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At least 19 recordsLinked to original sources
PubMed1998

Side effects from the pulsed dye laser: the importance of skin pigmentation and skin redness.

The pulsed dye laser is the treatment of choice for port-wine stains. In this study we evaluate the importance of preoperative skin pigmentation and skin redness for the development of side effects from one treatment with the pulsed dye laser. A risk assessment is performed and skin reflectance measurement objectifies postoperative pigmentary changes. Fourteen human volunteers (skin types I to V) were laser-treated on the inside of the proximal brachium. Photographic documentation was used for blinded, clinical evaluation of side effects 3 and 6 months postoperatively. Skin was artificially reddened using topical application of 10% nicotinic acid cream. The development of pigmentary alterations and texture changes depended on the preoperative pigmentation and redness degrees. The risk of inducing clinically visible pigmentary alterations and texture changes increased with higher preoperative skin pigmentation and redness degrees, and with the application of increasing laser doses. Pigmentary alterations were induced at a lower fluence level than texture changes. The risk of side effects was higher 3 months postoperatively than 6 months postoperatively, substantiating a gradual disappearance of side effects. Skin reflectance measurements documented postoperative hyperpigmentation that faded partially from 3 to 6 months postoperatively. This is the first human experimental model for port-wine stains which provides quantitative data on the relationship between preoperative skin colours and postoperative clinically disturbing side effects.

Administration, Cutaneous↗
PubMed1999

[Clinical differential diagnosis of pigmented skin changes and contribution of epiluminescence microscopy].

The differential diagnosis of skin pigmented lesions is an everyday challenge for the physician. The main goal is the early diagnosis of malignant melanoma because its prognosis is directly correlated with its thickness at the time of the excision. Identification criterion of invasive melanoma have been recognized in the past, like bleeding or ulceration. More subtle clinical criterion have been identified and are summarized in the ABCDE rule (Asymmetry, irregular Border, variegation in Colour, Dimension and Enlargement). A knowledge of the various kind of skin pigmented lesions should help the physician to differentiate benign lesions from suspicious or frankly malignant ones, in order to set up the indication for an histological procedure or for a subsequent follow-up of the patient. More recently, skin surface biomicroscopy, or dermoscopy, has revealed invisible structures to naked eye, allowing to enhance the clinical diagnosis of skin pigmented lesions, but a specific education is needed.

Diagnosis, Differential↗
PubMed1987

In vivo epiluminescence microscopy of pigmented skin lesions. I. Pattern analysis of pigmented skin lesions.

The importance of recognizing early melanoma is generally accepted. Because not all pigmented skin lesions can be diagnosed correctly by their clinical appearance, additional criteria are required for the clinical diagnosis of such lesions. In vivo epiluminescence microscopy provides for a more detailed inspection of the surface of pigmented skin lesions, and, by using the oil immersion technic, which renders the epidermis translucent, opens a new dimension of skin morphology by including the dermoepidermal junction into the macroscopic evaluation of a lesion. In an epiluminescence microscopy study of more than 3000 pigmented skin lesions we have defined morphologic criteria that are not readily apparent to the naked eye but that are detected easily by epiluminescence microscopy and represent relatively reliable markers of benign and malignant pigmented skin lesions. These features include specific patterns, colors, and intensities of pigmentation, as well as the configuration, regularity, and other characteristics of both the margin and the surface of pigmented skin lesions. Pattern analysis of these features permits a distinction between different types of pigmented skin lesions and, in particular, between benign and malignant growth patterns. Epiluminescence microscopy is thus a valuable addition to the diagnostic armamentarium of pigmented skin lesions at a clinical level.

Basal Cell Carcinoma↗
PubMed1990

Low-pigment skin type and predisposition for development of type I diabetes.

