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In Fitzpatrick III through V skin, common in Hispanic, Caribbean, and Mediterranean populations, PIE often presents differently than the classic pink or red appearance: Marks may look violet, dusky pink, or dark plum rather than bright red The blanch test still works (vascular marks blanch regardless of skin tone), but the color shift may be subtle and harder to see PIE frequently coexists with PIH in the same lesion, creating a layered red and brown appearance Both pathologies require concurrent treatment, not sequential When we evaluate PIE in patients with deeper skin tones at our Doral clinic, we adjust the protocol in three ways

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Quinn serves as Director of Wellness Student Support Services and is a Licensed Clinical Social Worker

Data Availability Statement The original contributions presented in the study are included in the article, further inquiries can be directed to the corresponding authors.

Discard insulin syringes according to safety guidelines and away from children.

This pain can extend its reach based on location of degenerative condition