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Variation with Skin Color

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

Acute Meningococcemia

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

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

 

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

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

Vitiligo

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

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

 

The depigmentation of vitiligo at the base of the thumb and wrist could easily be missed in this light-skinned patient

The depigmentation of vitiligo at the base of the thumb and wrist could easily be missed in this light-skinned patient