Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Hyperpigmentation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 901 records · Page 50Linked to original sources

Chronic moderate heat dermatitis (erythema ab igne) in five dogs, three cats and one silvered langur.

Erythema ab igne, an old and rare disease in the human literature, is an erythematous, often pigmented, reticular, macular dermatosis that occurs at the site of repeated exposure to moderate heat. We identified lesions consistent with erythema ab igne in five dogs, three cats and one silvered langur (Trachypithecus cristatus[Raffles, 1821]). In dogs and cats, the cutaneous lesion distribution typically reflected chronic exposure to moderate heat during lateral or sternal recumbency. The silvered langur developed cutaneous lesions on the dorsal neck from exposure to a heat lamp. Principal clinical lesions consisted of irregular areas of alopecia (7/9) and erythema (7/9), sometimes with hyperpigmentation (3/9). Principal histological features consisted of karyomegaly (9/9) and keratinocyte atypia (4/9), scattered apoptotic or vacuolated basal cells and/or apoptotic keratinocytes (6/9), mild mixed mononuclear interstitial or interface dermatitis (9/9) with adnexal atrophy (8/9), and a variable number of wavy eosinophilic elastic fibres (9/9). The presence of these cutaneous lesions in an animal indicates that the environment should be evaluated for exposure to chronic moderate heat, and the heat source should be eliminated or modified to prevent further exposure and progression of lesions.

Animal Husbandry↗

A 2-year study of liquid nitrogen therapy in cutaneous leishmaniasis.

BACKGROUND: Among the different modalities for treatment of cutaneous leishmaniasis, liquid nitrogen is considered an effective therapy with very mild side-effects. METHODS: A study was conducted using liquid nitrogen topically for the treatment of cutaneous leishmaniasis in the King Hussain Medical Centre, Amman-Jordan. Among 468 patients of cutaneous leishmaniasis, 293 were treated with liquid nitrogen and the rest were treated with other known treatment modalities. RESULTS: Of the patients treated with cryo surgery liquid nitrogen, 215 of 293 permitted appropriate follow-up; the clinical response was significant and effective. No systemic adverse effects were noted. Mild cutaneous complications were infrequent, and included hypopigmentation, hyperpigmentation, and scar formation. CONCLUSIONS: From the results of this study, liquid nitrogen therapy may be considered an effective treatment for cutaneous leishmaniasis.

Administration, Cutaneous↗

Notalgia paresthetica: a study on pathogenesis.

BACKGROUND: Notalgia paresthetica is a sensory neuropathy involving the dorsal spinal nerves. The characteristic symptom is pruritus on the back, occasionally accompanied by pain, paresthesia, and/or hyperesthesia, which results in a well-circumscribed hyperpigmented patch in the symptomatic area. The etiology of this condition has not yet been completely defined. OBJECTIVE: Possible mechanisms that could explain the pathogenesis of notalgia paresthetica were investigated through clinical examination and various diagnostic tests. METHODS: Ten cases of notalgia paresthetica underwent dermatologic, neurologic, and orthopedic examination. This was followed by skin biopsy, electrodiagnostic investigation, and radiography of the spine. RESULTS: All patients had a typical symptomatology and dermatologic picture. Neurologic examination and standard electrodiagnostic investigation results were normal in all cases. Histopathology was compatible with postinflammatory hyperpigmentation; there were no amyloid deposits. In seven cases, degenerative changes in the vertebrae were observed and, in all of these cases, these changes were most prominent in the vertebrae which corresponded to the dermatome of the cutaneous lesion. CONCLUSIONS: The striking correlation of notalgia paresthetica localization with degenerative changes in the spine suggests that spinal nerve impingement may contribute to the pathogenesis of this entity.

Adult↗

Prurigo pigmentosa.

