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At least 685 records · Page 38Linked to original sources
PubMed1993

Laser treatment of benign pigmented epidermal lesions using a 300 nsecond pulse and 510 nm wavelength.

Sixty-five patients having a total of 492 lesions were treated with the Candela pigmented lesion dye laser (510 nm, 300 ns). Lesions treated included café-au-lait macules, lentigines, seborrheic keratoses, and postinflammatory hyperpigmentation. Fluences varied from 2.0 J/cm2 to 3.5 J/cm2, but averaged 2.25 J/cm2. Response was good to excellent after one treatment with 40-50% completely clearing and an additional 33% clearing by 75% or more. Repeated treatments were capable of clearing residual lesions. Histologic examination revealed vacuolization of melanin-containing cells and suprabasilar vesicles. The only adverse sequelae were transient hypopigmentation and hyperpigmentation, which resolved in 4 to 6 months.

Adult↗
PubMed2004

Efficacy of hydroquinone (2%) versus tretinoin (0.025%) as adjunct topical agents for chemical peeling in patients of melasma.

BACKGROUND AND OBJECTIVES: In recent years, chemical peels have become increasingly popular in the treatment of melasma. However, postpeel hyperpigmentation is a frequently encountered side effect, especially in dark-skinned individuals. The role of priming agents in preventing this complication has not been adequately evaluated. Hence, we studied the effect of hydroquinone versus tretinoin as priming agents in minimizing the incidence of this side effect in a double-blind, randomized clinical trial of 50 patients with melasma. METHODS: Of a total of 50 patients, 25 patients each with a similar skin phototype, the nature and severity of melasma were assigned to groups I and II. The patients were primed with 2% hydroquinone in group I, and in group II with 0.025% tretinoin once daily (night time) 2 weeks before starting trichloroacetic acid peels. Subsequently, all of them received trichloroacetic acid peels at intervals of 2 weeks for 12 weeks, followed by monthly peels for next 12 weeks during the follow-up period. Patients continued to use a sunscreen with an SPF of greater than 15 and the recommended priming agent during the follow-up. Final assessment was made at 6 months, based on the impression of the patient, clinical examination by the physician, and photographic analysis. RESULTS: A total of 50 patients (25 in each group) participated in the study. The predominant Fitzpatrick skin type observed among them was type IV (56%), and the type of melasma was mixed (44%). The final results at 12 weeks were comparable in two groups. However, a significant difference was seen in the two groups during the follow-up period, with continued improvement in 24% and worsening in 28% of patients in group I and continued improvement in only 16% and worsening in 40% in group II patients. CONCLUSIONS: Hydroquinone is superior to tretinoin as a priming agent in maintaining the results achieved with peels and in decreasing the incidence of postpeel reactive hyperpigmentation.

Administration, Topical↗
PubMedDate not supplied

Erythromelanosis follicularis faciei et colli associated with keratosis pilaris in two brothers.

Erythromelanosis follicularis faciei et colli is characterized by well-demarcated erythema, hyperpigmentation, and follicular papules. Since the original description, it has seldom been reported in the literature. We present two adolescent brothers who had this disorder associated with keratosis pilaris on the shoulders and the extensor surfaces of the arms. Dermatologic examination found brown-red pigmentation, erythema, and follicular papules on both maxillary, preauricular regions, and the cheeks. The lesions of the older brother were more prominent. Histopathologic examination of skin biopsy specimens taken from both brothers revealed hyperpigmentation of the basal layer, follicular plugging, dermal vascular dilatation and congestion, and perivascular inflammatory infiltration. We suggest that the coexistence of these two conditions in brothers implies a genetic inheritance and a possible relationship between the disorders.

Adolescent↗
PubMed1997

Less common oral lesions associated with HIV infection: prevalence and classification.

