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PubMed2006

The dermal stem cell factor and c-kit are overexpressed in melasma.

BACKGROUND: The pathogenesis of melasma has not yet been clearly demonstrated. We tried to determine whether the stem cell factor (SCF) and its receptor c-kit are involved in the mechanism of hyperpigmentation of melasma because this factor is highly implicated in the stimulation of melanocyte function in vitro and in vivo. OBJECTIVES: The present study was conducted to investigate the expression of SCF and c-kit on the lesions of melasma compared with nonlesional skin. PATIENTS/METHODS: Skin samples were obtained from lesional and nonlesional facial skin of 60 Korean women with melasma. Immunohistochemistry and reverse transcriptase-polymerase chain reaction (RT-PCR) analysis was performed to determine the expression of SCF and c-kit in melasma. RESULTS: The expression of SCF was significantly increased at the lesional dermis compared with nonlesional dermis. However, there was no significant difference in the expression of SCF in lesional and nonlesional epidermis. The expression of c-kit was significantly increased at lesional epidermis compared with nonlesional skin. RT-PCR of SCF and c-kit mRNAs demonstrated increased expression of both types of transcripts in the lesional skin compared with nonlesional skin. CONCLUSIONS: These results suggest that the increased expression of SCF in the dermis and of c-kit in the epidermis play an important role in the mechanism of hyperpigmentation in melasma.

Adult↗
PubMed1990

The Laugier-Hunziker syndrome--a clinical review of six cases.

The Laugier-Hunziker syndrome is an acquired, benign, macular hyperpigmentation of the lips and buccal mucosa. The nails are often involved with the development of melanonychia. Twenty-two previous cases have been recorded in the literature. We present details of six Caucasian patients with the Laugier-Hunziker syndrome who are the first recorded from Britain. They all had acquired, macular hyperpigmentation of the lips and buccal mucosa. In five of these patients longitudinal pigmented bands were found on the nails. None had other family members affected. Although this is the first report of British patients with this syndrome, we believe that the condition is probably more common than is generally recognized.

Adult↗
PubMed1995

Reticular pigmented genodermatosis with milia--a special form of Naegeli-Franceschetti-Jadassohn syndrome or a new entity?

A 19-year-old woman with a condition since birth, comprising reticular hyperpigmentation, palmoplantar hyperkeratosis, dental anomalies, hypoplasia of dermatoglyphics and a slight yellowish hue to the nails is presented. Her father and grandfather were similarly affected. The reticular hyperpigmentation, although generalized, was more intense on the flexural areas where extensive milia formation was also observed. This case represents an unusual genodermatosis. The milia formation and the presence of normal perspiration indicate a special form of Naegeli-Franceschetti-Jadassohn (NFJ) syndrome, or a new entity close to the NFJ syndrome. The differential diagnosis from other congenital reticulate pigmentary disorders is discussed.

Adult↗
PubMed1982

Riehl's melanosis.

In Riehl's melanosis, first observed in 1917, facial hyperpigmentation, most pronounced on the forehead and in the zygomatic and/or temporal regions is the dominant symptom. Riehl could find no explanation for the condition, but suggested that certain foods used during the war could be responsible. Riehl's melanosis has later been observed in dark-complexioned people in whom hyperpigmentation with pigment incontinence may be the main sign of contact dermatitis caused by certain allergens. Riehl's melanosis is today almost synonymous with pigmented contact dermatitis of the face. The commonest cause has been sensitizing chemicals in cosmetics.

Cosmetics↗
PubMedDate not supplied

Melasma in men. A clinical and histologic study.

Melasma is characterized by a facial hypermelanosis of light to dark brown color, being more common in women of Hispanic origin. In this study, 27 men with melasma were evaluated clinically and histologically to compare their features with those of previous studies. Three patterns of localization were recognized, namely, centrofacial, malar, and mandibular. On the basis of Wood's light examination, an epidermal, a dermal, and a mixed type were identified. Epidermal hyperpigmentation only and epidermal and dermal hyperpigmentation were found in histologic analysis of the cases. Significant etiologic factors included exposure to sunlight in 66.6% as well as a familial predisposition in 70.4% of the cases. This study demonstrated that melasma in men shares the same clinicohistologic characteristics as in women, but hormonal factors do not seem to play major significant role.

