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At least 757 records · Page 42Linked to original sources
PubMed1999

Treatment of pseudofolliculitis barbae with the diode laser.

Pseudofolliculitis barbae is a common skin disorder of the beard area that is characterized by the presence of inflammatory follicular papules due to terminal hair shafts re-entering the epidermis. Postinflammatory hyperpigmentation and scarring often occur with pseudofolliculitis barbae. Such skin changes can lead to cosmetic disfigurement and be of great concern to the patient. We report a case of pseudofolliculitis barbae and hirsutism with associated postinflammatory hyperpigmentation in an African-American woman who was effectively treated with the diode laser.

Adult↗
PubMed2003

Non-ablative scar revision using a long pulsed frequency doubled Nd:YAG laser.

OBJECTIVE: Unsightly scars often are the only reminder of a previous surgical or traumatic wound. Surgical or ablative scar revision is sought by patients, sometimes unnecessarily. When the aesthetic drawback is mainly a result of hypervascularity or hyperpigmentation, these problems can be specifically targeted with a wavelength that is well absorbed by the two above mentioned chromophores. Some degree of epidermal tightening can also be achieved, which is sometimes useful in slightly atrophic scars. The average improvement after 2-3 sessions was 81% (75%-100%) clearance, as judged by an independent observer who reviewed pre- and post-treatment photographs. No undesired effects were reported. All our patients were satisfied and required no further treatment. METHODS: Selective photothermolysis by means of a long pulsed frequency doubled Nd:YAG laser (DioLite 532, IRIDEX Corporation, Mountain View, CA, USA) was used to eliminate the unsightly vascular and pigmented components of 23 mature scars (scars older than 2 years) in 22 consecutive patients. Energy densities of 17-22 j/cm2 were used with a 500 micron spot, or 65-90 j/cm2 with a 200 micron spot. RESULTS: overall scar clearance averaged 81% after 2.4 treatments. Facial scars showed the best clearance averaging 94% after 2 treatments. Inframammary scars were the most difficult to clear averaging 46%. Postoperative undesired effects were immediate erythema and swelling that subsided within 2-10 hours and microcrusting on 19/22 (88%) patients that resolved within one week. No other temporary or permanent undesired effects such as purpura, hypo- or hyperpigmentation were noticed, even in patients with darker skin types.

Adolescent↗
PubMed2004

Q-switched ruby laser irradiation on spotty pigmentation in the skin of the hairless dog.

OBJECTIVE: To investigate macroscopically and histopathologically the dermatological changes after Q-switched ruby laser (QRL) irradiation with different exposure doses in UVB-induced pigmentation in hairless dogs. METHODS: QRL irradiation with 3.0, 5.0 and 7.0 J/cm(2) was carried out on the UVB-induced spotty pigmentation in the skin of the hairless dog. Gross appearance was observed daily throughout this study. Histopathological examination was performed 1 day before QRL irradiation and 1 and 3 days and 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, 14 and 16 weeks after QRL irradiation. RESULTS: Immediately after QRL irradiation, spotty pigmentation was removed. One week after QRL irradiation, re-epithelialization started from the margin of the irradiated sites. between 5 and 10 weeks after QRL irradiation, the skin color returned to normal and some portions showed recurrence of hyperpigmentation. Histopathologically, spotty pigmentation had a heavy deposition of melanin granules in the stratum basale, spinosum and corneum. One day after QRL irradiation, the skin showed destruction of melanin granules. Seven days after QRL irradiation, re-epithelialization began from the surroundings of the QRL-irradiated sites and the pilosebaceous units. The delayed process of re-epithelialization was dependent on the incident exposure dose with QRL. The repaired epidermis was devoid of melanin granules. By 5 weeks after QRL irradiation with 3.0 and 5.0 J/cm(2), the stratum basale and spinosum revealed a redistribution of melanin granules. In the sites of recurrent hyperpigmentation, the bases of the remaining hair follicles showed a notable increase in the reproduction of melanin granules. Melanin granules abundantly aggregated in the bottom portion of the nucleus in each epidermal cell. CONCLUSION: These results revealed that hairless dogs were invaluable laboratory animals, which developed spotty pigmentation after successive UVB irradiation. In addition, UVB-induced spotty pigmentation in hairless dogs is useful for investigating the process of depigmentory treatment with QRL irradiation and recurrence of this lesion.