To ascertain whether skin pigmentation type and sensitivity to ultraviolet (UV) light are associated with susceptibility to type I (insulin-dependent) diabetes, 55 type I diabetic patients were examined, 38 new-onset and 17 long-term cases. They were compared to 72 control subjects of the same geographic region and nationality. To evaluate the individual skin pigmentation type, a standardized questionnaire was developed. Reactivity to UV light was determined by a stepwise-graded UV irradiation. Significantly more diabetic patients in southern Germany had blue eyes than nondiabetic control subjects (55 vs. 26%, P less than 0.01), and significantly more diabetic patients had a low-pigment eye color (blue or green) than control subjects (66 vs. 38%, P less than 0.01). In addition, more fair skin color was noted among diabetic versus control subjects (84 vs. 60%, P less than 0.01). In response to UV irradiation, diabetic patients more often showed an increased UV-light sensitivity than control subjects (83 vs. 23%, P less than 0.001). The relative risk for susceptibility to type I diabetes in subjects with low-pigment eye color was 3.1, in subjects with fair skin type 3.4, and in subjects with increased UV-light sensitivity 5.8. The highest risk for the development of diabetes was seen in subjects who had low-pigment eye color and/or increased UV-light sensitivity (95 vs. 51%, P = 0.00002, odds ratio 17.4). We conclude that a low-pigment skin type may predispose for the development of type I diabetes.

Adult↗
PubMed1987

In vivo epiluminescence microscopy of pigmented skin lesions. II. Diagnosis of small pigmented skin lesions and early detection of malignant melanoma.

Pattern analysis by epiluminescence microscopy of pigmented skin lesions was tested in a study of 318 small pigmented skin lesions that were diagnostically equivocal when examined with the naked eye. An improvement of clinical diagnosis was achieved by epiluminescence microscopy for practically all lesions, both benign and malignant, and was equally impressive for melanocytic and nonmelanocytic lesions. Improvement in diagnostic accuracy was as follows: for small nodular melanomas, from 50% to 70%; for superficial spreading melanoma in situ, from 46% to 80%; for invasive superficial spreading melanoma, from 64% to 90%; and for early lentigo maligna and lentigo maligna melanoma, from 67% to 88%. Conversely, the diagnosis of pigmented Spitz nevi improved from 46% to 93% and of pigmented basal cell carcinomas from 60% to 90%, which appears equally important because most of these lesions had clinically been considered to represent melanomas. The use of epiluminescence microscopy also resulted in considerable improvement in the diagnosis of dysplastic nevi, which was particularly helpful in making therapeutic decisions. Epiluminescence microscopy greatly expands the diagnostic armamentarium available for pigmented skin lesions at a clinical level and thus increases the chances of detecting or ruling out melanoma in its earliest stages.

Basal Cell Carcinoma↗
PubMed1993

Skin biopsies of pigmented skin lesions performed by general practitioners and hospital specialists.

The performance of skin biopsies by general practitioners has been examined in several recent studies. The aim of this study was to examine the difference between skin biopsies of pigmented skin lesions taken by general practitioners and those taken by hospital specialists. Reviewing all histopathology records at one hospital over a five year period revealed that there were 1000 patients who had had skin biopsies. General practitioners had carried out skin biopsies for 55% of these patients. Hospital specialists excised significantly more lesions that had increased in size (P < 0.001) or changed in colour (P < 0.001). General practitioners excised more lesions that had bled (P < 0.001). Hospital specialists excised more of the 15 melanomas diagnosed (80%) (P < 0.05), and general practitioners excised more squamous papillomas (P < 0.01). Forty per cent of melanomas excised were not suspected by the clinician. General practitioners were able to detect the majority of suspicious lesions, but because of the uncertainty of clinical diagnosis, all specimen's should be submitted for histopathological diagnosis. It is important that future general practitioners are trained in both the diagnostic and technical aspects of skin biopsy if they intend to perform this minor operation.

Adolescent↗
PubMed1995

Infraorbital pigmented skin. Preliminary observations of laser therapy.

BACKGROUND: The presence of infraobital dark skin, often known as dark circles under the eyes, is a frequent cosmetic concern. There has been little reported on therapy of this condition. One group of patients was determined to have dermal melanin deposition, which we treated with a Q-switched ruby laser. OBJECTIVE: Our study evaluated the clinical and histological appearance of infraobital skin pigment in 17 patients with dermal melanin deposition treated with a Q-switched ruby laser. METHODS: Seventeen patients with melanin deposition were treated with the Q-switched ruby laser (694 nm) with a pulse width of 28 nanoseconds and fluences of 7.5 J/cm2. Response to treatment was assessed by an independent investigator with patient and photograph evaluation. Skin Biopsies were obtained in nine of the 17 patients. RESULTS: Of those patients treated with one Q-switched ruby session, 23.5% achieved a greater than 50% response. Of those treated twice, 88.9% achieved greater than 50% response. In postreatment skin biopsies there was reduction of dermal melanin deposition. CONCLUSIONS: Patients with infraobital pigmented skin due to dermal melanin deposition may be considered candidates for Q-switched Ruby laser treatment.