This paper deals with a number of group II and III lesions, ie lesions definitely but less commonly, and lesions possibly associated with HIV infection, respectively. Salivary gland disease includes dry mouth and/or swelling of major salivary glands, often as a part of CD8-lymphocytosis syndrome. Xerostomia occurs commonly (2-10%) in HIV-infected individuals. Enlargement of the major salivary glands occurs frequently (19%) among HIV-infected children, but rarely among adults (0.8%). The major salivary glands show lymphoepithelial lesions or cysts histopathologically. Hyperpigmentation of the oral mucosa was found in 2.2% of 1710 HIV+ individuals in seven studies. The hyperpigmentation has been ascribed to a number of medicaments, and possibly to HIV. The prevalence of pigmentation is not significantly higher among HIV+ than HIV- individuals. Thrombocytopenia frequently occurs in HIV infection. Oral petechiae were reported in 2% of 1121 HIV+ in five studies. Human papilloma virus (HPV) infection occurred in 1.1% of 989 HIV+ in seven studies. Drug reactions (white lichenoid lesions, ulceration, toxic epidermal necrolysis) have been reported in a number of cases, not allowing prevalence figures. However certain drugs, notably Foscarnet, Interferon and 2,3-dideoxycytidine, may frequently cause oral ulcerations. Oral neurologic manifestations such as peripheral facial paralysis and sensory neuropathy have been reported in a few cases or series only.

Adult↗
PubMed1998

Bilateral involvement by age related maculopathy lesions in a population.

AIMS: To describe the influences of age and sex on the frequency of bilateral age related macular degeneration (AMD) and age related maculopathy (ARM) lesions. METHODS: The Blue Mountains Eye Study examined 3654 older Australians, 82% of permanent residents living in an area west of Sydney. Stereo macular photographs were graded for AMD (neovascular maculopathy and geographic atrophy) and early ARM lesions (soft drusen, reticular drusen, hyperpigmentation, and hypopigmentation). RESULTS: Among 230 gradable cases of AMD or early ARM, 183 (80%) were bilateral. For AMD, 39/69 cases (57%) were bilateral, while for early ARM, 123/161 cases (77%) had signs in both eyes. Of the individual lesions, reticular drusen (91%) and indistinct soft drusen (79%) were most frequently present in both eyes. Geographic atrophy was bilateral in 56%, neovascular AMD in 40%, and distinct soft drusen in 47%, while hyperpigmentation was bilateral in 38% and hypopigmentation in only 28% of cases. A consistent age related increase in bilateral distribution was observed for most lesions. After adjusting for effects of age, current smoking, and AMD family history AMD and ARM component lesions, except for soft drusen, were more frequently bilateral in women. This sex difference was significant only for neovascular AMD, odds ratio 7.7 (95% confidence intervals 1.3-46.7). An AMD family history was more frequently reported in cases with bilateral involvement. CONCLUSIONS: This study has documented differences in the age related bilaterality of individual ARM components with higher bilateral rates for reticular or indistinct soft drusen compared with other lesions. The increased bilaterality of most ARM lesions among women is likely to contribute to the increased age adjusted risk of AMD blindness found in women.

Age Factors↗
PubMed2001

Short wavelength automated perimetry in age related maculopathy.

BACKGROUND/AIMS: Previous studies reported the predictive value of the short wavelength sensitive (SWS) cone mediated sensitivity for visual outcome in age related macular degeneration. In this study SWS sensitivity was measured by commercially available blue on yellow perimetry in patients with non-exudative age related maculopathy (ARM) and compared with the presence of morphological risk factors and the status of the fellow eye. METHODS: In a prospective cross sectional study, 126 patients (57 males, 69 females, mean age 71 (SD 6) years) with ARM (visual acuity >20/50) were tested. Central visual fields (blue on yellow) were obtained with a conventional perimeter. Fundus slides were graded by two independent observers for soft drusen and presence of focal hyperpigmentation. RESULTS: Mean sensitivity and standard deviation of all patients exhibited a significant reduction with age. Patients with soft drusen had significantly lower sensitivity than those without, whereas there were no differences in visual acuity (log MAR). Sensitivity was also reduced in those eyes with fellow eyes having a sight threatening complication of age related macular degeneration (AMD). Eyes with focal hyperpigmentation compared with those without had no loss of sensitivity, but did have a significant decrease in the central part of the field compared with the more eccentric. CONCLUSION: SWS sensitivity loss is associated with common risk factors for progression to AMD. Short wavelength automated perimetry is moderately rapid and readily available. It may serve as a tool in future ARM trials.

