Dyschromia in skin of color.
BACKGROUND
Dyschromias are becoming a more common concern among patients, particularly among persons of color. There are a variety of treatments, including more novel agents for dyschromias. Evaluating common agents prescribed among various races may prompt efforts to enhance care for dyschromias in patients of color.


OBJECTIVE
To determine whether racial or ethnic groups are treated differently for dyschromia. The secondary objective is to discover the main treatments used and determine trends over time in demographics.


METHODS
We searched the 1993-2010 National Ambulatory Medical Care Survey (NAMCS) for visits associated with a diagnosis of dyschromia (ICD-9 codes 709.00 or 709.09). The demographics and leading treatments were tabulated, and trends over time were assessed by linear regression.


RESULTS
There were about 24.7 million visits for dyschromia over the 18-year period. Among 5,531,000 patients with the sole diagnosis of dyschromia, there were 2,800 visits from females and 1,200 visits from males per 100,000 population. Females were more likely to receive prescription combination therapy for dyschromia than males by a ratio of 10 to 1. Leading treatments overall prescribed by dermatologists included hydroquinone, topical corticosteroids, and retinoids. Asians were 27% more likely to receive a combination therapy than non-Asians. African Americans and Hispanics were less likely to have a procedure performed for dyschromia.


CONCLUSIONS
Data are based on a number of ambulatory care visits, which does not allow direct estimation of prevalence.


CONCLUSIONS
Dyschromia is a significant concern for many patients, and this is especially true among patients of color. Treatment for dyschromia is influenced by skin type, and thus ethnic or racial groups are treated differently. Studies have shown that combination therapy may offer better results than a single medication for hyperpigmentation disorders. Combination agents may be underutilized in African Americans and Hispanics for dyschromia.
Stephanie J
SJ
Kang
Scott A
SA
Davis
Steven R
SR
Feldman
Amy J
AJ
McMichael
D000293:Adolescent; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001741:Black or African American / Q000706:statistics & numerical data; D003879:Dermatologic Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000639:trends; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006873:Hydroquinones / Q000627:therapeutic use; D010859:Pigmentation Disorders / Q000188:drug therapy / Q000208:ethnology; D010818:Practice Patterns, Physicians' / Q000639:trends; D012176:Retinoids / Q000627:therapeutic use; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D001213:Asian / Q000706:statistics & numerical data; D000095223:White / Q000706:statistics & numerical data; D000328:Adult
D000305:Adrenal Cortex Hormones; D003879:Dermatologic Agents; C031927:hydroquinone; D006873:Hydroquinones; D012176:Retinoids