Exploring physiological differences in injury response by skin tone: A scoping review

Area of Science:

• Dermatology
• Physiology
• Wound Healing

Background:

• Pressure ulcers represent a significant clinical challenge, particularly in diverse patient populations.
• Understanding physiological variations in skin response is crucial for effective prevention and treatment.

Purpose of the Study:

• To systematically review the literature on physiological differences in pressure ulcer response related to skin tone.
• To identify potential mechanisms influencing skin vulnerability and resilience across different skin pigmentation levels.

Main Methods:

• A comprehensive scoping review of electronic databases (PubMed, CINAHL, Scopus, Cochrane, EMBASE) was conducted.
• Keywords included "pressure ulcer," "skin pigmentation," "melanin," and "risk factor."
• Data were extracted and analyzed using narrative synthesis.

Main Results:

• Five studies met the inclusion criteria.
• Potential influencing factors include stratum corneum structure, collagen density, fibroblast activity, mast cell density, and transepidermal water loss (TEWL).
• Increased TEWL and altered stratum corneum hydration may impact skin resilience in darker skin tones.

Conclusions:

• Physiological skin differences may alter pressure ulcer development response in individuals with dark skin.
• Recognizing these variations is vital for developing targeted prevention strategies.
• Further research is required to elucidate the underlying mechanisms.