by Ryan Whirty. This article originally appeared in The Louisiana Weekly.
All skin – and a particular skin disorder – is not the same, as a recent study into the effects and symptoms of eczema, a frustratingly itchy, often painful and potentially embarrassing affliction of the dermis, shows.
In a study published in September in Annals of Allergy, Asthma and Immunology – the scientific journal of the American College of Allergy, Asthma and Immunology – researchers examined the molecular differences between the skin of African Americans with atopic dermatitis (the formal name for eczema) from the skin of European Americans who also presented the skin disorder. Eczema is a skin disorder that can result in severe itching, rashes, dry skin and inflammation.
The researchers discovered that not only is the molecular profile of the skin of people with eczema different compared to those without it, but that African Americans with the disorder show more skin inflammation than European Americans with the condition.
Harder to Fight Off
Dr. Emma Guttman-Yassky, the lead author of the paper, said their inquiry also found that African Americans have a harder time fighting eczema than their white counterparts. She said the molecular immune profile – the skin’s natural defense against the disease – is more unbalanced than the profile of European Americans.
That means it can be harder for black eczema sufferers to fight off the disorder, a deficiency that leads to greater challenges in treatment for backs, including higher doses of medication required to combat it, because their skin is more resistant than white skin to the benefits of treatment.
Guttman-Yassky said that the group’s research revealed differences in the type and amounts of lymphocytes – the white blood cells the body uses to fight disease – in the skin of African Americans as opposed to European Americans, a factor that might explain the stronger association in blacks with other allergic diseases and sensitivities that can complicate treatment.
In general, she said, African Americans hoping to treat their eczema face more challenges than European Americans. “African Americans have increased disease severity, with more resistance to treatment of the disease. They also have a higher rate of allergic manifestations and sensitizations.”
But researchers and eczema organizations hope that with these surprising findings might also come improved treatment methods for African Americans suffering from the disorder.
In African American patients with the affliction, “therapeutic strategies should be able to effectively target [the specific lymphocytic combination], with appropriate attention also paid to the allergic background of these patients,” Guttman-Yassky said in an interview.
She added, “These treatments, if provided early, may also be contemplated for prevention of the other allergic associations in early disease in children.”
Racial Diversity Needed in Research
Allergist Dr. Donald Leung, the executive editor of Annals of Allergy, Asthma and Immunology, also expressed optimism about the long-term positive impact that could grow out of the recent study.
“This may prove to be a valuable enhancement for treatment options for African Americans,” he said in a prepared statement. “It will also reinforce the importance of racial diversity in clinical research studies for effective treatment for atopic dermatitis.”
Guttman-Yassky said several aspects of earlier eczema studies prompted the recent efforts of her and her colleagues. Noting that eczema has an overall greater prevalence among blacks than whites, she said other research has indicated that the skin lesions caused by eczema are thicker in African Americans than in European Americans, which also motivated her group to conduct the recent study.
“We wanted to understand if these differences translate also to differences in molecular phenotype in the active and uninvolved skin lesions,” she explained.
The paper’s online abstract notes that despite the disproportionate impact of the disease on African Americans with increased prevalence and therapeutic challenges unique to this population, scientific data collected so far “are derived primarily from European American patients. These studies are absent in African Americans, hindering development of effective treatments for this population.”
Nearly Half of Cases Black Children
In a 2013 study, researchers at the University of Pennsylvania focused on the fact that nearly half of the cases of atopic dermatitis diagnosed in the United States were found in African American children. Their research identified the precise mechanism as the lack of a key gene mutation that produces proteins that aid in fighting eczema.
As far back as two decades ago, researchers were finding that variations between the types of skin in different races could greatly impact treatment methods. A 1999 study in Houston discovered that a newly identified precursor lesion could help diagnose eczema in African American children much earlier, leading to the possible prevention of the more serious symptoms later.
“Atopic dermatitis is an emergency in blacks,” stated Dr. Theodore Rosen, of the Baylor College of Medicine in reporting on the research at that year’s annual meeting of the American Academy of Dermatology. “This precursor can help you identify these children before they develop permanent post-inflammatory hyperpigmentation.”
Rosen, also chief of dermatology at Houston’s Veterans Affairs Medical Center, added that in terms of treatment, “Anything you would do in your worst Caucasian eczema patient, do it sooner in African Americans.”
Ryan Whirty wrote this article for The Louisiana Weekly supported by a grant from the Gerontological Society of America, Journalists Network on Generations and Silver Century Foundation.
The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.