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At least 541 records · Page 30Linked to original sources

Pigmentary changes after alexandrite laser hair removal.

BACKGROUND: Postinflammatory pigmentary changes are a frequently encountered problem with numerous dermatologic procedures. Limited literature is available that documents this complication with laser hair removal. OBJECTIVE: It is important for all physicians performing laser hair removal to be aware of this potential complication. We present our experience with postinflammatory pigmentary change and discuss some potential etiologic factors. METHODS: Seven patients who experienced postinflammatory complications after alexandrite laser hair removal are presented. These are all the patients who developed this complication in our office over the past 2.5 years. RESULTS: The patients who we describe in this article all developed a similar pattern of initial hyperpigmented rings, later developing into a thin wafer-like crust followed by hypopigmentation with gradual return to their normal skin color. CONCLUSION: In general, the alexandrite laser is both safe and effective for hair removal in patients of varying skin types. Complication rates will increase as skin pigment increases and as the power used increases. However, even in light-skinned individuals without recent pretreatment or posttreatment sun exposure, with proper treatment parameters, complications, and side effects can arise. We have found this to be especially true when treating areas other than the face.

Adolescent↗

Night blindness, yellow vision, and yellow skin: symptoms and signs of malabsorption.

BACKGROUND: Rapidly progressing bilateral night blindness in an elderly patient suggests primarily a diagnosis of paraneoplastic retinopathy. Occasionally diffuse rod dysfunction can result from vitamin A deficiency. HISTORY AND SIGNS: A 70-year-old man complained of progressive night blindness and xanthopsia for the past 6 months. Visual acuity was 0.8 in both eyes with severe dyschromatopsia. Slit-lamp and fundus examination were normal. Visual field disclosed bilateral depression. Scotopic full-field ERG was severely reduced. The patient's medical history revealed an acute pancreatitis one year ago, followed by chronic jaundice and an increased blood bilirubin. Serum vitamin A level was decreased to 0.1 micromol/L (normal range 1.5 to 4.0). THERAPY AND OUTCOME: Intramuscular injections of vitamin A were provided. Subjective visual improvement was reported already one day after initiation of therapy. Scotopic full-field ERG was markedly improved 3 days after the injection and was only slightly subnormal 3 months later. CONCLUSIONS: In developed countries, vitamin A deficiency usually results from malabsorption syndromes and manifests initially by rod more than cone dysfunction. This diagnosis should be entertained early as vitamin A supplementation induces a rapid restoration of vision.

Aged↗

Cutaneous manifestations of alcohol abuse.

Alcohol consumption and abuse can have a variety of cutaneous manifestations. In addition to the well-recognized stigmata of the chronic alcoholic patient, even early abuse can result in distinctive skin changes or exacerbate existing cutaneous disorders. An accurate history of alcohol intake will facilitate recognition of these alcohol-induced cutaneous disorders and treatment resistance of dermatoses such as psoriasis as well as help decrease morbidity in surgical procedures. Familiarization with the spectrum of cutaneous manifestations of alcohol abuse and alcoholic liver disease can also allow for early detection and treatment in an attempt to minimize the medical consequences. We review the medical literature and discuss the spectrum of dermatologic disease associated with the use and abuse of alcohol.

Alcoholism↗

Hyperpigmentation due to cyclosporin therapy.

A 51 year old diabetic man had a cadaveric renal transplant performed. Cyclosporin immunosuppressive therapy was commenced routinely. He developed hyperpigmentation of the skin during 3 months' therapy which became increasingly marked and resolved after cyclosporin therapy was discontinued.

Cyclosporins↗

Ultraviolet light and hyperpigmentation in healing wounds.

The concept of permanent hyperpigmentation in wounds following ultraviolet light exposure during the postoperative period has found a place in plastic surgical literature but has not been documented. This study evaluates the effect of ultraviolet light on healing wounds in paraplegics. It failed to confirm permanent alteration in pigmentation response to ultraviolet exposure and suggests that other factors are of greater importance in the development of hyperpigmentation in the healing wound.

