancer may look different on darker skin. The recommendations call for looking for any spots or lesions that are changing, itching, or bleeding, or any ulcers or wounds that won’t heal.

Skin Cancer Prevention in People of Color

According to the new recommendations, unprotected exposure to ultraviolet (UV) rays is a risk factor for skin cancer in people of color. Basal cell carcinoma, the most commonly diagnosed skin in cancer in Asian Americans and Latinos, is most frequently found on sun-exposed areas of the skin, such as the head and neck.

All individuals should take the same sun-protection measures regardless of skin color. These include:

• Seeking shade whenever possible.
• Wearing sun-protective clothing, including a wide-brimmed hat and sunglasses.
• Avoiding tanning beds.
• Applying sunscreen with a sun-protection factor of at least 30 to all exposed areas of the skin 15 to 30 minutes before going outdoors and reapplying sunscreen every 2 hours when outdoors, and after swimming or sweating. People of color—especially individuals with darker skin—should take a vitamin D supplement because they are at a higher risk of vitamin D deficiency.

Lim says that awareness among dermatologists is increasing. “Education on this topic is now an integral part of many dermatology residency training programs. The younger-generation dermatologists should be familiar with this topic.”