Animals↗
PubMed1995

Cutaneous melanoma in women. III. Reproductive factors and oral contraceptive use.

Oral contraceptive use and reproductive factors were investigated in a population-based case-control study of 452 women aged 25-59 years who were diagnosed with cutaneous malignant melanoma during the period 1981-1986 and 930 controls. Ever use of oral contraceptives was reported by 72 percent of melanoma patients and 79 percent of control subjects in this San Francisco Bay Area study, although duration of use was slightly longer for women with superficial spreading melanoma (5.5 years) than for controls (4.3 years). While some subgroups had elevated or reduced odds ratios, no consistent association was observed between cutaneous melanoma risk and oral contraceptive use when use was examined by duration, latency, age at diagnosis, age at first use, and time period of first use. Neither number of live births nor age at birth of the first child was associated with risk for cutaneous melanoma; nor was a history of miscarriage, induced abortion, or endometriosis. No association was observed with regularity of menstrual periods or with use of fertility drugs or hormones to regulate menstrual periods. Women who reported experiencing hyperpigmentation of facial skin during a prior pregnancy had a lowered risk for all cutaneous melanoma (odds ratio (OR) = 0.64, 95% confidence interval (CI) 0.44-0.93) and superficial spreading melanoma (OR = 0.54, 95% CI 0.36-0.83). This effect was more pronounced for light-complexioned women (for superficial spreading melanoma, OR = 0.37, 95% CI 0.20-0.70) than for women with a dark or medium complexion (for superficial spreading melanoma, OR = 0.84, 95% CI 0.48-1.5). Women who reported use of acne medication also had a reduced risk of superficial spreading melanoma (OR = 0.55, 95% CI 0.35-0.84). These results indicate an overall lack of effect of oral contraceptives on cutaneous melanoma risk in this population of women. The reduced melanoma risks associated with hyperpigmentation during a prior pregnancy and use of acne medication (or related hormonal indications for its use) should be studied further.

Abortion, Induced↗
PubMed1991

Hypo- and hyperpigmented areas in incontinentia pigmenti. Light and electron microscopic studies.

Incontinentia pigmenti is a rare genodermatosis typically involving three stages: vesiculae, verrucous lesions, and hyperpigmentation. We clinically and pathologically documented a case from shortly after birth until the age of 17 years. Although the first two stages took a regular course, the third stage of the disease was characterized by hypopigmented streaks on the legs in addition to axillary hyperpigmentation. Similar hypopigmented areas were found in the patient's mother. Because pathological investigations of hypopigmented areas have been extremely rare, we performed light and electron microscopic studies and compared these with our findings in hyperpigmented regions. Light microscopy showed the hypopigmented streaks with slight epidermal atrophy and a reduced number of melanocytes and skin appendages. However, the main finding was round eosinophilic bodies in the upper dermis. Electron microscopic examination of these bodies demonstrated amorphous material that resembled colloid, suggesting degeneration of basal keratinocytes. Confirming previous reports, in hyperpigmented areas we found a reduction of pigment in those parts of the basal layer overlying melanophages located in the upper dermis.

Adolescent↗
PubMedDate not supplied

Aortic regurgitation and pigmentation - unusual features of Noonan syndrome.

A patient with typical features of Noonan's syndrome showed aortic regurgitation and widespread diffuse hyperpigmentation, features not previously associated with this syndrome. Detailed endocrine and dermatological studies failed to delineate the cause of hyperpigmentation. In addition to mild aortic regurgitation, cardiac catheterization revealed mild left ventricular dysfunction, probably due to primary myocardial disease. Other interesting findings included lymphedema and sexual infantilism despite normal testosterone levels.