Adult↗
PubMed2006

Autologous melanocyte transfer via epidermal grafts for lip vitiligo.

BACKGROUND: Vitiligo of the lips is a common concern of great psychologic consequence. Medical therapies are often ineffective due mainly to the absence of hair follicles. The transfer of melanocytes or melanocyte-bearing skin by a surgical procedure may repigment this condition. Only a few surgical modalities have been successful in this "difficult to treat" site. OBJECTIVE: To assess the effectiveness of autologous melanocyte transfer by epidermal grafts for lip vitiligo and to review the literature on the surgical correction of lip vitiligo. METHODS: Twenty-six vitiligo patients (20 women and six men; age range, 13-43 years; mean, 26.8 years) having 31 affected lips with stable disease were included in the study. The suction blisters were raised using our own modified device on the lateral aspect of the thigh. The roofs of the blisters were transferred to the dermabraded recipient area. The dressing, together with the grafts, was removed on day 8. Patients were given photochemotherapy for 6 weeks. In addition, meta-analysis of the published literature on the surgical management of lip vitiligo was also performed. RESULTS: Complete repigmentation was observed in 27 of the 31 lip areas (87%) in 23 of 25 patients (92%) in whom a follow-up for 6 months or more was available. Complications observed were persistent hyperpigmentation in 12 lips and reactivation of herpes in one patient. Minimal hyperpigmentation was seen in most of the remaining lips. The results of the meta-analysis revealed that the success rate varies from 32.5% to 100% with various surgical procedures. CONCLUSION: Autologous melanocyte transfer is an effective and safe therapeutic option for stable vitiligo of the lips. It is cosmetically more acceptable, as there is no abnormal keratinization, which is a problem associated with dermo-epidermal grafts.

Adolescent↗
PubMed1996

Trisomy 18 mosaicism associated with secondary amenorrhea: ratios of mosaicism in different samples and complications.

A 28-year-old woman who complained of irregular menstruation was diagnosed as suffering from trisomy 18 mosaicism. She was karyotyped because of her characteristic face, mild mental retardation and aberrant hyperpigmentation of the skin. Her motor function was within normal range. Physical and laboratory examinations, however, revealed obesity, short stature, minor anomalies of the fingers, many areas of hyperpigmentation on the trunk and the hips, hypergonadotropinemia, diabetes mellitus, liver dysfunction, and hyperlipidemia. The ratios of normal/trisomy 18 were 4:135 in blood lymphocytes, 3:11 in a hyperpigmented area of the skin, 20:0 in a normally pigmented area of the skin, and 14:6 in ascitic cells. Laparoscopy revealed that her ovaries contained neither follicles nor germ cells.

Abnormalities, Multiple↗
PubMed1996

Atopic eczema of adult type in Japan.

Atopic eczema of adult type presents with the classical features of eczema in combination with a red face subject to oozing attacks rippling hyperpigmentation of the neck and an exudative erythema of the trunk and limbs. The red face and hyperpigmentation appear to follow topical corticosteroid use while the exudative erythema is postulated to be due to late phase reaction of IgE. Treatment involves the avoidance of exacerbating factors together with topical emollients. Topical corticosteroids are ineffective and appear to exacerbate the red face, which causes a significant social problem, affecting the patient's quality of life. New therapies promoted through the media have caused confusion.

Adjuvants, Immunologic↗
PubMed1998

Isolated deficiency of glucocorticoids presenting with cholestasis.

