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 1,207 records · Page 67Linked to original sources
PubMed2006

Arsenic carcinogenesis in the skin.

Chronic arsenic poisoning is a world public health issue. Long-term exposure to inorganic arsenic (As) from drinking water has been documented to induce cancers in lung, urinary bladder, kidney, liver and skin in a dose-response relationship. Oxidative stress, chromosomal abnormality and altered growth factors are possible modes of action in arsenic carcinogenesis. Arsenic tends to accumulate in the skin. Skin hyperpigmentation and hyperkeratosis have long been known to be the hallmark signs of chronic As exposure. There are significant associations between these dermatological lesions and risk of skin cancer. The most common arsenic-induced skin cancers are Bowen's disease (carcinoma in situ), basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Arsenic-induced Bowen's disease (As-BD) is able to transform into invasive BCC and SCC. Individuals with As-BD are considered for more aggressive cancer screening in the lung and urinary bladder. As-BD provides an excellent model for studying the early stages of chemical carcinogenesis in human beings. Arsenic exposure is associated with G2/M cell cycle arrest and DNA aneuploidy in both cultured keratinocytes and As-BD lesions. These cellular abnormalities relate to the p53 dysfunction induced by arsenic. The characteristic clinical figures of arsenic-induced skin cancer are: (i) occurrence on sun-protected areas of the body; (ii) multiple and recrudescent lesions. Both As and UVB are able to induce skin cancer. Arsenic treatment enhances the cytotoxicity, mutagenicity and clastogenicity of UV in mammalian cells. Both As and UVB induce apoptosis in keratinocytes by caspase-9 and caspase-8 signaling, respectively. Combined UVB and As treatments resulted in the antiproliferative and proapoptotic effects by stimulating both caspase pathways in the keratinocytes. UVB irradiation inhibited mutant p53 and ki-67 expression, as well as increased in the number of apoptotic cells in As-BD lesions which resulted in an inhibitory effect on proliferation. As-UVB interaction provides a reasonable explanation for the rare occurrences of arsenical cancer in the sun-exposed skin. The multiple and recurrent skin lesions are associated with cellular immune dysfunction in chronic arsenism. A decrease in peripheral CD4+ cells was noticed in the inhabitants of arsenic exposure areas. There was a decrease in the number of Langerhans cells in As-BD lesion which results in an impaired immune function on the lesional sites. Since CD4+ cells are the target cell affected by As, the interaction between CD4+ cells and epidermal keratinocytes under As affection might be closely linked to the pathogenesis of multiple occurrence of arsenic-induced skin cancer. In this review, we provide and discuss the pathomechanisms of arsenic skin cancer and the relationship to its characteristic figures. Such information is critical for understanding the molecular mechanism for arsenic carcinogenesis in other internal organs.

Arsenic↗
PubMed2001

Novel vitamin E derivative with 4-substituted resorcinol moiety has both antioxidant and tyrosinase inhibitory properties.

A novel vitamin E derivative, (6"-hydroxy-2",5",7",8"-tetramethylchroman-2"-yl)methyl 3-(2',4'-dihydroxyphenyl)propionate (TM4R), which has a chromanoxyl ring and 4-substituted resorcinol moieties, was synthesized; and its inhibitory effects on tyrosinase, antioxidant ability, and lightening effect of ultraviolet B (UVB)-induced hyperpigmentation were estimated. TM4R showed potent inhibitory activity on tyrosinase, which is the rate-limiting enzyme in melanogenesis. The scavenging activities of TM4R on 1,1-diphenyl-2-picrylhydrazyl and hydroxyl radicals were found to be nearly the same as those of alpha-tocopherol. Furthermore, an efficient lightening effect was observed following topical application of TM4R to UVB-stimulated hyperpigmented dorsal skin of brownish guinea pigs. These results suggest that TM4R may be a candidate for an efficient whitening agent, possibly by inhibiting tyrosinase activity and biological reactions caused by reactive oxygen species.

Animals↗
PubMed2006

Retinitis pigmentosa, pigmentary retinopathies, and neurologic diseases.

