We aim to move away from the unambiguous concept of Eurocentric Dermatology which inevitably ignores the specificities of skins bearing a high melanin load, that is to say which contain a large quantity of this inherent pigment.
“Black” skin is not one, but there are much more “dark” skin tones, which are different from each other in terms of grading of pigmentation. Intense melanin pigmentation is a major factor influencing dermatological physiology and pathophysiology.
Our goal is to highlight the physiological, pathological and therapeutic properties that govern dark skin.
Dermatologists specializing in “black” skin, that is to say in dark-coloured phototypes, or more precisely, in skin with a high melanin load, know how important is to separate the skin tone (colour) from the origin or genetic background of each patient (ancestry). Since skin colour is a constitutive (genetic) characteristic, taking into account the particularities of black skin through obsolete racial logics, that is to say through social or societal constructions devoid of scientific genetic basis, is incorrect. It makes sense to analyze the pathological parameters that characterize dark skin and are largely due to the reactive behaviour of eumelanin - in terms of the risk of post-inflammatory hyperpigmentation.
The intensity of melanin pigmentation is the main element characterizing the peculiarities in terms of clinical manifestation and evolution of a classic skin disease in a dark-skinned patient. By extension, on a therapeutic level, the risk of hyperpigmentation which lurks due to a high melanin load, is a parameter to be taken into account in principle. The skin diseases found in black skin are neither asterisks in the footnotes of classic European or North American dermatology books, nor are they tropical or exotic. These are the same diseases that affect fair skin. The dermatologist must be trained in clinical skills allowing a thorough diagnostic approach to these patients.
