Skin of Color

Recent literature has established that there is much for the medical community to learn about highly pigmented skin, specifically in the realm of wound healing and even more so in diabetic foot ulcers (DFUs). Most distressing is the higher prevalence of amputation and mortality among patients with skin of color and DFUs as opposed to their Caucasian cohorts. In fact, a 2022 study found that patients identifying as Black were approximately 4% more likely to experience above-ankle amputation or death.

Skin is considered the body's largest organ, and any damage can often lead to scarring. Although the pathology and physiology of what leads to scarring are not entirely understood, some details are concrete, including the series of processes that occur after the skin is damaged. These processes will be discussed in detail below, as well as the different types of scars. The appearance of these scars, as a result of these processes, may also present differently on various skin tones and types.

Venous Leg Ulcers (VLUs) are among the most widespread chronic lower extremity wounds, with approximately 70% of chronic leg ulcers reported as VLUs. Across the population in the western hemisphere, it's estimated that 2% have VLUs, while those in the aging population have a greater prevalence at 5%. In the United States, 6 million people struggle with these wounds, a number dwarfed by those in other countries. For instance, in Africa, approximately 25-135 million individuals have VLUs.