Skin Color

Dermatology textbooks and atlases underrepresent disease presentation in people of color. Recognizing subtle color changes of erythema and purpura can be challenging in patients of color. Depigmentation is very easy to detect in darker-skinned patients, but it is subtle in lighter-skinned patients.

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  The violaceous color of purpura is obvious on this light-skinned child.

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  In a darker-skinned patient, purpura appears dark brown rather than violaceous.

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  The depigmentation of vitiligo is striking in this very dark-skinned patient.

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  The periorbital depigmentation and light pink patches of vitiligo could be easily missed in this light-skinned patient, though the associated poliosis in the eyelash accentuates the color loss.