Most skin diseases occur in people of all nationalities, regardless of their skin color. Certain problems encountered in the skin are more common in people with different hues of skin, and sometimes a disorder seems more prominent because it affects skin color. This week continues our review of these disorders and their treatment.
Dermatosis papulosa nigra
This most commonly occurs in African American patients. Being diagnosed with HIV, a potentially life-threatening disease, can be extremely troubling, but with proper treatment, HIV infection is no longer the automatic death sentence it used to be. Unfortunately, AIDS continues to devastate the African American community, as well as parts of Africa, Haiti and Asia where good treatments are not readily available.
We owe a great deal of gratitude to the researchers, doctors, pharmaceutical companies, AIDS support organizations, and all ancillary people who have waged the good fight against this disease and given hope to those with HIV infection. The next step is to find a cure and or eradicate the disease like we have smallpox.
The emotional, family, social, legal, healthcare management and logistics, and financial concerns after being diagnosed with HIV/AIDS can be extraordinarily challenging. There are tremendous support groups, support organizations, counselors, social workers and medical staff that can provide a wealth of assistance in these areas.
Prevention the key
We are not quite sure why HIV/AIDS is still a big problem in the African American community. African American women are 15 times more likely to contract HIV than their Caucasian counterparts. Perhaps it is a combination of multiple factors: education (HIV is not a gay White male disease), access to health care and testing, and practicing safe sex. Nevertheless, prevention is the key.
• Sexual partners must use new condoms every time for vaginal, anal and oral sex.
• If you are HIV infected, you absolutely must let your partner know and do not have unprotected sex with them.
• If you are HIV positive, you must inform all of your sexual contacts so that they may be tested.
• If you do illicit IV drugs, you must not share needles.
• If you are at high risk for contracting HIV, talk to your doctor about Truvada, a new FDA-approved anti-viral drug that can greatly reduce the chances HIV infection.
• If you are pregnant, you need to tell your doctor immediately so that you can begin drug treatments that will greatly reduce the likelihood you will transmit the infection to your developing baby.
Vigorous efforts called for
For many years, HIV infection and the subsequent development of AIDS were the equivalent of a death sentence. Thanks to dramatic development of medical treatment options, HIV-infected patients can have a relatively normal life expectancy with appropriate care and diligent effort.
Nonetheless, such treatments are expensive, have a significant impact on the patient’s lifestyle and routine, and are not 100 percent effective at eliminating all negative aspects of the condition. As a result, we must continue our vigorous efforts to reduce and eventually eradicate HIV infection, with the key to success being education.
Black community most at risk
While a critical concern of all demographics, this issue is especially important to the African American community, which has seen an unimaginable and disproportionate increase in the incidence of HIV infection and development of AIDS compared to other groups in the U.S. In fact, studies estimate that an African American adult female in this country is 15 times more likely to be diagnosed as HIV-positive than is a White adult female.
We must educate all high-risk groups about the risks of HIV and AIDS and how to prevent their spread through use of effective protection and changing behavior. The human and financial costs are simply too great to ignore, and we must redouble our commitment to addressing this risk in the community.
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.