Adult↗
PubMed2002

Combined cervicofacial rhytidectomy and laser skin resurfacing.

PURPOSE: To determine the safety and efficacy of simultaneous cervicofacial rhytidectomy (face lift) and laser skin resurfacing. METHODS: A retrospective study of 100 consecutive patients who underwent simultaneous face lift and carbon dioxide laser resurfacing procedures was performed. Patients received regional (periorbital and/or perioral), "T"-shaped (forehead and central face), or full face laser skin resurfacing, and were classified on this basis. All patients were assessed for flap necrosis, delayed reepithelialization, reactive hyperpigmentation, persistent erythema, scarring, or other unsatisfactory results postoperatively. RESULTS: One of 10 patients receiving full-face resurfacing, including the entire subcutaneously undermined flap, suffered full-thickness skin necrosis of the distal segment of one flap. Six of the 100 patients developed reactive hyperpigmentation postoperatively. One patient evidenced an imprint of the laser footprint over nonundermined skin, requiring a secondary procedure. Aside from the one patient with scar, no cases of delayed reepithelialization were identified. CONCLUSIONS: Carbon dioxide laser skin resurfacing combined with face lift procedures can achieve dramatic cervicofacial rejuvenation. Laser resurfacing over nonundermined skin during the face lift procedure does not appear to increase the risk of postoperative complication. Laser treatment over an undermined distal face lift flap appears to increase the potential for skin necrosis, and should not be considered a routine modality for facial rejuvenation.

Adult↗
PubMed2006

Evaluation of the toxicity of subretinal triamcinolone acetonide in the rabbit.

PURPOSE: Subretinal triamcinolone acetonide (TCA) might be a useful adjuvant in the treatment of subretinal neovascularization. The purpose of this study was to test the toxicity of subretinal TCA in the rabbit eye. METHODS: Sixteen New Zealand rabbits were vitrectomized and injected with either decanted TCA solution or vehicle. The concentration of injected TCA was 2 mg, and the delivered volume was 10 microL. Rabbits were examined on days 1, 3, and 7 and then once a week up to 3 months after surgery. Optical coherence tomography was performed at months 1, 2, and 3. After the last examination, which included electroretinography, the rabbits were killed, and the eyes were enucleated for histopathologic analysis. RESULTS: Subretinal TCA appeared as a white circumscribed deposit. As the drug disappeared, areas of hyperpigmentation were seen adjacent to the drug deposit. Electroretinography tracings were normal, indicating no widespread toxic effect. Histologic analysis revealed areas of absence and/or hyperpigmentation of the retinal pigment epithelium and damage to photoreceptors and the outer nuclear layer of the retina. CONCLUSION: Subretinal injection of TCA crystals can be toxic to the outer retina and retinal pigment epithelium. Whether the potential beneficial effect of such a high-dose steroid in limiting subretinal inflammation, angiogenesis, and proliferation outweighs toxicity can only be determined from a clinical trial.

Animals↗
PubMed2005

Laser resurfacing of smallpox scars.

BACKGROUND: At the beginning of the twentieth century, smallpox affected every continent and country in the world, but over the first half of the twentieth century this disease was eliminated in most countries, including Korea, thanks to the World Health Organization's eradication program. Most survivors of smallpox have facial scars with a distinct cobblestone appearance. Though most smallpox scar patients want smooth skin, it is difficult to achieve good results with dermabrasion or chemical peeling. Recently, with advances in laser technology, laser resurfacing has become more effective and safer than conventional methods because of its depth control precision. METHODS: Between September of 1996 and August of 2001, 76 patients with significant smallpox scars were treated with a high-powered carbon dioxide laser at Korea University's Anam Medical Center. Different resurfacing methods, such as even-depth resurfacing, the shoulder technique, and the laser punch-out method, were applied according to the depth and pattern of the scars. RESULTS: The authors found that 54 patients (71 percent) had excellent or good results. The sharply demarcated margins of the smallpox scars faded out, and the depth and width of the depressed scars improved in most patients. Only seven patients sustained hypertrophic scarring after laser resurfacing, but this was resolved by intradermal triamcinolone injections. Prolonged erythema occurred in six patients (7.9 percent) and hyperpigmentation occurred in 15 (19.7 percent), but the erythema disappeared spontaneously and the hyperpigmentation could be readily managed with postoperative skin care. CONCLUSION: Laser resurfacing was found to be a useful treatment method for smallpox scarring.

