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Published on: September 7, 2013
Review of Skin Depigmentation Practices and Cutaneous Malignancy
Lauren S Jones1, Emily McEldrew2, Cynthia L Bartus3
1Dr. Jones is with the Dermatology Residency Program at Lehigh Valley Health Network, Allentown, Pennsylvania.
Objective:
To investigate the association between skin bleaching agents and the development of cutaneous malignancy.
Methods:
A scoping literature search was conducted in the PubMed and Google Scholar databases to identify studies and reports that included both skin depigmentation practices and development of cutaneous malignancy. Articles published in English and French were considered for review.
Results:
To date, reports are limited to a relatively small number of case reports in Africa. The most common skin bleaching agents used were topical clobetasol and hydroquinone with a duration of at least 15 years. Most patients had a reported skin phenotype of Fitzpatrick VI, and the most common skin cancer reported in patients was squamous cell carcinoma (SCC). The majority of these lesions were large, invasive, and/or ulcerated lesions in chronically sun-exposed areas. The most common site of metastasis was the lungs, and the mortality rate was high.
Limitations:
This is a literature review; information included is limited to what is available in the literature.
Conclusion:
Skin bleaching agents have a powerful presence among a broad population, yet the consequences of their use in skin of color are poorly understood and potentially dangerous. Based on the available literature, there is potential for skin bleaching practices to be implicated as the causative agent for cutaneous SCC, especially in darker skin phenotypes. Therefore, there is a growing need for dermatologists to address this topic as a major public health concern with high morbidity and potential mortality to prompt further investigation.
Insights
Skin bleaching agents, like clobetasol and hydroquinone, may be linked to squamous cell carcinoma (SCC) in individuals with darker skin tones. Further research is needed due to potential public health risks and high mortality rates.
Area of Science:
- Dermatology
- Oncology
- Public Health
Background:
- Skin bleaching is prevalent globally, particularly in populations with darker skin phenotypes.
- The long-term effects of potent skin bleaching agents on skin of color are not well understood.
- There is a growing concern regarding the potential link between skin depigmentation practices and adverse dermatological outcomes.
Purpose of the Study:
- To investigate the association between the use of skin bleaching agents and the development of cutaneous malignancy.
- To review existing literature on skin depigmentation practices and their potential links to skin cancer.
Main Methods:
- A comprehensive scoping literature search was performed using PubMed and Google Scholar.
- Studies and reports published in English and French were included.
- The review focused on identifying research linking skin depigmentation and cutaneous malignancy.
Main Results:
- Case reports, primarily from Africa, indicate a potential association.
- Commonly used agents include topical clobetasol and hydroquinone over extended periods (≥15 years).
- Squamous cell carcinoma (SCC) was the most frequently reported malignancy, often presenting as large, invasive lesions on sun-exposed areas in individuals with Fitzpatrick VI skin phenotype. High rates of lung metastasis and mortality were noted.
Conclusions:
- Available literature suggests a potential role of skin bleaching in causing cutaneous SCC, especially in darker skin phenotypes.
- The widespread use of skin bleaching agents necessitates greater awareness of their potential dangers.
- Dermatologists must address this public health issue due to its high morbidity and mortality, prompting further investigation.
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