Adult↗
PubMed1997

Draft definition of stage I pressure ulcers: inclusion of persons with darkly pigmented skin. NPUAP Task Force on Stage I Definition and Darkly Pigmented Skin.

The National Pressure Ulcer Advisory Panel appointed a task force to review the definition of Stage I pressure ulcers, specifically to assess its adequacy in people with darkly pigmented skin. The process used by the task force to draft a new definition is described in this preliminary report of their work. The proposed definition and initial critique of it are given.

Humans↗
PubMed1998

Epithelioid blue nevus and psammomatous melanotic schwannoma: the unusual pigmented skin tumors of the Carney complex.

Carney complex, a familial multitumoral syndrome, comprises spotty skin pigmentation (lentigines and blue nevi), myxomas (heart, skin, and breast), endocrine tumors (adrenal cortex, pituitary, testis, and thyroid), and schwannomas. The skin pigmentary abnormality included two unusual conditions, epithelioid blue nevus and psammomatous melanotic schwannoma. The former tumor occurred on the extremities and trunk, less frequently on the head and neck; was multiple; and did not recur or metastasize. Clinically, it was pigmented, domed, and small (< 1 cm). Microscopically, it displayed two types of melanocytes--one intensely pigmented, globular, and fusiform and the other lightly pigmented, polygonal, and spindle. Nuclei of the latter cells were vesicular, with pale chromatin and single prominent nucleolus. None recurred or metastasized. The psammomatous melanotic schwannoma occurred in posterior spinal nerve roots, upper alimentary tract, bone, and skin. Microscopically, it was circumscribed but incompletely encapsulated and contained spindle and epithelioid cells, melanin, psammoma bodies, and fat. The spindle cells were arranged in interlacing fascicles, with whorling and occasional nuclear palisading. Twenty-one patients (68%) were alive without evidence of the neoplasm; two of these each had two local recurrences. Seven patients died, three (10%) as a result of metastasis.

Adolescent↗
PubMedDate not supplied

Ruby laser treatment of pigmented skin lesions.

Pigmented skin lesions were treated by a ruby laser with a wavelength of 694 nm and a pulse duration of 450 microseconds. The clinical result of laser treatment was good in 18 of the 55 cases (32%). Five of 21 cases (23.8%) with cafe-au-lait maculae, 9 of the 14 cases (64%) with senile pigmentation, and 3 of the 10 cases (30%) with nevocellular nevus had good results. The cafe-au-lait maculae showed excellent fading after laser treatment but the recurrence rate was high. The best therapeutic result was obtained in senile pigmentation.

Adolescent↗
PubMed1997

Seasonal variation of skin pigmentation.

We measured skin pigmentation by skin reflectance monthly from May 1992 to April 1993 in 36 healthy Caucasians. Pigmentation was measured at four UV-exposed sites at the forehead, the upper chest, the inside of the upper arm, and at the upper back. The pigmentation and UV sensitivity were simultaneously measured at UV-protected buttock skin. The results showed a considerable seasonal variation for skin pigmentation at the UV-exposed sites. Buttock skin had a pigmentation and UV sensitivity that varied only marginally. We recommend that measurements of genetically controlled skin pigmentation and constitutive UV sensitivity should be performed at UV-unexposed skin on the buttocks, except in persons that expose this site to artificial or natural sunlight.

Adult↗
PubMed1982

Increased skin pigment reduces the capacity of skin to synthesise vitamin D3.

To determine the effect of increased skin pigment on the cutaneous production of vitamin D3, circulating vitamin D concentrations were determined in two lightly pigmented Caucasian and three heavily pigmented Negro volunteers after exposure to a single standard dose of ultraviolet radiation (UVR). Exposure of Caucasian subjects to 1 minimal erythemal dose of UVR greatly increased serum vitamin-D concentrations by up to 60-fold 24-48 h after exposure, whereas this dose did not significantly change serum vitamin-D concentrations in Negro subjects. Re-exposure of one Negro subject to a dose of UVR six times larger than the standard dose increased circulating vitamin D to concentrations similar to those recorded in Caucasian subjects after exposure to the lower dose. These results indicate that increased skin pigment can greatly reduce the UVR-mediated synthesis of vitamin D.

Black People↗
PubMed1986

Graft exchange in vitiligo. Studies on the outcome of exchanging biopsies from vitiliginous skin to normal, pigmented skin and vice versa.