BACKGROUND: Isolated deficiency of glucocorticoids is characterized by elevated levels of adrenocorticotropin (ACTH) and normal aldosterone production. It is rare for isolated deficiency of glucocorticoids to be associated with liver involvement. A case of an infant with isolated deficiency of glucocorticoids presenting with cholestasis is presented in this article. A male infant on his 39th postnatal day was referred to our hospital for evaluation of prolonged jaundice and convulsion. He had two episodes of hypoglycemic convulsion on postnatal 8th and 39th day, after which he was admitted to our hospital. RESULTS: Physical examination revealed systemic jaundice, hyperpigmentation of the skin, hepatomegaly and splenomegaly on admission. He had normal male genitalia with 3.5 cm of penis and bilateral scrotal testes. Laboratory values were as follows: glucose 45 mg/dL, total biluribin 18.14 mg/dL, direct biluribin 6.54 mg/dL, aspartate aminotransferase 378 IU/L, alanine aminotransferase 46 IU/L, and alkaline phosphatase (ALP) 1302 IU/L. In abdominal ultrasound and biliary tract scanning, extra- and intrahepatic biliary tracts were shown to be normal. Finally, biopsy of the liver revealed cholestasis. An endocrinological evaluation showed high levels of adrenocorticotropin (ACTH, 1000 pg/mL), low levels of cortisol (1 microgram/dL) and normal aldosterone levels. CONCLUSIONS: The diagnosis of cholestasis secondary to isolated glucocorticoid deficiency was suspected with clinical and laboratory findings. Hydrocortisone treatment (30 mg/m2 per day) was initiated after which hyperpigmentation and jaundice decreased and ACTH and ALP levels reduced to 39 pg/mL and 440 IU/l, respectively. We emphasize that cholestasis in infants may be a component of isolated deficiency of glucocorticoids.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

Iris mammillations in ocular melanocytosis.

Hyperpigmentation of the ocular tissues and of the skin around the eye is uncommon. In ocular melanosis, the episclera, uveal tract and the angle of the anterior chamber may be involved. Heterochromia iridis may be present, if the iris is affected. In oculodermal melanocytosis or the naevus of Ota, hyperpigmentation of the skin follows the distribution of the first and second divisions of the fifth cranial nerve. This report documents a patient with episcleral pigment, heterochromia iridis and numerous tiny pigmented nodules on the iris (mammillations). The possible significance of these findings is discussed.

Journal Article↗
PubMed2004

Pyruvic acid peels for the treatment of photoaging.

BACKGROUND: Pyruvic acid (CH3-CO-COOH), an alpha-keto-acid, has been recently used as a medium chemical peeling agent in subjects with inflammatory acne, moderate acne scars, greasy skin, actinic keratosis, and warts. OBJECTIVE: The aim of our study was to evaluate the efficacy and tolerability of 50% pyruvic acid on moderately photodamaged facial skin. METHODS: We treated 20 patients with four peeling sessions at 4-week intervals. We evaluated the patients clinically, and in order to obtain an objective assessment of the effect of pyruvic acid on pigmentary components of the skin, erythema and hyperpigmentation response were measured in all the patients before and after treatment using a Minolta Tri-Stimulus Colorimeter II. RESULTS: The clinical evaluation of the patients after the peeling sessions demonstrated a smoother texture, less evident fine wrinkles, and evident lightening of hyperpigmentations (freckles and lentigines). In fact, chemical peels cause a thinning of the epidermis and a thickening of the dermis. The patients treated reported very limited or no discomfort in the postpeel period. CONCLUSION: Thus, 50% pyruvic acid peeling can be proposed as a safe and efficient treatment for moderate facial skin aging.

Adult↗
PubMed2004

Intense pulsed light for the treatment of refractory melasma in Asian persons.