Humans↗

Tattooing for the management of white patches.

Although biologically more or less inert, a white patch is a social taboo in India. When a white patch is localized and remains static in spite of conservative treatment, it can be dealt with by tattooing as a camouflage procedure. Inert pigments of skin color match are impregnated into the intradermal plane. The procedure is simpler than melanocyte transfer and serves the purpose of hiding a white patch. In the present study, histology of the tattooed skin was studied to confirm the retention of the pigments into the intradermal plane. The patient remains pain-free in the postoperative period. The procedure does not keep the patient away from work, nor does it require hospitalization or general anaesthesia. It can be dealt with as an office procedure, making it relatively inexpensive.

Humans↗

Iris transillumination defects in the pigment dispersion syndrome as detected with infrared videography: a comparison between a group of blacks and a group of nonblacks.

BACKGROUND: Infrared image analysis has been reported to be the most sensitive method to detect iris transillumination defects (ITDs) associated with the pigment dispersion syndrome (PDS). Although a common sign of PDS in patients with lighter irides, ITDs that are demonstrated with standard slit lamp examination are frequently absent in blacks with the disease. This absence may lead to confusion in diagnosis; therefore improved methods of evaluation could be beneficial. Although infrared image analysis has been investigated in nonblacks, it has not been applied to a group of blacks with the condition. METHODS: Six blacks (11 eyes, all irides brown) with PDS and eight nonblacks (15 eyes, 10 blue irides, 5 brown irides) with PDS underwent analysis. ITDs were searched for with traditional slit lamp examination and with infrared videography. RESULTS: Among the blacks, 2 of 11 eyes (18%) showed ITDs via infrared analysis, a frequency that was significantly lower (p < 0.001) than the frequency exhibited among the nonblacks (100%) when examined with the same technique. Standard slit lamp examination also showed a significantly lower frequency of ITDs among the blacks compared to the nonblacks (p < 0.001). Infrared videography detected ITDs at least one grade higher in 1 of 11 eyes (9%) among the black group and in 7 of the 15 eyes (47%) among the nonblacks. Using the Wilcoxon signed ranks test, the difference in the ability of infrared videography to detect and rank the iris defects in the nonblack PDS group was significantly greater when compared to standard slit lamp examination (p = 0.011), but infrared analysis did not increase detection or change the mean ranking of those in the black group (p = 0.317). CONCLUSION: In this group of patients, infrared videography did not significantly improve the detection and visibility of ITDs in blacks, as it did in the nonblacks. The frequency that ITDs were detected with standard slit lamp examination and with infrared videography was significantly greater in the group of nonblacks compared to the blacks who exhibited PDS.

Adolescent↗

The treatment of burn scar hypopigmentation and surface irregularity by dermabrasion and thin skin grafting.

Scar tissue and leukoderma-type discoloration of the skin due to deep burns are treated by dermabrasion and thin split-thickness skin-graft application. This method was applied to 18 patients on whom the treated lesion sites were located as follows: 8 in the facial area, 9 on the extremities, and 1 on the neck. Adequate repigmentation and flat surfaces were obtained in all patients at the end of 6 months, and results persist at the end of a considerable follow-up period (1 to 4 years). The technique, advantages, disadvantages, and results are discussed.

Adolescent↗

Immunochemistry of elastotic material in sun-damaged skin.

The nature of elastotic material in sun-damaged human skin was investigated by indirect immunofluorescence. Antibodies were used against the following components of the dermis: type I and type VI collagens, aminopropeptide of type I and type III procollagens, fibronectin, elastin, microfibrillar proteins, and basement membrane represented by the 7S domain of type IV collagen, laminin, and nidogen. The elastotic material exhibited marked fluorescence for elastin and microfibrillar proteins which codistributed with fibronectin. The presence of type I and VI collagens and procollagen type III were demonstrated to a lesser extent within the elastotic material. These results suggest that solar elastosis is primarily derived from elastic fibers and not from preexisting or newly synthesized collagens.

Antibodies↗