BACKGROUND: Prurigo pigmentosa is a rare inflammatory dermatosis of unknown etiology characterized by recurrent, pruritic erythematous papules and gross reticulate hyperpigmentation. It is seen most commonly among young adult Japanese females. Only 20 cases have been described outside Japan. METHODS: We report two female, Turkish patients aged 20 and 26 years who had a pruritic rash with the characteristic clinical appearance and supportive histopathology of prurigo pigmentosa. RESULTS: They were successfully treated with minocycline and doxycycline. CONCLUSIONS: Prurigo pigmentosa is a relatively new clinical entity, and we believe that a more widespread knowledge of this disease will lessen its misdiagnosis. We find it noteworthy to point out that there may be a predisposition to prurigo pigmentosa amongst the Turkish and Sicilian populations.

Adult↗

Photodistributed blue-gray pigmentation of the skin associated with long-term imipramine use.

A 72-year-old white woman presented with progressively increasing slate-gray pigmentation of the face and extensor aspect of the forearms, which she had been suffering from for 8 years. She had been taking imipramine for approximately 30 years. Her other medications included ranitidine and anacin. Physical examination revealed slate-gray hyperpigmentation of the skin photodistributed on the face (Figs 1, 2) and extensor aspects of the forearms. Relative sparing of the skin folds, mucous membranes, sclerae, teeth, and nails was noted. The remainder of the physical examination revealed no abnormalities. Skin biopsy specimens from the right cheek and right forearm were obtained. Histologic examination revealed collections of variably sized, round to ovoid, yellow-brown globular deposits in the upper and mid dermis (Fig. 2). The deposits were identified within macrophages and free within the dermis. The epidermis was unremarkable and free of deposits. The deposits stained for melanin with a Fontana-Masson stain, but did not stain for iron.

Aged↗

Efficacy of hydroquinone cream (USP 4%) used alone or in combination with salicylic acid peels in improving photodamage on the neck and upper chest.

BACKGROUND: Salicylic acid, hydroquinone, and glycolic acid have been proved effective in the treatment of photodamaged facial skin. Few reports are available on the treatment of photodamage on the neck and upper chest. OBJECTIVE: This study's purpose was to evaluate the efficacy of a cream containing 4% hydroquinone and 2% glycolic acid (LUSTRA) used alone or with salicylic acid peels in reversing actinic damage on the neck and upper chest. METHODS: Nineteen women with moderate to advanced photodamage on the neck and upper chest applied a cream containing 4% hydroquinone and 2% glycolic acid twice daily on photodamaged areas for 12 weeks. Nine of these subjects had salicylic acid peels every 3 weeks. Improvements were assessed by the investigator, the subjects, and Mexameter readings measuring melanin and erythema levels. RESULTS: The result shows that there was a 33-71% improvement in photodamage, hyperpigmentation, texture, fine lines, dryness, tone, and clarity in both groups. There were no significant differences between the two treatments. CONCLUSION: Hydroquinone 4% cream with 2% glycolic acid is safe and effective in improving photodamage on the neck and upper chest when used alone or in combination with salicylic acid peels.

Chemexfoliation↗

Intense pulsed light for melanocytic lesions.

BACKGROUND: Few reports about melanocytic lesion treatment using intense pulsed light have been published. OBJECTIVES: To evaluate the clinical results of diverse melanocytic lesions after treatment with an intense pulsed light source. METHODS: Superficial and deep melanocytic lesions were treated by an intense pulsed light source with the following parameters: filters of 590, 615, and 755 nm, a fluence energy of 34-38 J/cm2, double mode, a pulse width of 3.8-4.5 msec, and a delay of 20 msec, at 4- to 8-week intervals. Two treatment sessions were applied to superficial lesions, while deep ones received four. RESULTS: A clearance of 76-100% (excellent) was obtained for superficial lesions such as ephelides, epidermal melasma, and café au lait macules. Nevus spilus showed good clinical clearance (51-75%); however, deep lesions such as nevus of Becker, epidermal nevus, and mixed melasma showed an average clearance of less than 25%. Postinflammatory hyperpigmentation was observed in melasma. CONCLUSION: Intense pulsed light is an effective treatment for superficial melanocytic lesions; however, those with a deep component improve only if repetitive treatment sessions are applied.

