Influence of Ethnicities and Skin Color Variations in Different Populations: A Review.

BACKGROUND: In the world scientific tradition, skin color is the primary physical characteristic used to divide humans into groups. Human skin has a wide range of tones and colors, which can be seen in a wide range of demographic populations. Many factors influence the color of people's skin, but the pigment melanin is by far the most important. Melanin is produced by cells called melanocytes in the skin and is the primary determinant of skin color in people with darker skin. Indeed, >150 genes have now been identified as having a direct or indirect effect on skin color. Vitamin D has recently been discovered to regulate cellular proliferation and differentiation in a variety of tissues, including the skin. The mechanisms through which the active vitamin D metabolite 1,25 dihydroxyvitamin D3 (or calcitriol) affects keratinocyte development are numerous and overlap with the mechanisms by which calcium influences keratinocyte differentiation. Ultraviolet (UV) is the most major modifiable risk factor for skin cancer and many other environmental-influenced skin disorders when it is abundant in the environment. Although the UV component of sunlight is known to cause skin damage, few researches have looked at the impact of non-UV solar radiation on skin physiology in terms of inflammation, and there is less information on the role of visible light in pigmentation. SUMMARY: The quantity and quality of melanin are regulating by the expression of genes. The enzyme tyrosinase is primarily responsible for the genetic mechanism that controls human skin color. Genetics determines constitutive skin color, which is reinforced by facultative melanogenesis and tanning reactions. High quantities of melanin and melanogenic substances are typically accepted in darker skin to protect against UV radiation-induced molecular damage. Previous research has proposed that skin color variation is caused by a dynamic genetic mechanism, contributing to our understanding of how population demographic history and natural selection shape human genetic and phenotypic diversity. However, the most significant ethnic skin color difference is determined by melanin content. This current review aimed to assess the influence of skin color variations in skin structure and functions as well as difference in dermatological disease patterns. Also, this article reviewed several cases of skin color adaptation in different populations. Key Messages: Skin color impacts the composition and activity. Therefore, the contrast of dermatological ailments between distinct race-related categories is remarkable. Skin color adaptation is a challenging procedure. Refinement of skin color is an age-old craving of humans with ever-evolving drifts.

Association between alopecia areata and thyroid dysfunction.

Alopecia Areata is an inflammatory and T cell-mediated autoimmune reaction against unknown autoantigen of hair follicles characterized by patchy, non-scarring loss of hair follicles in the anagen phase. Although its etiology is minimally understood, genetic susceptibility, autoimmunity and stress are thought to be causative factors. It occurs in episodic and recurrent patterns with an incidence rate of 0.1-0.2% in the general population and 7-30 cases per 1000 dermatological patients with a lifetime risk of 1.7%. The lesions can be single and self-limiting or may be widespread. Autoimmune disorders such as Hashimoto's thyroiditis, Vitiligo, celiac disease, diabetes mellitus, psoriasis ad lupus erythematosus were observed as an associated comorbid disorder in AA patients, but hypothyroidism and Vitiligo have the strongest association. Its clinical course is unpredictable and shows no significant predilection to age, gender or race. AA is a heterogeneous variant of alopecia and has clinical types such as patchy alopecia, alopecia reticularis and alopecia totalis. Various epidemiological reports demonstrate an increased frequency of AA in thyroid disease patients. Contemporary research has shed spotlight on circulating auto-reactive cells in evolution of AA, which may play a role in ultimately linking these diseases. Comprehension of complex interplay between autoantigens and immune cells is still evolving. The present study will explore this association of Alopecia Areata in patients with thyroid dysfunction. This correlation was studied briefly with literature available in the medical database such as PubMed and Google Scholar.

Clinical Significance of Diabetic Dermatopathy.

Diabetic dermopathy is a cutaneous manifestation commonly seen in diabetes patients and was initially described by Melin in 1964. These lesions are well-demarcated, hyperpigmented macules or papules with atrophic depression and were commonly sighted on shins of the tibia with bilateral asymmetrical distribution and rarely seen on arms, thighs and abdomen. The incidence of DD ranges from 0.2 to 55%. It has been frequently associated with microangiopathic complications of diabetes such as nephropathy, retinopathy and polyneuropathy. Although the exact mechanism of occurrence is unknown, it may be related to impaired wound healing due to decreased blood flow, local thermal trauma or local subcutaneous nerve degeneration. Diagnosis is made by clinical examination and the differential diagnosis includes stasis dermatitis, early lesion of necrobiosis lipoidica and purpuric dermatitis. Prevention of dermopathy lesions includes optimized glucose control. No active treatment is recommended or proven effective and DD is known to resolve on its own as time passes. Modified collagen and high glycerine-based lotion have shown marked improvement in skin color changes due to diabetic dermopathy. Diabetic dermopathy is known to have a strong association with microangiopathic complications; the presence of such lesions must raise strong suspicion and prompt investigation for severe underlying pathology. Enhanced scrutinized glycemic control in diabetic dermatopathy patients can even lead to abatement in further progression to microvascular complications and improved long-term patient outcomes.

Hyperprolactinaemia induced by proton pump inhibitor.

A case of a 13 year old girl who manifested hyperprolactinaemia and galactorrhea induced by Omeprazole, a commonly used proton pump inhibitor is presented.

Cerebral salt wasting syndrome in tuberculous meningitis.

Case of a seventy year old female, who developed cerebral salt wasting syndrome in association with Tuberculous Meningitis is presented.