Aged↗
PubMed2001

Unusual halo nevi--darkening rather than lightening of the central nevus.

Although the classic halo nevus is a brown nevus with a surrounding rim of depigmentation, i.e. a stage I halo nevus, these nevi can have several clinical stages. The central nevus may lose its pigmentation and appear pink with a surrounding halo (stage II), the central papule may disappear leading to a circular area of depigmentation (stage III) or the depigmented area may repigment (stage IV), leaving no trace of its prior existence. Herein we describe an unusual phenomenon--darkening of the central nevus rather than lightening--following the appearance of the halo phenomenon. An 18-year-old boy who had multiple atypical nevi developed multiple halo nevi beginning at the age of 12 years. Following the appearance of the peripheral halos, 2 of his nevi that were originally solid medium brown in color darkened and the hyperpigmentation had a reticulated pattern with perifollicular sparing. One possible explanation is a postinflammatory hyperpigmentation induced by the infiltrating lymphocytes.

Adolescent↗
PubMed2006

Prurigo pigmentosa successfully treated with low-dose isotretinoin.

BACKGROUND/AIMS: Prurigo pigmentosa (PP) is an uncommon inflammatory disease with pruritic reddish papules, papulovesicules or vesicules that are symmetrically localized on the trunk and nape, accompanied by reticular hyperpigmentation. Currently available therapeutic options seem somewhat unsatisfying. Herein, we report an 18-year-old female with PP successfully treated with low-dose isotretinoin. METHODS: The patient presented with a symmetrical pruritic eruption on the lateral sides of her trunk with erythematous papules on a hyperpigmented background. Based on the typical clinical and associated histological findings, the patient was diagnosed as PP and a treatment with low-dose isotretinoin 0.3 mg/kg/day (20 mg/day) was started. RESULTS: After a total of 3 months of 20 mg/day isotretinoin therapy, all erythematous macules and papules resolved and the residual pigmentation had almost disappeared. CONCLUSION: Low-dose isotretinoin is not only adequate for the improvement of erythematous lesions, it also helps resolve the reticular hyperpigmentation of PP. Further studies are needed to observe the efficacy of isotretinoin in the treatment of PP.

Adolescent↗
PubMed2000

Effects of renal transplantation on hearing and ocular changes in a monozygotic twin with Alport's syndrome: comparison with other twin on hemodialysis.

AIM: To present a unique case of Alport's syndrome in monozygotic twins with two different treatment modalities - renal transplantation and hemodialysis, and to evaluate the effects of therapy on hearing and ophthalmological findings. METHODS: Pure-tone audiogram and ophthalmologic examinations were performed in both twins at the age of 30. At the age of 46, 4 years after renal transplantation in the first twin and after 6 years of hemodialysis in the second twin, both twins underwent control audiometric and ophthalmologic examinations. RESULTS: Control audiometric measurements showed the progression of bilateral sensorineural hearing loss in the high-frequency range (>2,000 Hz) in both twins. The hearing threshold progressed from initial 50 dB in both twins at the time of the diagnosis to 55 dB in the twin on hemodialysis, and 85 dB in the twin with a transplanted kidney. Retinal blurry hyperpigmentations disappeared in the twin with a transplanted kidney. CONCLUSION: In comparison with hemodialysis, renal transplantation in Alport's syndrome may have deleterious effect on hearing, when associated with plasma hyperviscosity and hyperlipidemia, but may lead to regression of retinal hyperpigmentation.