Retinitis pigmentosa (RP) refers to a group of inherited retinal diseases with phenotypic and genetic heterogeneity. The pathophysiologic basis of the progressive visual loss in patients with RP is not completely understood but is felt to be due to a primary retinal photoreceptor cell degenerative process mainly affecting the rods of the peripheral retina. In most cases RP is seen in isolation (nonsyndromic), but in some other cases it may be a part of a genetic, metabolic, or neurologic syndrome or disorder. Nyctalopia, or night blindness, is the most common symptom of RP. The classic fundus appearance of RP includes retinal pigment epithelial cell changes resulting in retinal hypo- or hyperpigmentation ("salt-and-pepper"), retinal granularity, and bone spicule formation. The retinal vessels are often narrowed or attenuated and there is a waxy pallor appearance of the optic nerve head. Electroretinography will demonstrate rod and cone photoreceptor cell dysfunction and is a helpful test in the diagnosis and monitoring of patients with RP. A detailed history with pedigree analysis, a complete ocular examination, and the appropriate paraclinical testing should be performed in patients complaining of visual difficulties at night or in dim light. This review discusses the clinical manifestations of RP as well as describing the various systemic diseases, with a special emphasis on neurologic diseases, associated with a pigmentary retinopathy.

Humans↗
PubMed1979

Chronic graft versus host disease: a syndrome of disordered immunity.

A chronic, debilitating syndrome related to graft-versus-host disease (GVHD) has been recognized in long-term survivors following allogeneic bone marrow transplantation. In six of 20 marrow graft recipients who survived for more than one year after receiving a transplant, this complication developed; they were studied to better define the syndrome. There was no association between the sex of either donor or recipient, HLA type, blood group, conditioning regimen or marrow cell dose and subsequent development of chronic GVHD. All six patients had mild to moderate manifestations of acute GVHD following prompt engraftment. Chronic GVHD was characterized in each patient by progression to scleroderma-like skin involvement with hyperkeratosis, reticular hyperpigmentation, atrophy with ulceration and fibrosis with limitation of joint movement. A sicca syndrome was prominent in five patients. Four patients had idiopathic interstitial pneumonitis. Infectious complications were frequent, and DNA viral infections were prominent. Autoimmune hemolytic anemia was present in three patients, and one patient had antinuclear antibody (ANA). A spectrum of immune abnormalities was observed including hypergammaglobulinemia, immunoglobulin M (IgM) paraprotein, elevated circulating immune complexes, plasma cell hyperplasia, lymphocytotoxic antibodies and autoantibodies to autologous or donor lymphocytes. Despite clinical similarity to collagen vascular diseases, none of these patients had anti-DNA antibodies or antibodies to smooth muscle, thyroid or extractable nuclear antigens. In one patient, a skin graft from the marrow donor remained healthy despite progressive involvement in recipient skin, whereas unrelated skin grafts were rejected. Immunosuppressive therapy and plasmapheresis have not been effective. Four patients have died (median survival 458 days from transplantation). Chronic GVHD appears to be a syndrome of disordered immune regulation features of immunodeficiency and autoimmunity.

Adolescent↗
PubMed1982

Activation of virilizing adrenal rest tissues by excessive ACTH production. An unusual presentation of Nelson's syndrome.

Nelson's syndrome occurs in 10 to 35 percent of patients treated for Cushing's disease by bilateral adrenalectomy and features an ACTH-producing pituitary tumor and hyperpigmentation. Cortisol-producing testicular tumors activated by markedly elevated ACTH levels have been described in male patients with Nelson's syndrome. We now describe a female patient with Nelson's syndrome who presented with virilization. Abdominal exploration revealed adrenal rest tumors in the paraovarian tissues and adrenal beds. Iodocholesterol scanning gave negative results. This case illustrates the need for follow-up study of patients with bilateral adrenalectomy for Cushing's disease and describes some of the unusual features these patients may present.

Adrenal Cortex Hormones↗
PubMed1986

Avascular necrosis of bone in dyskeratosis congenita.

A case of dyskeratosis congenita, a rare X-linked disorder, is presented. The patient had the classic triad of cutaneous findings: reticulated hyperpigmentation, nail dystrophy, and leukoplakia. In addition, a previously unreported finding developed, avascular necrosis of bone without systemic steroid therapy. Recognition of this disorder is important because pancytopenia and malignancy develop in up to 50 percent of patients.

Adult↗
PubMed1987

Idiopathic hemochromatosis presenting as amenorrhea and arthritis.

