By: Carlton Moses Jr. Mentor: Dr. Andrew F. Alexis St. Luke’s Roosevelt Hospital Center University Hospital of Columbia University College of Physicians and Surgeons. Skin Problems in Men of Color. 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.
The Epidermis consist of four basic cell parts
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.
The Epidermis consist of 5 layers:
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.
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.
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.
A Key Factor in the etiology of PFB if the unique structure of the hair follicle in people of color.
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
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.
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.
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.
Dr. Sat Bhattacharya
Dr. Andrew Alexis
Ms. Jasmyne Jones
Mrs. Cathleen Donovan; Med. Ed. Coordinator
Mrs. Linda Cooper
Grover Cleveland High School
Harlem Children Society
St. Luke’s Roosevelt High School