In 27 patients with vitiligo punch biopsies from vitiliginous skin to normal skin and vice versa were performed. Of the vitiligo grafts 69% showed donor dominance and 31% receptor dominance. When normal skin was transplanted 74% showed receptor dominance and 26% donor dominance. In 13 patients (52%) blood screening pointed towards an autoimmune disease.

Adolescent↗
PubMed2005

Effects of skin pigmentation on pulse oximeter accuracy at low saturation.

BACKGROUND: It is uncertain whether skin pigmentation affects pulse oximeter accuracy at low HbO2 saturation. METHODS: The accuracy of finger pulse oximeters during stable, plateau levels of arterial oxygen saturation (Sao2) between 60 and 100% were evaluated in 11 subjects with darkly pigmented skin and in 10 with light skin pigmentation. Oximeters tested were the Nellcor N-595 with the OxiMax-A probe (Nellcor Inc., Pleasanton, CA), the Novametrix 513 (Novametrix Inc., Wallingford, CT), and the Nonin Onyx (Nonin Inc., Plymouth, MN). Semisupine subjects breathed air-nitrogen-carbon dioxide mixtures through a mouthpiece. A computer used end-tidal oxygen and carbon dioxide concentrations determined by mass spectrometry to estimate breath-by-breath Sao2, from which an operator adjusted inspired gas to rapidly achieve 2- to 3-min stable plateaus of desaturation. Comparisons of oxygen saturation measured by pulse oximetry (Spo2) with Sao2 (by Radiometer OSM3) were used in a multivariate model to determine the interrelation between saturation, skin pigmentation, and oximeter bias (Spo2 - Sao2). RESULTS: At 60-70% Sao2, Spo2 (mean of three oximeters) overestimated Sao2 (bias +/- SD) by 3.56 +/- 2.45% (n = 29) in darkly pigmented subjects, compared with 0.37 +/- 3.20% (n = 58) in lightly pigmented subjects (P < 0.0001). The SD of bias was not greater with dark than light skin. The dark-light skin differences at 60-70% Sao2 were 2.35% (Nonin), 3.38% (Novametrix), and 4.30% (Nellcor). Skin pigment-related differences were significant with Nonin below 70% Sao2, with Novametrix below 90%, and with Nellcor at all ranges. Pigment-related bias increased approximately in proportion to desaturation. CONCLUSIONS: The three tested pulse oximeters overestimated arterial oxygen saturation during hypoxia in dark-skinned individuals.

Adult↗
PubMed2006

Identifying genes underlying skin pigmentation differences among human populations.

Skin pigmentation is a human phenotype that varies greatly among human populations and it has long been speculated that this variation is adaptive. We therefore expect the genes that contribute to these large differences in phenotype to show large allele frequency differences among populations and to possibly harbor signatures of positive selection. To identify the loci that likely contribute to among-population human skin pigmentation differences, we measured allele frequency differentiation among Europeans, Chinese and Africans for 24 human pigmentation genes from 2 publicly available, large scale SNP data sets. Several skin pigmentation genes show unusually large allele frequency differences among these populations. To determine whether these allele frequency differences might be due to selection, we employed a within-population test based on long-range haplotype structure and identified several outliers that have not been previously identified as putatively adaptive. Most notably, we identify the DCT gene as a candidate for recent positive selection in the Chinese. Moreover, our analyses suggest that it is likely that different genes are responsible for the lighter skin pigmentation found in different non-African populations.

Asian People↗
PubMed1985

Effect of skin pigmentation on the response to intradermal histamine.

The effects of injecting histamine phosphate, in serial 10-fold dilutions ranging from 0.0001 to 0.1 mg/ml histamine base, intradermally into three groups of nonatopic healthy volunteers with varying degrees of skin pigmentation were studied. The wheal sizes in the 30 Negroid subjects with darkly pigmented skins were consistently greater than those in both the 30 Caucasian subjects with light skin pigmentation and the 15 mixed Caucasian/Negroid subjects with light brown skins. The overall wheal response was the smallest in the Caucasian subjects. The differences in wheal sizes were greatest between the Negroid and Caucasian subjects for all dilutions, and these differences were statistically significant (p less than 0.005). From this study it appears that skin pigmentation has a profound effect on the wheal response to intradermally injected histamine. It is speculated that this difference in response may be related to the melanin pigment in the skin.

Black People↗