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At least 235 records · Page 13Linked to original sources

Hyperpigmentation induced by argon laser therapy of hemangiomas. Optical and electron microscope studies.

The technique of argon laser treatment of port wine hemangiomas has been greatly improved since first used in the medical field. Complications may however occur and the authors report in this paper their experience and special studies performed on hyperpigmentation. This complication is due to an increase in melanic normal production as it has been proved by optical and electron microscope studies on pigmented skin biopsies.

Adolescent↗

Polyneuropathy, skin hyperpigmentation, edema, and hypertrichosis in localized osteosclerotic myeloma.

1 61-year-old man had osteosclerotic myeloma that was localized in the eleventh thoracic vertebral body and associated with sensorimotor polyneuropathy, skin hyperipigmentation, edema, hypertrichosis, gynecomastia, and white nails. Cases of osteosclerotic myeloma with and without polyneuropathy in the literature were reviewed with special reference to accompanying dermatologic and endocrinologic signs and synmptoms. We assume that the polyneuropathy, cutaneous hyperpigmentation, edema, hypertrichosis, gynecomastia, and white nails are causally related to each other and are a remote effect of osteosclerotic myeloma. Quantitative histologic analysis of two sural nerves biopsied within 2 years of each other during the course of the disease indicated that both large and small myelinated fibers degenerated progressively, with relative preservation of unmyelinated fibers.

Edema↗

[Marked endocrine abnormalities in polyneuritis with skin hyperpigmentation, hypertrichosis, edema and increased lambda type immunoglobulin A: a case report].

A syndrome which is known as plasma cell dyscrasia with polyneuropathy and various endocrine manifestations or plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, abnormal M protein and skin changes is very interesting because this syndrome has miscellaneous manifestations such as skin hyperpigmentation, hypertrichosis, polyneuropathy, M protein abnormality, plasma cell dyscrasia and endocrine disturbances. Miscellaneous endocrine abnormalities which have not been described so far are reported here. A 47 year old female was admitted with the chief complaints of edema and gait disturbance. Past and family histories were noncontributory. In April 1981, edema appeared in her face and legs. In June she noticed paresthesia in her legs. Edema increased gradually and she had difficulty walking. Her skin became pigmented and hairy. In October she was admitted because of polyneuropathy with increased cerebrospinal fluid protein without pleocytosis. Prednisolone was started. Walking improved slightly, but edema and paresthesia remained unchanged. Prednisolone was stopped at the end of the following March. In May 1982, she was admitted for further evaluation of edema and polyneuropathy. The patient was alert and cooperative. On standing the skin of her legs became cyanotic. There was hypertrichosis on the arms and legs. Her fingers were clubbed. A moderate swelling of the cervical lymph nodes was noted. There was mild hepatomegaly without splenomegaly. All tendon reflexes were lost. Plantar response was flexor. Muscular strength diminished mildly. She complained of paresthesia on the soles. Superficial sensation was normal. Vibratory sense decreased mildly. Cerebellar function and cranial nerves were normal. There was no sphincter disturbance. The examination of urine, stool and peripheral blood was normal.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗

[Linear hyperpigmentation caused by bleomycin].

We report on an uncommon but characteristic cutaneous side-effect of bleomycin. A 52-year-old woman being treated for carcinoma of the cervix developed linear hyperpigmentation in wheals in the lumbosacral region, the lateral thorax and above the elbow. The skin lesions appeared during the fourth cycle of chemotherapy with bleomycin. Histologically, incontinence of melanin, focal parakeratosis and a lymphocytic infiltrate with epidermotropism were prominent. By electron microscopic examination metabolically highly active melanocytes were found, with increased number of melanosomes at all stages of maturation and deposits of extracellular melanin in the underlying dermis. The epidermal keratinocytes were unchanged.

Antineoplastic Agents↗

Reticulate hyperpigmentation of Iijima, Naito and Uyeno. A European case.

A 15-year-old girl is presented with symmetric, hyperpigmented streaks and whorls on trunk and extremities. The pigmentation is located in the basal layer of the epidermis. The clinical and histopathological picture seems to be identical to the reticulate hyperpigmentation of Iijima, Naito and Uyeno, hitherto only described from Japan.

Adolescent↗

[Bazex's para-neoplastic acrokeratosis. A clinical case with hyperpigmentation].

We studied a white skin type 3 male patient aged 68 years old with a paraneoplastic acrokeratosis of Bazex, suffering from an oesophagus neoplasm. Cutaneous manifestations preceded in months the cancer. Dermatosis affected fingers of hands and feet, soles, nose and helix. Black melanic hyperpigmentation was the first cutaneous sign and were followed by an hyperkeratosis, becoming the most clinical characteristic of the syndrome. The sequence of these signs induces us to suggest that hormonal factors elaborated by the tumoral cells are the ones responsible for the pigmentary changes since they appeared before the hyperkeratosis.

Acrodermatitis↗

[Mottled hyperpigmentation of the fundus oculi associated with angioid streaks in pseudoxanthoma elasticum].

