1/21. Malignant acanthosis nigricans: potential role of chemotherapy.acanthosis nigricans is an uncommon skin condition characterized by hyperkeratosis and skin hyperpigmentation. Most causes are benign, but it may also be associated with gastrointestinal and other malignancies. When associated with malignant disease, the skin pathology may be more severe and treatment often unsuccessful. We describe a 66-year-old man with acanthosis nigricans associated with carcinoma of the stomach, with distressing generalized cutaneous, perioral and perineal disease, whose skin condition resolved completely with combination chemotherapy. In patients with malignant acanthosis, chemotherapy may relieve many of the distressing cutaneous symptoms. A close liaison between gastroenterologists, dermatologists and oncologists is required.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
2/21. Treatment of cutaneous leishmaniasis with 20% paromomycin ointment.Cutaneous leishmaniasis is an infectious disease caused by flagellate protozoa of the genus Leishmania. In Mediterranean countries, the most common causative agents are Leishmania (L.) major, L. infantum and L. tropica. In croatia, cutaneous leishmaniasis is a rare disease, the last case being reported in 1988. Our patient was a 5-year-old boy with a left cheek skin lesion in the form of papule with central exulceration, hyperkeratotic crust and erythema of a 6-month duration. The diagnosis of cutaneous leishmaniasis was based on history data (stay in the southernmost region of croatia and multiple mosquito bites), light microscopic histology (dense infiltrates of large histiocytes with extracellular bodies), and positive montenegro (leishmanin) test. A new therapy with aminosidine (paromomycin), an aminoglycoside antibiotic, in the form of ointment at a concentration of 20%, was for the first time used in croatia. Four-week therapy resulted in complete regression of the skin lesions with residual hyperpigmentation. During therapy, no local or systemic side effects were observed. Thus, topical therapy with paromomycin could be considered an efficient therapeutic alternative in the management of cutaneous leishmaniasis.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
3/21. Post laser hyperpigmentation and occupational ultraviolet radiation exposure.hyperpigmentation is an occasional complication of laser therapy. patients working in an environment with excessive exposure to ultraviolet radiation may be at increased risk.- - - - - - - - - - ranking = 4keywords = hyperpigmentation (Clic here for more details about this article) |
4/21. chediak-higashi syndrome.A case of chediak-higashi syndrome is reported in a four-year-old boy who presented with recurrent chest infection, partial albinism, hyperpigmentation of the extremities and presence of giant granules in leucocytes and melanocytes in the skin. Parental consanguinity was present. Though uncommon, hyperpigmentation of sun exposed areas may be the initial symptom in chediak-higashi syndrome.- - - - - - - - - - ranking = 2keywords = hyperpigmentation (Clic here for more details about this article) |
5/21. Treatment of pseudofolliculitis barbae with the diode laser.Pseudofolliculitis barbae is a common skin disorder of the beard area that is characterized by the presence of inflammatory follicular papules due to terminal hair shafts re-entering the epidermis. Postinflammatory hyperpigmentation and scarring often occur with pseudofolliculitis barbae. Such skin changes can lead to cosmetic disfigurement and be of great concern to the patient. We report a case of pseudofolliculitis barbae and hirsutism with associated postinflammatory hyperpigmentation in an African-American woman who was effectively treated with the diode laser.- - - - - - - - - - ranking = 2keywords = hyperpigmentation (Clic here for more details about this article) |
6/21. hyperpigmentation due to pyrimethamine use.pyrimethamine is used for the treatment of toxoplasmosis and the prophylaxis of malaria. Among the well-documented side effects are megaloblastic anemia, leukopenia, thrombopenia, rash, vomiting, and diarrhea. hyperpigmentation is a very rare side effect. In some patients, associated hiv infection makes it difficult to distinguish the reasons for the etiology. We herein describe an hiv-negative patient who developed hyperpigmentation after pyrimethamine use.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
7/21. diltiazem-induced photodistributed hyperpigmentation.diltiazem is a calcium-channel antagonist commonly prescribed in the treatment of cardiovascular disease. Although an extensive spectrum of cutaneous reactions to diltiazem has been described, only two published reports of hyperpigmentation induced by diltiazem are known. We report the cases of a 71-year-old black male and a 49-year-old Hispanic male, who both presented with characteristic hyperpigmentation on sun-exposed areas after taking an extended-release form of diltiazem hydrochloride (Tiazac).- - - - - - - - - - ranking = 6keywords = hyperpigmentation (Clic here for more details about this article) |