BACKGROUND: Patients with dermal or mixed-type melasmas are often refractory to various treatments. Intense pulsed light has been used to treat melanocytic lesions with promising results. OBJECTIVE: The purpose of this study was to clarify the effectiveness of intense pulsed light for refractory melasma in Asian persons. METHODS: Seventeen patients were treated with intense pulsed light, during four sessions at 4-week intervals. The patients were also given 4% hydroquinone cream and broad-spectrum sunscreens to prevent and treat postinflammatory hyperpigmentation. Sixteen patients in the control group were treated with hydroquinone cream and sunscreens. The treatment efficacy was evaluated using reflectance spectrophotometer and patient satisfaction questionnaire. RESULTS: Patients in the intense pulsed light group achieved an average of 39.8% improvement in relative melanin index, compared to 11.6% improvement in the control group (p<0.05) at Week 16. Six (35%) patients in the intense pulsed light group had more than 50% improvement, compared to two (14%) patients in the control group. Two patients in the intense pulsed light group, however, experienced transient postinflammatory hyperpigmentation, and partial repigmentation was noted 24 weeks after the last treatment session. CONCLUSION: Intense pulsed light is a safe and effective treatment for refractory melasma in Asian persons, with minimal side effects. Further treatment sessions are required for maintenance therapy.

Adult↗
PubMed2006

Use of onion extract, heparin, allantoin gel in prevention of scarring in chinese patients having laser removal of tattoos: a prospective randomized controlled trial.

BACKGROUND: With rapid advancement in cutaneous laser therapy, Q-switched lasers have become the standard treatment for tattoo removal. The longer wavelength Q-switched Nd:YAG laser is used when removing tattoos in darker skin patients to avoid scarring and permanent pigment changes. Nevertheless, the local experience revealed that nearly 25% of the Chinese patients developed scarring. Meanwhile, multiple clinical studies have shown that Contractubex gel (Merz Pharma, Frankfurt, Germany) was effective in the treatment and prevention of hypertrophic scars and keloids. OBJECTIVE: To evaluate the efficacy of Contractubex gel in the prevention of scarring after laser removal of tattoos in Chinese patients. METHODS: A total of 120 Chinese patients with 144 professional blue-black tattoos were recruited into the study. They were randomly assigned into the Contractubex group or the control group. All patients were treated with a QS 1,064-nm Nd:YAG laser using a 3-mm spot size, a 10-Hz repeat rate, a pulse duration of 6 nanoseconds, and fluences that ranged from 3.6 to 4.8 J/cm2 (mean fluence, 4.2 J/cm2). The treated areas were assessed 3 months after the last treatments for clinical clearance and complications. RESULTS: Fifty-two patients with 61 tattoos in the Contractubex group were able to achieve a mean clearing rate of 82.3+/-11.6%. There were 7 tattoos in 7 patients that developed scarring, 4 patients had permanent hypopigmentation, and 3 patients had transient hyperpigmentation. In contrast, 55 patients with 68 tattoos in the control group had a mean clearing rate of 80.4+/-11.3%. Among them, 16 tattoos in 14 patients developed scarring, 4 patients had permanent hypopigmentation, and 5 patients had transient hyperpigmentation. Although there was no significant difference in age, sex, fluence, treatment session, and clinical clearance between the two groups, the Contractubex group had a statistically significantly lower rate of scarring than the control group (p<.05). CONCLUSION: Contractubex gel is effective in scar prevention in Chinese patients having laser removal of tattoos.

Adult↗
PubMed2006

Cutaneous effects of cryogen spray cooling on in vivo human skin.

BACKGROUND: Despite widespread clinical use of cryogen spray cooling (CSC) in conjunction with laser dermatologic surgery, in vivo cutaneous effects have not been systematically evaluated. OBJECTIVE: The authors characterize the in vivo cutaneous effects for Fitzpatrick skin types I through VI after CSC exposures of varying spurt durations and spurt delivery patterns (single vs. multiple spurts). MATERIALS AND METHODS: Twenty-seven normal human subjects were exposed to single cryogen spurts from 10 to 80 milliseconds, and multiple spurt patterns consisting of two 20-millisecond spurts, four 10-millisecond spurts, and eight 5-millisecond spurts. Subjects were evaluated by clinical observation and photography at 1 hour, 1 day, and 1, 4, 8, and 12 weeks after CSC exposure. RESULTS: Acute erythema and urticaria (1-24 hours) were noted in 14 of 27 and 3 of 27 subjects, respectively. Transient hyperpigmentation occurred in 4 of 27 subjects (skin types III-VI) but resolved spontaneously without medical intervention in all subjects by 8 weeks. No permanent skin changes were noted in any subjects. Skin reactions were more common with longer single-spurt durations (50 milliseconds or greater) and multiple spurt patterns. CONCLUSION: Acute erythema, urticaria, and, less commonly, transient hyperpigmentation were observed after CSC exposure. Permanent skin injury was not observed and is unlikely.