Aged↗
PubMed2006

Intralesional bleomycin for the treatment of hemangiomas.

BACKGROUND: Hemangiomas, although often small at birth, enter a proliferative phase in which growth may be rapid and unpredictable. Furthermore, involution often takes many years, with attendant psychological sequelae to the child. This is aggravated by the fact that most hemangiomas affect the head and neck and are visible and difficult to conceal. METHODS: Thirty children (five boys and 25 girls) were treated at a pediatric teaching hospital during an 18-month period with a protocol of intralesional bleomycin, 0.3 to 0.6 mg/kg (per dose), administered under general anesthesia. The lesions were measured and photographed serially. Complications were also recorded. RESULTS: The mean age of the children was 20 months (range, 3 months to 8 years) and the mean number of injections given was five (range, three to eight). The mean total dose administered was 13.6 mg (range, 1.4 to 25 mg). Outcome was assessed by a panel of five plastic surgeons. Twenty-two children were assessed as achieving a response of greater than 75 percent reduction in the size of the hemangioma (of which 10 children were assessed as having total involution >90 percent response). In seven children, there was a 50 to 75 percent reduction in size of the hemangiomas, and one child was judged to have a 25 to 50 percent reduction in size of the hemangioma. Hyperpigmentation was the most common complication, and occurred in 13 children. The mean follow-up period was 14 months (range, 3 to 35 months). CONCLUSIONS: Intralesional bleomycin is another method with which to treat hemangiomas in children and may be particularly helpful for large hemangiomas of the head and neck. Repeated general anesthetics are required, and scarring with hyperpigmentation may occur.

Antibiotics, Antineoplastic↗
PubMed2005

Histologic characteristics of the human prepuce pertaining to its clinical behavior as a dual graft.

The aim of this study was to investigate the unique histologic structure of the normal human prepuce, paying particular attention to the resemblance and dissimilarities between the inner (ie, mucosa) and outer (ie, skin) layers. Histologic sections were stained using hematoxylin-eosin and Van Gieson stains. Transmission electron microscopy was used to evaluate the ultrastructure. Dense capillary networks can be observed in both the upper and lower dermal zones. The dermis lacks a dense collagenous zone. Melanocytes could not be observed in the mucosa. Elastin fibers and bundles were very abundant and dense. Early edema formation can be explained by the loose character of the dermal structure. Better graft "take" in mucosal grafts may be the result of the dense vascular dermal network. Mild hyperpigmentation can be explained by the limited number of melanocytes. However, this can also be observed in mucosal grafts, despite the absence of melanocytes. This may be solely the result of inflammatory hyperpigmentation, which can be seen in skin grafts. The abundance of elastin fibers in the prepuce may be the reason behind the superior wound contraction inhibition.

Humans↗
PubMed1987

Pigment change and melanocyte distribution in guinea pig skin after cutaneous freeze injury.

