Dermatosis papulosa nigra (DPN) affects about 35 percent of African Americans but also occurs in other dark-skinned groups such as Asians and Polynesians. DPN appears as multiple small (1-5 mm) smooth black or brown papules on the face and neck. The spots are not cancerous but may be cosmetically undesirable.
DPN begins in adolescents and as the person ages the lesions typically increase in number and size. The papules are most common on the cheeks and forehead but may also occur in the neck, upper back and chest.
They appear simply as darkened spots on the skin and do not bleed or crust over. Women are more affected than men and 40 to 50 percent of those with DPN have a family history of them.
While treatment is not required for DNP some people desire to have them removed, especially if on the face. A doctor may send off a biopsy if there is any doubt what the lesions are but the histology usually comes back similar to another skin condition called seborrhoeic keratosis.
There is some risk in treating DNP. It is possible to create more scarring, cause more hypo- or hyper-pigmentation areas and even cause keloid formation.
Make sure to seek the care of an experienced dermatologist who has worked with people of color if you seek care for DPN.
Go to the American Academy of Dermatology to their dermatologist search screen below. Select “skin of color” for the specialty and put in your zip code. http://www.aad.org/find-a-derm/
Possible removal options:
--Curettage involves the use of a spoon-like instrument that scrapes the skin lesion to remove it from the skin. In dark-skinned individuals there is always a risk of developing a larger scar where the papule was removed.
--Electrodessication involves the use of electric current that destroys the tissue. According to Realself.com, electrodessication can be very effective in removing DNP lesions if used with a low setting. Patients should avoid picking the areas afterwards to avoid the risk of discoloration.
--Cryotherapy is when liquid nitrogen (the most common solution used) is applied to freeze off a lesion from the skin.