Adolescent↗

Photorejuvenation for Asian skin by intense pulsed light.

BACKGROUND: Dermabrasion and deep chemical peeling are used in the treatment of photoaged skin. These ablative procedures are effective enough to produce a certain improvement but have often caused postinflammatory hyperpigmentation among Asian patients. To avoid such adverse effects, a new, nonablative procedure has been sought. OBJECTIVE: To determine the effectiveness of photorejuvenation for Asian skin using intense pulsed light (IPL). The specific parameters used, improvement ratios, side-effects, and downtime required are also discussed. METHODS: Ninety-seven patients were treated for photoaging using IPL. The cutoff filters of 550 nm and 570 nm were utilized for three to six treatments at intervals of 2 to 3 weeks. RESULTS: Treatment results were evaluated and rated by both patients and physicians at the end of the third treatment based on improvement in pigmentation, telangiectasia, and skin texture. A combined rating of "good" or "excellent" was given to more than 90% of the patients for pigmentation, more than 83% for telangiectasia, and more than 65% for skin texture. There were some minor complications in four cases: one had erythema that continued to the next day and three had minor blisters leaving no marks. CONCLUSION: Photorejuvenation using IPL is a completely safe and effective procedure even for Asian skin. It will be increasingly used for skin rejuvenation in the future.

Adult↗

One-pass CO2 versus multiple-pass Er:YAG laser resurfacing in the treatment of rhytides: a comparison side-by-side study of pulsed CO2 and Er:YAG lasers.

BACKGROUND: The CO2 laser is normally described as an aggressive resurfacing tool, whereas the erbium:YAG laser has enjoyed a reputation as the ideal tool for superficial resurfacing. The implication from many studies is that the CO2 laser is incapable of "minimally invasive" resurfacing. OBJECTIVE: To compare a short-pulsed CO2 laser with an Er:YAG laser over a range of parameters intended to produce equivalent microscopic and clinical injuries. METHODS: A prospective, randomized, comparative interventional trial was conducted in a tertiary care teaching hospital. Thirteen patients with facial wrinkles were enrolled in the study. A side-by-side comparison was performed using periorbital and perioral regions as treatment sites. One side was treated with a pulsed CO2 laser and the other with an Er:YAG laser. Postauricular skin was treated in an identical fashion to the study sites and biopsied for microscopic analysis. The biopsies were obtained before treatment, immediately after treatment, and either 3 or 6 months after treatment to evaluate the acute level of injury and subsequent degree of fibroplasia. Photographs were taken at baseline, immediately after treatment, 1, 2, and 6 weeks, and 3 and 6 months after treatment. Nine physicians evaluated the photographs for erythema, pigmentation, and wrinkle improvement. RESULTS: Investigator assessment showed no statistically significant differences between the lasers with respect to hyperpigmentation and wrinkle reduction. There was less erythema at the CO2 laser-treated sites 2 weeks after treatment; the differences had resolved by 6 weeks after treatment. Histologic examination demonstrated equivalent dermal thermal injury on immediate postoperative biopsies and equivalent fibroplasia on subsequent biopsies. Both CO2 and Er:YAG laser-treated sites showed overall modest wrinkle improvement compared to the pretreatment photographs. CONCLUSION: When CO2 and Er:YAG lasers are used in a manner such that there are equivalent immediate postoperative histologic results, equivalent healing and cosmetic improvement occurs. One can use CO2 laser with one pass to mimic a moderately aggressive Er:YAG laser treatment.

Adult↗

Cosmetic color improvement of the nipple-areola complex by optimal use of tretinoin and hydroquinone.