Cryosurgery has been recommended for the treatment of cutaneous neoplasms, including benign and malignant melanocytic tumors. The main side effect of this treatment is pigment disruption which may be prolonged. There are no quantitative studies on melanocyte distribution after freeze injury. In this study the effect of standardized freeze times on melanocytes in guinea pig skin (tricolored) is described at the anatomic level and at the light and electron microscopic level. Melanocytes are quantified in epidermal sheets following dopa staining at 1-, 2-, and 3-month intervals after freezing. All the lesions were initially hypopigmented with a peripheral rim of hyperpigmentation. This was a transient phenomenon associated with an absence of melanocytes. Pigment migrated into the lesions so that after 3 months all the lesions on black skin were diffusely hyperpigmented. Pigment was slower to return to the red skin. Hair follicles were destroyed in the center of the lesion. The epidermal sheets demonstrated that the hyperpigmentation was an epidermal phenomenon and was associated with increased numbers of melanocytes (p less than 0.001). These melanocytes were distributed evenly throughout the lesion in contrast to the irregular distribution in normal skin.

Animals↗
PubMed2000

Depigmenting effect of alpha-tocopheryl ferulate on normal human melanocytes.

Oral vitamin E supplementation has been reported to improve facial hyperpigmentation. alpha-Tocopheryl ferulate (alpha-TF) is a compound of alpha-tocopherol (alpha-T) and ferulic acid connected by an ester bond. Ferulic acid is also an antioxidant, and could scavenge free radicals induced by ultraviolet (UV) radiation, and thus maintain the long-lasting antioxidative effect of alpha-T. Previously we have reported that alpha-TF inhibited melanogenesis in human melanoma cells. To know whether alpha-TF might be useful as a whitening agent to improve and prevent facial hyperpigmentation, the depigmenting effect of alpha-TF in normal human melanocytes was examined in this study. The results showed that 30 microg/ml of alpha-TF dissolved in 150 microg/ml of lecithin inhibited melanization significantly without inhibiting cell growth. This phenotypic change was associated with the inhibition of tyrosinase and the degree of inhibition was dose dependent. No significant effect on DOPAchrome tautomerase (DT) activity was observed. These results suggest that alpha-TF is a candidate for an efficient whitening agent which suppresses melanogenesis. In this paper, the role of alpha-T and alpha-TF in inhibiting biological reactions induced by reactive oxygen species (ROS) is also discussed.

Adult↗
PubMed2001

Linear and whorled nevoid hypermelanosis.

Linear and whorled nevoid hypermelanosis (LWNHM) is a reticulate pigmentary disorder with a sporadic occurrence, representing genetic mosaicism. It is characterised by hyperpigmented macules in a reticulate pattern along Blaschko's lines, sparing the mucous membranes and stabilising after one to two years. It may be associated with various neurological abnormalities. The disorder may resemble incontinentia pigmenti, epidermal nevus, or zebra-like hyperpigmentation clinically. We report LWMNHM in a 15-year-old girl with progressively increasing streaks of reticulate hyperpigmented macules arranged in a whorled pattern over the trunk and extremities, which appeared soon after birth. There was no history of any preceding eruption or any associated systemic abnormality. Histopathological examination revealed basal cell hyperpigmentation without any pigmentary incontinence. CT scan of the brain was normal.

Abdomen↗
PubMed2007

Efficacy and safety of serial glycolic acid peels and a topical regimen in the treatment of recalcitrant melasma.

Melasma is a common acquired disorder of facial hyperpigmentation. In this study we investigated the efficacy and safety of a combined treatment regimen including serial glycolic acid peels, topical azelaic acid cream and adapalene gel in the treatment of recalcitrant melasma. Twenty-eight patients with recalcitrant melasma were enrolled in a prospective, randomized, controlled trial lasting 20 weeks. The patients of the group receiving chemical peels underwent serial glycolic acid peels in combination with topical azelaic acid 20% cream (b.i.d.) and adapalene 0.1% gel (q.i.d., applied at night). The control group received only topical treatment including topical azelaic acid and adapalene. The clinical improvement was assessed with the Melasma Area Severity Index (MASI) at baseline and monthly during the 20-week treatment period. The results showed a prominent decrease in MASI scores at the end of the treatment in both groups, although the results were better in the group receiving chemical peels (P=0.048). All patients tolerated the topical agents well with minimal irritation observed in the first few weeks of the therapy. Three patients in the glycolic acid peel group developed a mild-degree postinflammatory hyperpigmentation with total clearance at the end of the treatment period. Therefore, the present study suggests that combined treatment with serial glycolic acid peels, azelaic acid cream and adapalene gel should be considered as an effective and safe therapy in recalcitrant melasma.

