CaSMO Recommendations for Prevention and Treatment of Cutaneous Adverse Events Related to Cancer Therapies in Darker Skin Phototypes

The Canadian Skin Management in Oncology (CaSMO) project has expanded its practical recommendations to address cancer therapy-related cutaneous adverse events (CAEs) in patients with diverse skin phototypes, particularly those with darker skin phototypes. This initiative responds to growing awareness of the underrepresentation of non-White populations in cancer research, clinical trials, and dermatologic literature. The guidelines emphasize that CAEs often present differently in individuals with darker skin phototypes, where common clinical signs such as erythema or inflammation may be subtle, atypical, or altogether absent. These diagnostic challenges can lead to delayed recognition, undertreatment, or even misdiagnosis of skin toxicities, increasing the risk of long-term complications such as post-inflammatory hyperpigmentation (PIH) and scarring. Improved clinician awareness of these variations is essential for ensuring timely and equitable management of CAEs across all skin phototypes. The paper presents practical guidance for CAE prevention and management tailored to diverse skin types, including skincare, sun protection, and treatment of pigmentary changes. It also outlines the need for personalized skincare based on individual preferences and physiological differences. The authors advocate for improved clinician education, more inclusive clinical trials, and culturally sensitive care approaches to reduce inequities in oncology dermatology. The article concludes by calling for better representation, research, and resources to support equitable care for patients with skin diversity in Canada.