Idiopathic hemochromatosis in young adults has been increasingly recognized over the last three decades. Younger patients with hemochromatosis frequently have presenting problems other than diabetes, cirrhosis, and hyperpigmentation. A young woman with idiopathic hemochromatosis is described. Arthritis and secondary amenorrhea developed at age 20, and liver biopsy showed hemochromatosis at age 29. Further work-up revealed that the amenorrhea was due to underproduction of pituitary gonadotropins. The patient was treated with phlebotomy. Estrogen and progesterone replacement was begun because of severe osteoporosis. Serum iron studies may be useful in young patients with unexplained amenorrhea and/or arthropathy.

Adult↗
PubMed1988

Development of Nelson's syndrome in a patient with recurrent Cushing's disease. Analysis of secretory behavior of the pituitary tumor.

A markedly cushingoid 32-year-old man presented to Queens Hospital Center with headache, hyperpigmentation, and visual field loss. Twelve years earlier, he had undergone subtotal adrenalectomy for Cushing's disease, but symptoms of hypercortisolemia promptly recurred. Workup revealed the presence of a large, expanding intrasellar mass, plasma ACTH levels between 3,000 and 10,000 pg/ml, and markedly elevated cortisol levels. The secretion of ACTH (mainly ACTH 1-39-like peptide) by the pituitary tumor showed neither diurnal periodicity nor response to a variety of pharmacologic agents known to affect ACTH secretion. The patient demonstrates a rarely observed presentation of Nelson's syndrome, with aggressive adrenotropic pituitary tumor growth even in the presence of chronic hypercortisolemia.

Adrenalectomy↗
PubMed1994

POEMS syndrome: a study of 25 cases and a review of the literature. French Study Group on POEMS Syndrome.

OBJECTIVE: To determine whether there are peculiarities of the POEMS syndrome (a multisystemic disorder associated with polyneuropathy, organomegaly, endocrinopathy of various forms, production of a monoclonal [M] component, and skin changes) in Caucasian patients, especially signs and symptoms absent in other series; and to attempt a reappraisal of the neuropathy and endocrinopathy to find a unifying mechanism. DESIGN: A retrospective, cooperative study compared 25 cases, observed over a 15-year period, with two published series of patients, one of Japanese patients and one of American patients, and with a review of the literature on non-Asian cases. Details were obtained of patients' medical history, physical examination, immunochemical and hormonal testing, roentgenographic examination, computed tomography imaging, and electromyography. RESULTS: The main features of the syndrome found in these patients were those first described in Japan: polyneuropathy, enlargement of the lymph nodes, liver, and spleen, endocrine disturbances, low concentration of the monoclonal component, hyperpigmentation, and hypertrichosis. Three other symptoms were found more frequently than previously reported: skin angiomas, scleroderma changes of the hands, and thrombocytosis. Electromyography and nerve biopsy showed a variety of abnormalities ranging from demyelination to axonal degeneration. Nerve deposits of immunoglobulin were absent. Organomegaly seemed to be heterogeneous. Pathologic findings in the enlarged lymph nodes and spleen were compatible with Castleman's disease. Liver biopsies were usually normal. The endocrine changes were surprisingly diverse, with some observations combining unrelated primary and secondary insufficiencies. No single hypothesis emerged regarding their mechanism. All M components had a lambda-light chain. An IgG M component was found more frequently in solitary lesions. An IgA M component was found more frequently in patients without bone lesions. Sedimentation rate was usually normal. Radiotherapy of solitary plasma-cytomas was followed by dramatic improvement of extramedullary signs and symptoms in all cases. CONCLUSIONS: The symptoms, clinical course, and management of the patients reported here were similar to those observed in the literature. This study confirms the existence of a close link between symptoms and lambda-light-chain production. There are indications that a plasma cell growth factor that does not cross-react with interleukin-6 (IL-6) may be involved.

Adult↗
PubMed1979

Posterior pole neovascularization in a patient with hemoglobin SC disease.