BACKGROUND: A successful treatment to improve the color of nipple-areola complex (NAC) has never been reported, although the number of women seeking the more attractively colored NAC is not small. OBJECTIVE: To determine the effectiveness of our bleaching protocol for cosmetic improvement of the NAC. METHODS: The protocol was composed of two phases: bleaching phase (4-8 weeks) and healing phase (4-6 weeks). 0.2-0.4% tretinoin aqueous gel was applied concomitantly with 5% hydroquinone, 7% lactic acid ointment for bleaching twice a day. Tretinoin was applied to the NAC with a small cotton applicator, while hydroquinone was widely applied beyond the NAC area. After obtaining sufficient improvement in NAC color, the application of tretinoin was discontinued and hydroquinone alone was continually applied in the healing phase until the reactive erythema was eliminated. Fifteen female patients were involved in this study. RESULTS: The average treatment period was 16.6 weeks. Improvement of NAC color was obtained in 12 patients (80%) by the physician's estimation, and 11 patients (73%) satisfied with their final results. The treatment was repeated after a 1-month interval of tretinoin application in 4 patients: 2 desired further improvement in color, and 2 had the second course conducted to treat the postinflammatory hyperpigmentation on the surrounding mound induced by the first course. CONCLUSION: This approach appeared to be most effective for cosmetic improvement of NAC color among treatments available so far.

Administration, Cutaneous↗

The effect of combination treatment of the recalcitrant pigmentary disorders with pigmented laser and chemical peeling.

BACKGROUND: The pigmentary disorders including melasma, freckles, postinflammatory hyperpigmentation, or acquired bilateral nevus of Ota-like macules, etc. are usually resistant to all treatment modalities, and are therefore very frustrating to the patient and clinician. OBJECTIVE: The purpose of this study was to demonstrate the effect of the combination treatment of recalcitrant pigmentary disorders with pigmented laser and chemical peeling and to observe any side-effects. METHODS: Twenty-four patients with recalcitrant facial pigmentary disorders were treated with the Q-switched alexandrite laser at fluences of 7.0-8.0 J/cm2 or the pigmented lesion dye laser (PLDL) at fluences of 2.0-2.5 J/cm2, and at the same session, 15-25% trichloroactic acid (TCA) with or without Jessner's solution were used for the chemical peeling. And the results were clinically analyzed. RESULTS: In the assessment by the patients, 63% of them considered the result as "clear, excellent, or good" in respect to the color and 54% of them assessed that the size of the lesion had cleared more than 50%. In the assessment by a clinician, 67% of the patients were categorized into the grade of clear, excellent, or good. There were no significant complications with this combination method. CONCLUSIONS: The combination treatment with pigmented laser and chemical peeling is effective, safe, and relatively inexpensive treatment modalities in the recalcitrant pigmentary disorders.

Adult↗

Treatment of facial rhytides with a nonablative 1,450-nm diode laser: a controlled clinical and histologic study.

OBJECTIVE: To evaluate the safety and effectiveness of a nonablative 1,450-nm midinfrared diode laser in the treatment of facial rhytides. METHODS: Twenty-five patients (skin phototypes I-III) with mild-to-moderate perioral or periorbital rhytides received four successive treatments at 3- to 4-week intervals with a 1,450-nm diode laser (SmoothBeam; Candela Corp., Wayland, MA). Symmetrical matched areas were left untreated to serve as controls. Patients were evaluated with digital photography at each treatment session and at 1, 3, 6, and 12 months after the final laser treatment. Skin biopsies were obtained from treatment and control facial sites for histologic evaluation before treatment, immediately after the first treatment, and 3, 6, and 12 months after the fourth treatment. Patient satisfaction scores were obtained at each follow-up visit. RESULTS: Mild to moderate improvement in treated facial rhytides was observed in all patients. Increased dermal collagen was seen 6 months after four successive treatments. Patient satisfaction scores paralleled the photographic and histopathologic changes seen. Side effects were limited to transient erythema, edema, and postinflammatory hyperpigmentation. CONCLUSION: The nonablative 1,450-nm diode laser is safe and effective for the treatment of mild-to-moderate facial rhytides.