The Authors report mottled fundus in association with pseudoxanthoma elasticum in 8 of 9 patients. The mottled hyperpigmentation is an early uncommonly described finding, consisting of a speckled, yellowish mottling of the posterior pole temporal to the macula at ophthalmoscopic examination; this appearance, called "peau d'orange", is believed to be caused by changes in the retinal pigmented epithelium overlying a calcified and degenerating Bruch's membrane. This finding is virtually pathognomonic of pseudoxanthoma elasticum and may be present even in the first decade of the disease, prior to the appearance of the angioid streaks. The Authors emphasize the significance of the retinal finding, that may represent an incomplete genetic expression of an autosomal recessive carrier state.

Adolescent↗

[Chloroquine-induced isolated palatal hyperpigmentation].

We report about an isolated slate-greyish discoloration of the palatinum during chloroquine therapy of cutaneous lupus erythematosus of a 28-year-old woman. The hyperpigmentation is harmless. It is due to increased melanin synthesis and not due to deposition of the drug or its metabolites. The oculist should be consulted however, to exclude possible retinopathia.

Adult↗

[Hyperpigmentation of the oral mucosa in HIV infection].

In ten HIV-infected patients oral hyperpigmentations (HP) were observed, which seemed to be unrelated to any of the known endogenous or exogenous etiological factors. Light microscopy revealed accumulation of Fe-negative pigment in keratinocytes of the stratum basale as well as extra- and intracellularly within the subepithelial connective tissue. The ultrastructure of HP was characterised by the occurrence of melanosomes and premelanosomes within keratinocytes, melanocytes, macrophages and occasionally in fibroblasts, while especially in keratinocytes of the superficial cell layers immature melanosomes were found. Immunohistochemical examination pointed to an increase of HLA-DR positive cells and an altered distribution pattern of immunocompetent cells within the hyperpigmented mucosa. The finding of oral HP in HIV-infected patients may occur due to an increased activity of melanocytes, an increased production of melanosomes and their increased transfer to keratinocytes.

Adult↗

[Hyperpigmentation of the Laugier-Hunziker-syndrome type appearing during antineoplastic polychemotherapy].

The Authors report a case of multiple brown slate macules localized on the lips and on the oral mucosa, occurred to a 66 year-old woman during cancer polychemotherapy with cis-diamminedichloroplatinum and Cyclophosphamide due to an ovary's serous cystadenocarcinoma with peritoneal metastasis. The histological test taken on a lip's lesion, fully excised, points out main focal hyperpigmentation of basal epidermal layer and numerous melanophages in the papillary dermis. The Authors, after a comparison among the information obtained from the literature, exclude any possible secondary reaction due to chemotherapy or any paraneoplastic syndrome. What they emphasize is the great similarity between the clinical and histological pictures noticed in this case and the ones described in the Laugier-Hunziker's syndrome. The particular association observed in this case is noteworthy but, nowadays following the existing knowledges, no relation of cause and effect between polychemotherapy, cancer and Laugier-Hunziker's disease can be advanced.

Aged↗

Chrysiasis: the role of sun exposure in dermal hyperpigmentation secondary to gold therapy.

To investigate the role of sun exposure in the pathophysiology of chrysiasis, we studied 10 Caucasian female patients with rheumatoid arthritis: 4 with clinically apparent chrysiasis and 6 without apparent pigmentation. Three patients without chrysiasis had received over 4 g of gold and 3 less than one g. The mean melanin score, determined by histological examination of sun exposed and nonsun exposed skin, was significantly higher in the sun exposed skin of the chrysiasis and high dose controls than low dose controls (p less than .05). Concentration of gold measured semiquantitatively by transmission electron microscopy and quantitatively by atomic absorption showed increased gold concentration in sun exposed when compared to nonsun exposed skin of chrysiasis and high dose controls (p = .26). Low dose controls had no gold demonstrated by either method. Our results suggest that gold deposition in the dermis stimulates melain production and that melanin is important in hyperpigmentation of chrysiasis. Furthermore ultraviolet light may induce preferential uptake of gold by the skin.

Arthritis, Rheumatoid↗

Methacycline hyperpigmentation: a five-year follow-up.

A five-year follow-up is presented of a unique material of patients who acquired a greyish black hyperpigmentation during long-term methacycline therapy for chronic bronchitis. The melanosis disappeared in cases in which tetracycline therapy was discontinued during the observation period but not in those in which doxycycline had been substituted. In two autopsy cases pigment deposits were also found in cartilage and atherosclerotic lesions. Overall clinical and microscopic findings suggest a similarity to the pigmentation occurring in iatrogenic ochronosis.

Bronchitis↗

[Bleomycin-induced linear hyperpigmentation].

We describe the progression of bleomycin-induced inflammatory lesions to linear hyperpigmentations in 2 patients. Striking, hitherto unreported observations were the development of streaking after a single dose of 5 mg bleomycin (patient 1) and vacuolar degeneration of melanocytes in the inflammatory stage (patient 2).

Bleomycin↗