Adapalene↗
PubMed1990

Dermatological findings in children exposed transplacentally to heat-degraded polychlorinated biphenyls in Taiwan.

We studied 128 children who were transplacentally exposed to polychlorinated biphenyls and dibenzofurans in Taiwan, their parents and siblings who were directly exposed, and 115 control children. Direct exposure of the mothers stopped in 1979 and the children were born as late as 1985. At birth, exposed children had increased rates of hyperpigmentation, eyelid swelling and discharge, deformed nails, acne, natal teeth and swollen gums compared to controls. On examination, they had a much higher rate of dystrophic finger-nails and pigmented or dystrophic toe-nails than controls. They also had an increased rate of hyperpigmentation and acne. In addition they had more generalized itching, localized skin infections and hair loss. The findings seen in transplacentally exposed children differ from those seen in people directly exposed, particularly in the latter group in higher prevalence of acne.

Acne Vulgaris↗
PubMed1993

Characterization of pigmented granules in minocycline-induced cutaneous pigmentation: observations using fluorescence microscopy and high-performance liquid chromatography.

We describe a technique to facilitate histopathological detection and quantitative measurement of trace amounts of tissue minocycline. In a patient with minocycline-induced hyperpigmentation, a series of biopsies were taken from the affected skin over a period of 54 months, and examined for tissue minocycline deposition. Frozen sections treated with 1 M MgCl2-ethanol yielded minocycline-specific yellowish fluorescence, the location of which corresponded to clumps of granular deposits in the dermis. A decrease in the number of fluorescent granules correlated with the clinical resolution of hyperpigmentation and a significant decrease in the tissue minocycline level. Our data also provide further support for the concept that the pigment granules contain insoluble complexes of minocycline chelated with iron. The fluorescence technique is simple, sensitive, and reproducible.

Chromatography, High Pressure Liquid↗
PubMed1993

Topical tretinoin (retinoic acid) improves melasma. A vehicle-controlled, clinical trial.

Melasma is a common disorder of cutaneous hyperpigmentation predominantly affecting the faces of women. Little is known about the aetiology of melasma, and treatment is frequently disappointing. Topical tretinoin is of benefit in treating other forms of hyperpigmentation, for example liver spots, and we therefore investigated its effectiveness in melasma. Thirty-eight women completed a randomized, vehicle-controlled study, in which they applied 0.1% tretinoin (n = 19) or vehicle cream (n = 19) once daily to the face for 40 weeks. At the end of treatment 13 (68%) of 19 tretinoin-treated patients were clinically rated as improved or much improved, compared with 1 (5%) of 19 in the vehicle group (P = 0.0006). Significant improvement first occurred after 24 weeks of tretinoin treatment. Colorimetry (an objective measure of skin colour) demonstrated a 0.9 unit lightening of tretinoin-treated melasma and a 0.3 unit darkening with vehicle (P = 0.01); these results correlated with clinical lightening (r = 0.55, P = 0.0005). Histologically, epidermal pigment was reduced 36% following tretinoin treatment, compared with a 50% increase with vehicle (P = 0.002). Reduction in epidermal pigment also correlated with clinical lightening (r = -0.41, P = 0.01). Moderate cutaneous side-effects of erythema and desquamation occurred in 88% of tretinoin-treated and 29% of vehicle-treated patients. Topical 0.1% tretinoin produces significant clinical improvement of melasma, mainly due to reduction in epidermal pigment, but improvement is slow.

Administration, Topical↗