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Techniques for a structural analysis of dermatoscopic imagery.

Techniques were developed for automated detection and characterization of dermatoscopic structures, including the pigment network and brown globules. These techniques incorporate algorithms for grayscale shape extraction based on differential geometry developed by Steger, a snake algorithm, and a modification of the region competition strategy of Zhu and Yuille. A novel approach was developed for global segmentation of pigmented lesions, based on stabilized inverse diffusion equations. Procedures for detection of air bubbles and hairs in dermatoscopic images are also reported.

Air↗

Dermatography as a treatment after periocular surgery.

Dermatography is the application of tattooing techniques in medicine. In the past, several techniques have been tried but none of these led to reproducible results. Over the last 17 years, dermatography has been developed into a technique that is both generally applicable and reproducible. It is a suitable treatment modality for disturbing skin discolorations and scars. With dermatography these can be permanently camouflaged. In this paper, the use of dermatography as a treatment after periocular interventions is discussed.

Cicatrix, Hypertrophic↗

Incontinentia pigmenti achromians (Ito).

A patient with incontinentia pigmenti achromians was reported. She displayed other abnormalities such as a saddle nose, malformed auricles, growth retardation, convulsions and abnormal EEG. Histopathologically, a partial decrease in melanin granules in the basal layer and the presence of melanocytes which showed a weak dopa reaction were the main findings. The hypofunction of melanin production was detected by electron microscopy.

Abnormalities, Multiple↗

Sneddon's syndrome.

A 24 year old woman presented with generalised livedo reticularis and progressive intellectual decline. A CT scan of her head showed multifocal low density areas, consistent with cerebral infarction. Cerebral angiography revealed occlusive disease of major vessels, an arteriovenous malformation, and moya-moya type anastomoses. There was no other associated systemic illness. Sneddon's syndrome was the provisional diagnosis. Her older brother had the same skin condition and was also shown to have occlusive cerebrovascular disease. The pathogenesis and natural history of this uncommon disease are highlighted.

Adult↗

Resolution of chlorpromazine-induced cutaneous pigmentation following substitution with levomepromazine or other neuroleptics.

Eleven chronic schizophrenic patients with abnormal skin pigmentation associated with neuroleptic treatment were withdrawn from chlorpromazine (CPZ), which was replaced by levomepromazine (n = 4), trifluoperazine (n = 1) or thioproperazine (n = 1) as the sole neuroleptic, by a combination of these phenothiazines (n = 4) or with haloperidol plus pipotiazine (n = 1). Seven patients showed complete resolution of abnormal skin pigmentation over a period of 1-5 years and 4 markedly improved over 2.0-2.6 years of follow-up. Our observations suggest that neuroleptic-induced abnormal skin pigmentation is (i) predominantly, if not exclusively, a side effect of CPZ and (ii) reversible, providing that CPZ is withdrawn and sufficient time is allowed to elapse.

Adult↗