Adult↗

Leg edema from intrathecal opiate infusions.

Despite the increasing popularity of intrathecal infusions to treat patients with long-term non-cancer-related pain, this therapy is not without serious side-effects. Five out of 23 patients who had intrathecal infusions of opiates for longer than 24 months developed leg and feet edema. As predisposing factors, cardiovascular disease, deep venous thrombosis, peripheral vascular disease, and venous stasis of the lower extremities were considered. Every patient who developed pedal and leg edema after the implantation of an infusion pump was also found to have leg edema and venous stasis prior to the time when the pump was inserted. This complication was severe enough to limit their physical activity, and to produce lymphedema, ulcerations and hyperpigmentation of the skin. Reduction of the edema occurred when the dose of the opiate was decreased, and in two cases in which the infusion was discontinued, there was almost complete resolution of the syndrome. It appears that the pre-existence of pedal edema and of venous stasis is a relative contraindication to the long-term intrathecal infusion of opiates in patients with chronic non-cancer pain.

Arachnoiditis↗

Quantitative comparison of skin colors in patients with ESRD undergoing different dialysis modalities.

BACKGROUND: Little is known about the alterations in skin pigmentation in patients with end-stage renal disease (ESRD) in the modern dialysis era. Aims of this study are to quantitatively investigate the skin color of patients with ESRD undergoing different dialysis modalities and determine factors associated with skin color changes. METHODS: One hundred twenty-four patients with ESRD undergoing either hemodialysis (HD; n = 51) or peritoneal dialysis (PD; n = 73) were enrolled, and 59 subjects with normal renal function served as controls. Skin colors of the abdomen (non-sun-exposed site) and forearm (sun-exposed site) were measured by using a reflected-light colorimeter and recorded by using the Commission Internationale de l'Eclairage recommended L*a*b* system, in which a higher L* value represents brighter skin. RESULTS: For sun-exposed skin, brightness was not different between patients with ESRD and controls. However, patients with ESRD had a lower L* value in the non-sun-exposed skin area (P < 0.001). HD and PD patients had similar L* values in both sun-exposed and non-sun-exposed skin areas. PD patients with adequate weekly creatinine clearance or residual urine greater than 100 mL/d had brighter skin in the non-sun-exposed area (P = 0.001 and P = 0.035, respectively). CONCLUSION: Patients with ESRD in Taiwan have significantly darker skin in the non-sun-exposed area, but not the sun-exposed area, than subjects with normal renal function. However, there is no difference in skin darkness between HD and PD patients. Efforts to increase weekly creatinine clearance and preserve residual urine may alleviate hyperpigmentation in PD patients.

Adult↗

Treatment of arborising telangiectasia with pulsed tunable dye laser (SPTL-1b).

Arborising telangiectasia is a rare but distinct progressive condition of unknown aetiology. The vessels are subepidermal and measure less than 0.2 mm in diameter. Twenty-three patients with this condition, involving the lower limbs and in extensive cases the upper limbs and trunk, have been treated with the flash lamp pulsed tunable dye laser (SPTL-1b, Candela Laser Corp.). Retrospective review of 17 of these patients, who have finished their treatment (average five sessions of therapy per patient, given at 3-4 monthly intervals), shows complete clearance of the telangiectasia in all cases. The mean follow-up time after the last session of treatment was 7 months. Temporary hyperpigmentation was seen in eight patients. Persistent pigmentary changes (one hyper- and one hypopigmentation) were noted in two patients. No evidence of scarring or change in skin texture was encountered. No progression or recurrence of telangiectasia was noted during the period of follow-up.

Adolescent↗

[Prerenal kidney failure in type 1 diabetes mellitus].

