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Publications

Journal Article Scoping Review Ppublish 1 citation

PubMed: 40086146 DOI: 10.1016/j.jtv.2025.100871

Exploring physiological differences in injury response by skin tone: A scoping review.

J Tissue Viability 34(2):100871

Authors: Pinar Avsar, Zena Moore, Declan Patton, Tom O'Connor, Lone Skoubo Bertelsen, Desmond J Tobin, Giulio Brunetti, Keryln Carville, Vignesh Iyer, Hannah Wilson

Affiliations

  • Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland; University of Wales, Cardiff, UK.
  • Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland; University of Wales, Cardiff, UK; School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland; Fakeeh College of Health Sciences, Jeddah, Saudi Arabia; School of Nursing and Midwifery, Griffith University, Queensland, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium; Lida Institute, Shanghai, China; National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Queensland, Australia.
  • Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland; School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland; Fakeeh College of Health Sciences, Jeddah, Saudi Arabia; School of Nursing and Midwifery, Griffith University, Queensland, Australia; Faculty of Science, Medicine and Health, University of Wollongong, Australia.
  • Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland; Fakeeh College of Health Sciences, Jeddah, Saudi Arabia; Lida Institute, Shanghai, China.
  • Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland.
  • Irish Melanoma Forum, Scientific Comm. Alopecia UK, UK; Frontiers in Physiology, Skin Physiology, UK; British Society for Investigative Dermatology, UK; Charles Institute of Dermatology, School of Medicine, University College Dublin, Belfield, Dublin, 4, Ireland.
  • Tissue Engineering Research Group (TERG), The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland.
  • Silverchain Primary Health Care and Community, Australia.
  • Bruin Biometrics LLC, Global Medical Affairs and Market Access, Ireland.
  • Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland.

Abstract

AIM

To explore existing literature examining physiological differences in pressure ulcer response among individuals with differing skin tones.

METHODS

This was a scoping review. Articles meeting the inclusion criteria were retrieved from electronic databases including PubMed, CINAHL, Scopus, Cochrane, and EMBASE, using the keywords "pressure ulcer," "skin pigmentation," "melanin," and "risk factor." Data were extracted using a predesigned data extraction tool and analysed using a narrative synthesis.

RESULTS

Five papers met the inclusion criteria. Analysis of findings suggests there are potential mechanisms which may influence the skin's ability to withstand mechanical stress and its inflammatory response to damage among those with different skin tones; the structure of the stratum corneum, collagen density, fibroblast activity, mast cell density, and transepidermal water loss (TEWL). The stratum corneum can compromise skin resilience, while collagen density and fibroblast activity may impact skin strength and repair. Mast cells affect inflammation, which can exacerbate pressure ulcer damage, and increased TEWL in those with dark skin tones can result in lower water content in the stratum corneum, affecting hydration.Conversely, factors like melanosome size, hair follicle and hair fiber characteristics, sebaceous gland activity, vitamin D production, UVR protection, and desquamation rate, although relevant to overall skin health, may not directly affect the mechanical processes leading to pressure ulcer formation.

CONCLUSIONS

Physiological differences in skin structure may contribute to alterations in the response to pressure ulcer development among individuals with dark skin. Recognising these differences is important for targeted prevention strategies within diverse populations. However, further research is needed to explore the mechanisms underlying this association in greater detail.

MeSH

Skin, Cells, Pressure Ulcer, Collagen, Ulcer, Fibroblasts, Skin Pigmentation, Wounds And Injuries, Mast Cells