Adolescent↗
PubMed2000

Addison's disease: the potentially life-threatening tan.

Addison's disease is a potentially life-threatening endocrine disorder. The classic dermatologic sign of Addison's disease is diffuse hyperpigmentation of the skin with focal hyperpigmentation of scars, nails, and the oral mucosa. Recognition of these dermatologic manifestations in a patient with otherwise vague constitutional symptoms warrants a consideration of Addison's disease.

Addison Disease↗
PubMed2003

Single-pass CO2 laser skin resurfacing of light and dark skin: extended experience with 52 patients.

BACKGROUND: Multiple-pass carbon dioxide (CO2) laser skin resurfacing has been a favored treatment modality for photodamaged and acne-scarred skin over the past several years. Its association with numerous side effects and complications, particularly prolonged erythema and dyspigmentation, however, has dampened the initial enthusiasm reserved for its use. By reducing the laser-associated tissue ablation depth and degree of thermal necrosis, it is possible that the incidence of these side effects can also be reduced. PURPOSE: To evaluate the clinical efficacy and side effect profile of single-pass CO2 laser skin resurfacing in a large series of patients. MATERIALS AND METHODS: A total of 52 consecutive patients (skin photo-types I-VI) with mild facial rhytides,atrophic scars, or infraorbital hyper-pigmentation underwent single-pass treatment with a high-energy, pulsed CO2 laser. Side effects to treatment were closely monitored and tabulated. Clinical improvement using a quartile grading scale was assessed independently by two masked medical evaluators at 1, 3, 6, and 12 months postoperatively. RESULTS: Significant clinical improvement was seen in all patients, with peak improvement scores noted 12 months. Greater clinical improvement was seen in patients with darker skin tones despite the near universal incidence of transient postoperative hyperpigmentation in these patients. CONCLUSIONS: Single-pass CO2 laser skin resurfacing can improve the appearance of fine rhytides, mild atrophic scars, and infraorbital hyperpigmentation in all skin types. The severity and duration of side effects and complications are reduced with this technique (compared with multiple-pass procedures)and may offer a possible solution to the problem of treating patients with darker complexions.

Adolescent↗
PubMed2004

The use of lasers and intense pulsed light sources for the treatment of pigmentary lesions.

Lasers and intense pulsed light sources are frequently used for the treatment of pigmented lesions, and the appropriate selection of devices for different lesions is vital to achieving satisfactory clinical outcomes. In dark-skinned patients, the risk of post-inflammatory hyperpigmentation is of particular importance. In general, long-pulse laser and intense pulsed light sources can be effective with a low risk of post-inflammatory hyperpigmentation (PIH) when used for the treatment of lentigines. However, for dermal pigmentation and tattoo, Q-switched lasers are effective, with a lower risk of complications. In the removal of melanocytic nevi, a combined approach with a long-pulse pigmented laser and a Q-switched laser is particularly applicable.

Adult↗
PubMedDate not supplied

The role of number of treatments in laser-assisted hair removal using a 755-nm alexandrite laser.