Administration, Topical↗
PubMed2006

Regression of atypical nevus: an anecdotal dermoscopic observation.

BACKGROUND: Clark nevi (atypical melanocytic nevi) can be considered as risk markers and potential precursors of melanoma. The authors report on the morphologic changes of an atypical nevus by dermoscopic follow-up examination over a 7-year period. CASE REPORT: A 43-year-old man had a brown macule on his back, sized 5 mm, with an irregular shape, clinically and dermoscopically diagnosed as an equivocal melanocytic lesion. Dermoscopically during the initial examination, a predominant reticular pattern with peripheral eccentric hyperpigmentation in the lower portion of the lesion could be seen. After 7 months, the area of peripheral eccentric hyperpigmentation had regressed, and after 4.5 years the atypical pigment network had almost disappeared. After 7 years of follow-up, a diffuse area of hypopigmentation and a residual light brown pigmentation were detectable. The histopathologic diagnosis was consistent with an atypical junctional nevus with regression with features of a Clark nevus. CONCLUSION: Based on our observation, even a dermoscopically atypical nevus may undergo regression as documented by long-term dermoscopic follow-up.

Adult↗
PubMed1991

Discrete pigmentation after chemotherapy.

Discrete areas of cutaneous hyperpigmentation were seen in two children with metastatic sarcoma who received chemotherapeutic bone marrow ablation with cyclophosphamide, etoposide, and carboplatin prior to autologous bone marrow transplantation. The hyperpigmented patches occurred only in areas of skin occluded by tape, electrocardiogram pads, or elastic bandages. Identical skin findings were reported in five adult women who received intravenous thiotepa and cyclophosphamide. Measurable levels of thiotepa were detected in these patients' serum, skin, sweat, and occluded gauze, suggesting that the chemical was excreted onto the skin surface in sweat and accumulated under occlusive dressing, thus producing some toxic effect on the epidermis or melanocytes resulting in abnormal pigmentation. We suspect that a similar mechanism was operative in our patients to produce the unusual patterned hyperpigmentation, and suggest that this complication may be prevented by minimizing sweat accumulation in areas occluded by adhesive materials.

Adolescent↗
PubMed1976

Treatment of the aging skin by dermatologic methods.

Adverse physiologic and biochemical changes in the aging skin are aggravated by unprotected, continuous or repeated exposure to the harmful rays of the sun. Waning hormonal activity contributes to these changes. The associated clinical entities are skin dryness, accentuation of facial lines and wrinkles, hyperpigmentation, and multiple benign or malignant growths. The skin should be protected by sunscreening and sunblocking agents. Overexposure to the sun must be avoided. Repeated applications of moisturizing creams, vegetable oils, and appropriate hormonal cosmetics may be helpful in hydrating the skin and thus improving its external appearance. Chemosurgery (peeling) and dermabrasion may reduce hyperpigmentation and fine facial lines and wrinkles. New growths can be removed by various surgical methods. Biopsy should be performed to determine the presence of a malignant lesion requiring additional x-ray therapy.

Aged↗
PubMed1985

Naphthol AS as a cause of pigmented contact dermatitis.

Naphthol AS is a coupling agent of cotton dyeing. 2 elderly women with hyperpigmentation of the neck and limbs are described. Both felt itching on the neck, forearms, and lower extremities and noted hyperpigmentation a month later. Both had worn cotton flannel nightdresses in winter. Patch testing with cotton flannel and methanol extracts were positive, but after estraction with methanol, the residual flannel did not react. The methanol extracts of cotton flannel, were analysed. The patients were tested with 5 extracted components; Naphthol AS was found to be the causative agent.

Coloring Agents↗