A 33-year-old black woman with hemoglobin SC disease and a history of photocoagulation for peripherally located retinal neovascularization had a neovascular frond at the temporal border of her right macula. Multiple zones of black sunburst hyperpigmentation were located nearby. Fluorescein angiography showed that the lesions were closely related to an extensive zone of avascular retina in the posterior pole. The perifoveal vasculature was uninvolved, and the patient was unaware of any visual deficit. Although sickle cell maculopathy is a well-recognized entity, there have been no published reports, to the best of our knowledge, of posterior pole neovascularization in patients with sickle cell hemoglobinopathy. The fluorescein angiographic findings in our case provide further support for the hypothesis that retinal hypoxia is an important stimulus for retinal neovascularization.

Adult↗
PubMed1980

Adult-onset foveomacular pigment epithelial dystrophy.

Thirty-three pateints had adult-onset foveomacular dystrophy. The macular lesions typically resulted in a mild to moderate decrease in vision and appeared as small, yellow, bilateral, slightly elevated, pigment epithelial lesions with areas of hyperpigmentation. The characteristic finding on fluorescein angiography was a ring of hyperfluorescence surrounding an area of hypofluorescence. The electro-oculograms were either normal or slightly subnormal in most cases. This dystrophy appears to have an autosomal dominant transmission.

Adult↗
PubMed1986

Pseudomonas keratitis and folliculitis from whirlpool exposure.

A local outbreak of pseudomonal folliculitis from whirlpool exposure occurred in 12 persons. A corneal ulcer developed in one patient within 48 hours of using the whirlpool. Treatment with fortified gentamicin resolved the corneal infiltrate and vision returned to normal. A second patient, who had not showered immediately after leaving the whirlpool, was left with areas of skin hyperpigmentation and scarring despite treatment with ultraviolet rays and tetracycline. Although the skin rash may be self-limited, the potential for visual loss from pseudomonal keratitis emphasizes the need for proper disinfection of swimming and whirlpool water.

Adult↗
PubMed1986

Ocular rosacea in blacks.

In three black men (57, 64, and 61 years old) with the ocular manifestations of rosacea, the diagnosis was not initially suspected because the pathognomonic skin changes of rosacea were obscured by the skin hyperpigmentation. Ocular involvement ranged from blepharitis and conjunctival hyperemia to sight-threatening problems such as corneal neovascularization, thinning, ulceration, and perforation. Treatment with oral tetracycline and topical corticosteroids appeared to be as effective in these patients as in previously described white patients.

Black People↗
PubMed1989

Pseudoglaucomatous physiologic large cups.

Using planimetric analysis of stereoscopic optic disk photographs, we studied 21 optic nerve heads of 11 subjects who shared the common feature of optic cups that were larger than the mean + 2 S.D. within the normal population. A comparison of these findings to those of 571 normal optic disks and 706 optic nerve heads in eyes with chronic primary open-angle glaucoma showed the following morphologic characteristics: (1) abnormally large optic disk area (mean +/- S.D., 4.49 +/- 0.56 mm2), (2) large cup/disk ratios with the horizontal ratio (0.78 +/- 0.03) significantly (P less than .001) larger that the vertical (0.71 +/- 0.03), (3) increased incidence of cilioretinal arteries, (4) normal neuroretinal rim area (2.06 +/- 0.35 mm2), (5) normal neuroretinal rim configuration, inferiorly (0.43 +/- 0.08 mm) broader (P less than .001, Wilcoxon test) than superiorly (0.33 +/- 0.06 mm), smallest (P less than .0001) temporally (0.20 +/- 0.04 mm), (6) normal form of zone alpha (irregular hypopigmentation and hyperpigmentation) of the parapapillary chorioretinal atrophy with its widest extension in the temporal horizontal area, (7) no zone beta (visible large choroidal vessels and sclera), (8) normal caliber of the parapapillary retinal vessels, and (9) normal parapillary retinal nerve fiber layer. These characteristics are helpful in the differentiation of primary and secondary large cups.

Adult↗
PubMed1984

Primary malignant melanoma of the oral cavity. A review of 20 cases.

Twenty patients with primary malignant melanoma of the oral cavity have been described. They formed 3.9 percent of the total number of patients with malignant neoplasms of the oral cavity. The upper gingiva was most commonly affected. In this series, there were 14 male patients and 6 female patients who ranged in age from 26 to 80 years (average 58 years). The first symptom of melanoma was hyperpigmentation of the mucosa in 10 patients, tumor in 7, and pain in 3 edentulous patients with prostheses. Radical surgery was performed in 13 patients, followed by chemotherapy and radiotherapy in 9 cases. Only 1 patient survived 9 years. The remaining 12 died 11 to 18 months after radical treatment. Palliative therapy was applied in three patients, two patients were treated symptomatically, and two patients refused treatment. Early detection of melanoma is an indication for radical treatment and may increase the survival rate of patients with this disease, which is still very low.

