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Skin Problems in Men of Color

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Skin Problems in Men of Color By: Carlton Moses Jr. Mentor: Dr. Andrew F. Alexis St. Luke s Roosevelt Hospital Center University Hospital of Columbia University ... – PowerPoint PPT presentation

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Title: Skin Problems in Men of Color


1
Skin Problems in Men of Color
  • By Carlton Moses Jr.
  • Mentor Dr. Andrew F. Alexis
  • St. Lukes Roosevelt Hospital Center
  • University Hospital of Columbia University
    College of Physicians and Surgeons

2
Learning Objective
  • Describe the common clinical presentation of
    Pseudofolliclitis Barbae (PFB) and Acne
    Keloidalis Nuchae (AKN) in men of color.
  • Describe the differential diagnosis for PFB and
    AKN.
  • Explain the Medical and Surgical management for
    patients with PFB and AKN.

3
Pseudofolliculitis Barbae
  • PFB is a Chronic Inflammatory disorder of the
    hair-bearing skin.
  • PFB occurs as a consequence of hair removal when
    tightly coiled hair shafts, after being shaved or
    plucked, reenter the epidermis or penetrate the
    hair follicle wall causing inflammation.

4
What Is Actually Going on?
5
The Skin
6
The Epidermis
  • The Epidermis consist of four basic cell parts
  • Keratinocyte
  • Melanocytes
  • Langerbans
  • Granstein

7
What Do These Cells Do ?
  • Keratinocyte - helps to waterproof, defend and
    immunise.
  • Melanocytes - are located at the base of the
    skin, and protects the melanin pigments, which
    are responsible for the absorption of Ultraviolet
    light.
  • Langerhans and Granstein - arise from the bone
    marrow, and help the immune responses of the
    skin, and usually act as markers of antigens,
    which are attacked by the T-Lymphocyte immunity
    cells.

8
5 Layers of the Epidermis
  • The Epidermis consist of 5 layers
  • Stranum corneum
  • Stranum spinosum
  • Stranum lucidium
  • Stranum garnulosum
  • Stranum basale

9
Whats the Function of each layer?
  • Stranum corneum  The top layer consists of 25
    layers of dead cells, filled with tough keratin
    the substance that makes nails, and used in
    protective chainsaw suits. These are continuously
    being shed and replaced. It serves as an
    effective barrier against light, heat, bacteria
    and chemicals. In the manufacture of these cells,
    a process called keratinisation, new cells are
    pushed up from the basal layers. The period
    between forming and shedding takes about two
    weeks.

10
Whats the Function of each layer? Cont
  • Stranum spinosum This layer contains many sided
    cells that fit together.
  • Stranum lucidium This layer is found only in
    thick skin, such as the palm and soles. They
    contain clear dead cells called eleidin, which is
    eventually transformed into keratin.

11
Whats the Function of each layer? Cont
  • Stranum garnulosum The second layer consists of
    4 rows of flattened cells that contain forms of
    stained keratin. This provides a waterproofing
    protein. They are in a vigorous state of
    degradation.
  • Stranum basale This single layer pushes up
    towards the surface. The nuclei disintegrate and
    become the next layer. Other cells may arise and
    forms hair follicles or glands.

12
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13
Etiology and Pathogenesis
  • A Key Factor in the etiology of PFB if the unique
    structure of the hair follicle in people of
    color.

14
Folliculitis
  • What is folliculitis?
  • Folliculitis is an infection of the hair
    follicles. Each hair on your body grows out of a
    tiny pouch called a follicle. You can have
    folliculitis on any part of your body that has
    hair. But it is most common on the face, scalp,
    and areas rubbed by clothing, such as the thighs
    and groin

15
Folliculitis Cont
  • What causes folliculitis?
  • It is usually caused by bacteria, especially the
    type called staph (Staphylococcus). It can also
    be caused by yeast and another type of fungus.
    Folliculitis caused by a fungus is most often
    seen in people who have trouble fighting
    infections because they have an impaired immune
    system.
  • Often folliculitis develops because you have
    damaged your hair follicles. Shaving or wearing
    clothes that rub the skin can irritate the
    follicles. They can also become blocked or
    irritated by substances like sweat, machine oils,
    or makeup. Once the follicles are injured, they
    are more likely to become infected.