BACKGROUND: It is generally accepted that multiple laser treatments yield more effective clinical results; however, it is not clearly known whether increasing the number of treatments would affect the incidence of adverse effect. The main objective of the study was to assess the role of the number of treatments in the efficacy and safety of laser-assisted hair removal in a relatively dark-skinned population. METHODS: A retrospective study of 313 consecutive laser-assisted hair removal treatments was conducted on a total of 23 patients (22 women, 1 man) with 58 anatomic areas by means of an alexandrite laser. Skin types of III and IV were represented. The long-pulsed alexandrite system (Aphrodite, Quanta system, Italy) was used at a 755-nm wavelength to deliver fluences ranging from 17 to 25 j/cm2 through a 10 mm spot size. The patients were divided into 4 groups according to the number of treatments (group I < or =4, group II = 5, group III = 6, and group IV > or =7 treatments). Digital photographs of the patients were used for hair counting. Adverse effects (hyperpigmentation, hypopigmentation, blister, folliculitis) were questioned. The treatment was defined as successful if there was more than 50% hair reduction and an absence of the adverse effects. RESULTS: There was a positive correlation between hair reduction and number of treatments (r = .402, p < .005). The following side effects were observed: hyperpigmentation (two patients, both in group IV); hypopigmentation (one patient in group IV) and blister (one patient in group IV); folliculitis (two patients in group III and IV). Treatment was successful in 48.3% (28 out of 58) of the treatment sites. The success rate was 25% for < or =4 treatments, and 76%, 58%, and 15% for 5, 6, and > or =7 treatments respectively (p = .002). CONCLUSION: Patients who undergo more treatment sessions achieve a higher rate of hair reduction; although this may be concomitant with an increase in the incidence of adverse effects. The benefit of more laser treatments should be balanced with the risk of occurrence of side effects in each patient.

Adult↗
PubMed2005

Addisonian pigmentation of the oral mucosa.

Cutaneous pigmentation is a hallmark of Addison disease. When present, the hyperpigmentation generally localizes to sun-exposed surfaces. This case highlights a less well-recognized cutaneous feature that is pathognomonic for the disease: oral mucous membrane hyperpigmentation. We describe this unique type of discoloration in detail and contrast it with other forms of oral pigmentation.

Addison Disease↗
PubMed1993

Skin side-effects of amiodarone therapy.

Amiodarone is a antiarrhythmic drug with many side-effects which include also the induction of photosensitivity and the development of greyish-blue pigmentations on the skin exposed to light. The authors examined 64 patients treated with amiodarone and 32 controls by means of a phototest using a xenon lamp. In 9.4% photosensitivity was recorded, in 9.4% there were greyish-blue hyperpigmentations in the face and on the back of the hands. Histological identification of these hyperpigmentations including electron microscopy was also performed.

Adult↗
PubMed1996

Histochemical and ultrastructural study of diffuse melanoderma after bone marrow transplantation.

Hyperpigmentation is a well-recognized feature of cutaneous graft-versus-host disease (GVHD), and is usually restricted to sites where lichenoid or sclerodermiform lesions have occurred. Since 1975, two of 745 patients treated by allogeneic bone marrow transplantation in our institution have developed diffuse melanoderma which differed considerably from the classic presentations. They both developed acute GVHD, then lichen planus-like chronic lesions and diffuse melanoderma. Histology of biopsies of the pigmented skin showed intense pigment deposition in the basal and suprabasal layers, and in dermal macrophages. On split-dopa, melanocyte counts were 98 and 93 per field, respectively. Electron microscopy showed melanocytes protruding into the dermis, and dark melanosomes in all epidermal layers and in macrophages. These findings were suggestive of post-inflammatory hyperpigmentation. In bone marrow recipients, de novo melanoderma is a rare event which could represent a feature of cutaneous GVHD in pigmented subjects.

Adolescent↗
PubMed1996

[Cutaneous pigmentation, only manifestation of porphyria cutanea tarda in a HIV-1 positive patient].

INTRODUCTION: Porphyria cutanea tarda (PCT) is an unfrequent disorder in patients with acquired immunodeficiency syndrome (AIDS) due to deficiency in uroporphyrinogen decarboxilase. The more frequent cutaneous manifestations are skin fragility and hypertrichosis. CASE REPORT: A 44-years-old man with AIDS presented an intense cutaneous hyperpigmentation, preferently involving sun-exposed areas. Histopathologic studies showed perivascular PAS-positive deposits. Biochemical studies confirmed the diagnosis of PCT. DISCUSSION: PCT should be included in the differential diagnosis of cutaneous hyperpigmentation in patients infected by human immunodeficiency virus (HIV).

Adult↗