Review of Skin Depigmentation Practices and Cutaneous Malignancy.

objectiveTo investigate the association between skin bleaching agents and the development of cutaneous malignancy.

methodsA scoping literature search was conducted in the PubMed and Google Scholar databases to identify studies and reports that included both skin depigmentation practices and development of cutaneous malignancy. Articles published in English and French were considered for review.

resultsTo date, reports are limited to a relatively small number of case reports in Africa. The most common skin bleaching agents used were topical clobetasol and hydroquinone with a duration of at least 15 years. Most patients had a reported skin phenotype of Fitzpatrick VI, and the most common skin cancer reported in patients was squamous cell carcinoma (SCC). The majority of these lesions were large, invasive, and/or ulcerated lesions in chronically sun-exposed areas. The most common site of metastasis was the lungs, and the mortality rate was high. LIMITATIONS: This is a literature review; information included is limited to what is available in the literature.

conclusionSkin bleaching agents have a powerful presence among a broad population, yet the consequences of their use in skin of color are poorly understood and potentially dangerous. Based on the available literature, there is potential for skin bleaching practices to be implicated as the causative agent for cutaneous SCC, especially in darker skin phenotypes. Therefore, there is a growing need for dermatologists to address this topic as a major public health concern with high morbidity and potential mortality to prompt further investigation.