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MYTH 2: People with darker skin do not get skin cancer.

Although rare, skin cancer can occur in darker skinned patients. Bob Marley, a Jamaican musician, developed
a skin cancer on his foot. The spot was initially misdiagnosed as a soccer injury under his toenail, but turned
out to be an aggressive form of melanoma; he ultimately died at the age of 36.
When skin cancer develops in skin of color, the cancer is more often advanced by the time it is diagnosed.
Researchers are not sure why. It could be that the cancer is not recognized until the later stages in skin of
color. Another possibility is that skin cancer tends to be more aggressive in skin of color.

Skin cancer in darker skinned individuals may occur in areas that are not exposed to the sun, including the
palms of the hand, soles of the feet, and nails. Reported risk factors for skin cancer in darker skin include
burn scars, radiation therapy, trauma, and medical conditions like lupus.

Types of Skin Cancer
Basal cell carcinoma (BCC).
Most common type of skin
cancer in Caucasians, Hispanics,
and Asians. Ultraviolet
radiation exposure is the most
common etiologic factor in all
racial groups.
BCC on the nose.
Squamous cell carcinoma
(SCC). Most common type of
skin cancer in African
Americans. Risk factors include
scars from previous burns,
chronic leg ulcers, previous
sites of radiation, and lupus.
SCC on the leg. Gohara M, Perez M. Skin cancer and skin of color.
http://www.skincancer.org/prevention/skin-cancer-and-skin-of-color

Melanoma is the deadliest form of skin
cancer. Acral lentiginous melanoma (ALM) is a
potentially aggressive melanoma, which
makes up the majority of melanomas found in
skin of color. ALM develops beneath nails, on
the soles of the feet and palms of the hands,
and in mucous membranes (ie, inside the
mouth, nose, anus, genital areas. This makes
ALM more difficult to recognize.
Melanoma of the nail. Melanoma of the foot.

How to protect your self from skin cancer

• Perform monthly self-skin examinations, paying close attention to the nails, palms, soles, mucous
membranes, groin. and genital area. When examining your skin, remember to look for change. Is there
a bruise or sore that does not heal? Is there a change in or near a scar or mole? Did a stripe develop
beneath a nail? Is something growing quickly? These changes should be examined by a dermatologist.
• Seek shade whenever possible.
• Wear sun protective clothing.
• Wear a wide-brimmed hat to shade the face and neck, and shoes that cover the entire foot.
• Wear sunglasses with ultraviolet-absorbing lenses.
• Apply a broad-spectrum sunscreen with a sun-protection factor of 30 or greater.
• Apply sunscreen to dry skin 15 to 30 minutes before going outdoors. When outdoors, reapply every 2
hours to all exposed skin, and after perspiring or swimming.
• Avoid exposure to indoor tanning beds.

References
1. Bradford, PT. Skin in skin of color. Dermatology Nursing. 2009; 21:4 (170-177).
2. Agbai, ON, et al. Skin cancer and photoprotection in people of color. JAAD. 2014 Apr; 70 (4): 748-62
3, www.aad.org
4. Skin Cancer: A Fact of Life in Skin of Color; www.skincarephysicians.com/skincancernet/skin_of_color.html

Dr. Porcia Bradford Love, Board-certified Dermatologist www.montgomerydermatology.com

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