8/21. diltiazem-induced hyperpigmentation.A healthy-appearing 66-year-old black woman presented with a 5-year history of facial hyperpigmentation that was unresponsive to topical sunscreen, hydroquinone, tretinoin, and azelaic acid. Her medications included extended-release diltiazem for hypertension for the past 7 years, rofecoxib for arthritis, and pantoprazole for esophagitis. On examination, the woman displayed hyperpigmented patches and papules involving most of her face. The punch biopsy findings from a hyperpigmented papule on the right temple revealed compact hyperkeratosis, follicular dilation, and dense inflammatory infiltrate along the dermal-epidermal junction with abundant dying keratinocytes. Her diltiazem therapy was discontinued, which led to gradual resolution of her hyperpigmentation.- - - - - - - - - - ranking = 6keywords = hyperpigmentation (Clic here for more details about this article) |
9/21. minocycline-induced hyperpigmentation masquerading as alkaptonuria in individuals with joint pain.alkaptonuria, a rare autosomal-recessive disorder caused by mutations in the HGD gene and a deficiency of homogentisate 1,2-dioxygenase, is characterized by accumulation of homogentisic acid (HGA), ochronosis, and destruction of connective tissue resulting in joint disease. Certain medications have been reported to cause cutaneous hyperpigmentation resembling that of alkaptonuria. We present 5 such cases. Eighty-eight patients with a possible diagnosis of alkaptonuria were examined at the National Institutes of health Clinical Center between June 2000 and March 2004. The diagnosis of alkaptonuria was confirmed or ruled out by measurement of HGA in the urine. Five patients with findings consistent with ochronosis, including pigmentary changes of the ear and mild degenerative disease of the spine and large joints, were diagnosed clinically as having alkaptonuria, but the diagnosis was withdrawn based on normal urine HGA levels. All 5 patients were women who had taken minocycline for dermatologic or rheumatologic disorders for extended periods. minocycline-induced hyperpigmentation should be considered in the differential diagnosis of ochronosis. This could be of increased significance now that minocycline and other tetracyclines have been proposed as therapeutic options for rheumatoid arthritis, bringing a new population of patients with ochronosis and arthritis to medical attention with the potential, but incorrect, diagnosis of alkaptonuria.- - - - - - - - - - ranking = 6keywords = hyperpigmentation (Clic here for more details about this article) |
10/21. Intense pulsed light treatment of persistent facial hypermelanosis following drug-induced toxic epidermal necrolysis.BACKGROUND: Cutaneous hyperpigmentation is one of the most cosmetically disturbing sequel of drug-induced toxic epidermal necrolysis. Intense pulsed light is a promising tool for treating some melanocytic lesions. OBJECTIVE: The objective was to assess the effect of intense pulsed light in treating post-toxic epidermal necrolysis facial hypermelanosis. methods: Two Caucasian men aged 35 and 50 years presented with long-standing (32 and 39 years) severe hypermelanosis of the face after sulfonamide-induced toxic epidermal necrolysis. They were treated by intense pulsed light. Cutoff filters of 550, 590, and 615 nm were employed for five intense pulsed light sessions at 4-week intervals. The treatment was characterized by energy fluence of 25 to 32 J/cm2, pulse width of 2.2 to 3.2 ms, and double- to triple-pulse mode respecting a 30-ms delay. Before intense pulsed light treatment, and 2 months after the fifth intense pulsed light session, clinical photographs and skin biopsies were performed in combination with quantitative narrow-band remittance spectrophotometry of melanin pigmentation. patients were clinically followed-up for 8 months after the end of the treatment. RESULTS: In both patients, clinical, histologic, and spectrophotometric assessments showed an average of 80% decrease in the hypermelanosis. No clinical recurrence of the hypermelanosis developed during the 8-month follow-up after intense pulsed light treatment. No major persistent side effects were experienced, especially hypopigmentation. CONCLUSION: Intense pulsed light appears to be effective and safe for treating post-toxic epidermal necrolysis hypermelanosis in Caucasian patients.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
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