HISTORY AND ADMISSION FINDINGS: A 22-year-old man was admitted in a severely reduced condition. Type 1 diabetes mellitus had been diagnosed when he was 13 years old, hypothyroidism was treated with L-thyroxine for 2 years. For the past 3 years he suffered from repetitive hypoglycemia, combined with vertigo, weakness and low blood pressure. INVESTIGATIONS: He presented with hypotension and hyperpigmentation of the skin. Pathological laboratory results were: serum creatinine 2.5 mg/dl; urea 145 mg/dl; sodium 124 mmol/l; potassium 8.3 mmol/l, HbA (1c) 9.1%. The ECG showed large T waves. Additionally, plasma aldosterone was decreased (<10 ng/l), plasma renin was increased (2404 ng/l), basal serum cortisol was decreased (16.1 microg/l). No increase of plasma cortisol after i. v. stimulation with ACTH (1-24) occurred. Plasma ACTH was increased to 630 pg/ml. Test for adrenal autoantibodies were positive. DIAGNOSIS: Primary adrenal insufficiency with prerenal renal failure. Autoimmune polyglandular syndrome (APS) type II with Addison's disease, diabetes mellitus type 1 and hypothyroidism (Schmidt-Carpenter-Syndrome) were diagnosed. TREATMENT AND COURSE: Initially, the patient was treated with sodium chloride 0.9% i. v. and oral sodium 5 g 4 times/day. In addition, he was given hydrocortisone 100 mg i. v., and then switched to 40 mg per day (20-10-10 mg), fludrocortisone 0.05 mg/ day and L-thyroxine 75 microg/ day orally the clinical condition improved dramatically within 24 hours. Intensified conventional insulin therapy was continued. CONCLUSION: In patients with type 1 diabetes, especially in combination with associated organ-specific autoimmune diseases, autoimmune polyglandular syndrome should be considered and adequately treated with those hormones that are reduced.

Addison Disease↗

[A young diabetic with small-nodule liver cirrhosis, high transferrin saturation and negative HFE test].

HISTORY: A 28 year young female presented to our hospital for further evaluation with recently diagnosed diabetes mellitus, hyperpigmentation of the skin, hepato- and splenomegaly, thrombocytopenia and an elevated transferrin saturation (96 %), but a negative test for HFE gene mutations such as C282Y and H63D. FINDINGS: Using the mini-laparascopic technique we diagnosed a smallnodular liver cirrhosis with an iron overload. DIAGNOSIS AND TREATMENT: This is the clinical presentation of one subtype of the so called Non-HFE-hemochromatosis, the juvenile hemochromatosis (HFE2). Other causes of primary and secondary iron overload have been ruled out. Different from the HFE-positive hemochromatosis (HFE 1) in which the gene defect is located on chromosome 6, the defect in HFE 2 is located on chromosome 1. The underlying genetic defect has been localized within recently identified HJV gene. Phlebotomy is the treatment of choice, to be performed until the ferritin level is lower than 50 microg/l. CONCLUSIONS: If liver cirrhosis is present in hemochromatosis, the overall risk of developing heptatocellular carcinoma is 20 times higher than in the normal population. Therefore it is suggested to perform an ultrasound examination of the liver and an AFP-test every 6 months, whereas an MRI-scan should be performed once a year, as a basis for further treatment options.

Adult↗

Persistent serpentine supravenous hyperpigmented eruption as an adverse reaction to chemotherapy combining actinomycin and vincristine.

A 15-year-old boy experienced a macular serpentine erythematous eruption that subsided with a persistent hyperpigmentation overlying the superficial venous network of the left forearm. This reaction occurred at the injection site of a chemotherapy regimen that combined actinomycin and vincristine a few hours after the first course. After a single injection of actinomycin in the right arm, a similar reaction occurred, implicating it as the responsible agent. A skin biopsy specimen demonstrated a cell-poor interface tissue reaction associated with an eccrine neutrophilic hidradenitis. To our knowledge, this is the first case of persistent supravenous serpentine hyperpigmented eruption reported in a child treated with this particular drug combination.

Adolescent↗