Adult↗
PubMed1987

Depression of rat testicular 17-hydroxylase and 17,20-lyase after administration of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD).

Toxic effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), such as chloracne, hirsutism, and skin hyperpigmentation, suggest endocrine involvement, however, little is known about the effects of TCDD on steroidogenic organs. It is known that TCDD can cause decreases in testicular heme, testicular microsomal cytochrome P-450, and serum testosterone in the rat. This study was designed to examine the activities of the testicular hemoprotein microsomal cytochrome P-450-dependent enzymes, 17-hydroxylase and 17,20-lyase, following a single, oral dose of either 12.5, 25, or 50 micrograms/kg TCDD. TCDD caused dose- and time-dependent decreases in the activity of the 17-hydroxylase enzyme. Significant decreases were observed at 3, 7 and 14 days at the lowest dose of 12.5 micrograms/kg TCDD. The 17,20-lyase enzyme seemed to be less sensitive to the toxic effects of TCDD with significant decreases in enzyme activity being observed at days 3, 7 and 14 only after treatment with 50 micrograms/kg TCDD. Both microsomal cytochrome P-450 and serum testosterone levels decreased in a dose- and time-dependent manner following 12.5, 25 and 50 micrograms/kg doses of TCDD. These results indicate that decreased testosterone production following treatment with TCDD is related to decreased activities of the testicular microsomal cytochrome P-450-dependent enzymes 17-hydroxylase and 17,20-lyase.

Aldehyde-Lyases↗
PubMed1990

Copper vapour laser treatment of port-wine stains and other vascular malformations.

Over a 2-year period more than 1350 treatment sessions have been conducted with yellow 578 nm light from a copper vapour laser on a variety of vascular malformations. Of these sessions half were of port-wine stains, from 297 patients. The light is applied by scanning a 1 mm optical fibre approximately 2 mm above the lesion along the lines of Langer. We use a maximum scan rate of 3 s/cm2, which is the highest rate at which minimal blanching can be produced. Up to 6.5 watts of light has been used, and a typical energy fluence is 20 to 30 J/cm2. Topical melanin suppressing creams are used before and after treatment, in order to maximise the effectiveness of the treatment. Non-vasoconstricting anaesthetics are always used. Repeat treatments are 3 months apart. The scan rate we used was directly correlated with the light intensity. The degree to which the colour of the port-wine stains lightened after the first treatment was also well correlated with the scan rate (p less than 0.0005). The faster the scan rate, the greater the colour reduction. This provides some supporting evidence for the short illumination time that theoretical models have indicated as "ideal". The lightening was more marked for patients whose lesion colour was initially dark (p less than 0.0005). Those whose skin had a high melanin content (Maori, Polynesian and Asian) responded more slowly than others. Thirty-six patients have had a greater than 70% reduction in the size of their lesions after an average of four treatments. Ten patients have responded poorly after at least four treatments (10% of all those who have had four or more treatments). The occurrence of scarring, hyperpigmentation and hypopigmentation was low in comparison with that reported previously from the green light of argon ion lasers.

Adolescent↗
PubMed1993

Clinical experience with the PLDL-1 (Pigmented Lesion Dye Laser) in the treatment of pigmented birthmarks: a preliminary report.

Twenty patients aged between 2 years and 17 years (mean 9 years) with pigmented birthmarks, mainly of the head and neck, were treated with the PLDL-1 laser (Pigmented Lesion Dye Laser--Candela Corporation, Wayland, Massachusetts, USA) which emits light with a wavelength of 510 nanometers and a pulse duration of 300 +/- 50 nano-seconds. Nine patients (45%) showed excellent results after a test-patch was performed. Two patients (10%) showed some lightening of colour after initial test-patch. Six patients (30%) showed no improvement and 3 patients (15%) showed some hyperpigmentation at the test-patch sites which had not disappeared at 6 months follow-up. There was no change in the clinical behaviour at 6 months follow-up and no evidence of scarring was encountered.

Adolescent↗