Darkly pigmented lesions in dark-skinned patients.

It is well known that fair-haired, fair-complected individuals have an increased risk of skin malignancies. Current literature, however, gives no aid in evaluating darkly pigmented lesions in the dark-skinned patient. Blacks have an incidence of malignant melanoma from 5 to 18 times less than whites, while Hispanics have a higher incidence than blacks, but 3.5 to 4.5 times less than whites. Basal-cell epitheliomas are more likely to be darkly pigmented in both groups, leading to erroneous diagnosis and treatment as melanomas.