Fitzpatrick Skin Type for Indonesian Population
People from Indonesia typically have Fitzpatrick skin types IV to V, with the majority falling into type IV, though there is variation across the diverse Indonesian archipelago 1.
Skin Type Characteristics in Asian Populations
Indonesian individuals are part of the broader Asian population, which demonstrates considerable diversity in skin phototypes:
- Asian populations range from Fitzpatrick type III to V, with specific variations by geographic region and ethnicity 1
- Chinese and Japanese populations typically present with types III to IV 1
- Indian and Pakistani populations more commonly demonstrate types IV to V 1
- Indonesian skin, being part of Southeast Asian populations, predominantly falls into the type IV category, with many individuals also classified as type V 1
Clinical Implications for Phototherapy
When treating Indonesian patients with phototherapy, specific dosing adjustments are essential:
- For PUVA therapy in type IV skin: Start at 2.0 J/cm² with incremental increases 2
- For PUVA therapy in type V skin: Start at 2.5 J/cm² with incremental increases 2
- For NB-UVB therapy in type IV skin: Start at 330 mJ/cm² 2
- For NB-UVB therapy in type V skin: Start at 350 mJ/cm² 2
Pigmentary Considerations
Indonesian patients with types IV-V skin are particularly susceptible to specific pigmentary changes:
- Significant delayed tanning responses occur, especially with types III to VI 3
- Nail changes (melanonychia) commonly develop during PUVA therapy in types IV to VI 3
- Mottled hypo- and hyperpigmentation can appear as early as 4 weeks into phototherapy 3
- Postinflammatory hyperpigmentation is a common concern in Asian skin 1
Important Clinical Caveats
- The melanin content in type IV-V skin provides natural photoprotection compared to lighter skin types 1
- Intense pulsed light (IPL) should be used with extreme caution in Indonesian patients, as skin types above Fitzpatrick IV have increased melanin that can attract more light, causing burns and pigmentation changes 3
- Treatment intervals of at least 48-72 hours between phototherapy sessions are essential to assess for photoreactions 2