16
Hair Follicle
17
Nestin-GFP expression in hair follicle stem cells
during hair cycle
18
More Hair Follicle
19
Acne Keloidalis Nuchae
  • Acne keloidalis nuchae (AKN) occurs when hairs
    on the back of the head and neck grow into the
    skin, become inflamed, and cause scar tissue
  • AKN is more common in people with stiff or curly
    hair and those with darker skin.

20
Acne Keloidalis Nuchae Examples
21
Future Research
  • For Future Research Dr. Alexis and I will try to
    find out which are the common skin diseases among
    not only African Americans, but of people of all
    ethnic backgrounds and skin colors. We will do
    this by looking in to records of the patients and
    formulating a table including the person's name
    , gender, diagnosis, doctor who attended them,
    and weather their follow-up patients or new.

22
How the Data will be Recorded
23
References
  • Alexander AM Evaluation of a foil-guarded shaver
    in the management of pseudofolliculitis barbae.
    Cutis 1981 May 27(5) 534-7, 540-2Medline.
  • Alexander AM, Delph WI Pseudofolliculitis barbae
    in the military. A medical, administrative and
    social problem. J Natl Med Assoc 1974 Nov 66(6)
    459-64, 479Medline.
  • Brauner GJ, Flandermeyer KL Pseudofolliculitis
    barbae. Medical consequences of interracial
    friction in the US Army. Cutis 1979 Jan 23(1)
    61-6Medline.
  • Bridgeman-Shah S The medical and surgical
    therapy of pseudofolliculitis barbae. Dermatol
    Ther 2004 17(2) 158-63Medline.
  • Brown LA Jr Pathogenesis and treatment of
    pseudofolliculitis barbae. Cutis 1983 Oct 32(4)
    373-5Medline.
  • Childs ND Tretinoin, hydrocortisone cream
    controls PFB. Skin and Allergy News 1999 30(5)
    20.
  • Coquilla BH, Lewis CW Management of
    pseudofolliculitis barbae. Mil Med 1995 May
    160(5) 263-9Medline.
  • Crutchfield CE 3rd The causes and treatment of
    pseudofolliculitis barbae. Cutis 1998 Jun 61(6)
    351-6Medline.
  • Galaznik JG A Pseudofolliculitis Barbae clinic
    for the black male who has to shave. J Am Coll
    Health 1984 Dec 33(3) 126-7Medline.
  • Garcia-Zuazaga J Pseudofolliculitis barbae
    review and update on new treatment modalities.
    Mil Med 2003 Jul 168(7) 561-4Medline.
  • Halder RM Pseudofolliculitis barbae and related
    disorders. Dermatol Clin 1988 Jul 6(3)
    407-12Medline.
  • Kauvar AN Treatment of pseudofolliculitis with a
    pulsed infrared laser. Arch Dermatol 2000 Nov
    136(11) 1343-6Medline.
  • Kligman AM, Mills OH Jr Pseudofolliculitis of
    the beard and topically applied tretinoin. Arch
    Dermatol 1973 Apr 107(4) 551-2Medline.
  • Leyden JJ Topical treatment for the inflamed
    lesion in acne, rosacea, and pseudofolliculitis
    barbae. Cutis 2004 Jun 73(6 Suppl)
    4-5Medline.
  • Nidecke A Saving face help black men avoid
    pseudofollicultis barbae. Skin and Allergy News
    1998 29 (10) 46.
  • Olsen EA Methods of hair removal. J Am Acad
    Dermatol 1999 Feb 40(2 Pt 1) 143-55 quiz
    156-7Medline.
  • Scheinfeld NS Pseudofolliculitis barbae. Skinmed
    2004 May-Jun 3(3) 165-6Medline.

24
Acknowledgments
  • Dr. Sat Bhattacharya
  • Dr. Andrew Alexis
  • Ms. Jasmyne Jones
  • Mrs. Cathleen Donovan Med. Ed. Coordinator
  • Mrs. Linda Cooper
  • Mr. Keifer
  • Grover Cleveland High School
  • MSKCC
  • Harlem Children Society
  • St. Lukes Roosevelt High School
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