1/8. Pulsed dye laser therapy for viral warts.Twenty-eight patients with 103 recalcitrant and 20 simple viral warts were treated with the Cynosure PhotoGenica V pulsed dye laser at 585 nm, and fluencies of 6.0-9.0 J/cm(2). An eradication rate of 92% for recalcitrant warts after an average of 2.1 (range 1-7) treatments and 75% for simple warts after an average of 1.6 (range 1-2) treatments was achieved with a mean follow-up period of 7.2 (range 3-15) months. Mild hypopigmentation was noted in one patient and superficial infection in another. Unlike ablative treatment modalities, with pulsed dye laser therapy, no wound was created thus avoiding prolonged postoperative pain, disability and scarring. Treatment was well tolerated by patients, most of whom returned to work or normal activities immediately postoperatively. Pulsed dye laser is an effective treatment for both recalcitrant and simple warts. It is the treatment of choice for these lesions in cosmetically sensitive areas.- - - - - - - - - - ranking = 1keywords = hypopigmentation (Clic here for more details about this article) |
2/8. Acute allergic contact dermatitis due to para-phenylenediamine after temporary henna painting.The use of temporary natural henna painting for body adornment and hair dyeing is very common in several countries of the Indian subcontinent, middle east, and North africa, and the fad is spreading in other parts of the world. Several cases of para-phenylenediamine (PPD) contaminated, temporary traditional/natural henna induced sensitization and acute allergic reaction have been reported, along with occasional serious long term and rare fatal consequences. We report here a 17-year-old girl with blisters over her hands of five-days duration that appeared within 72 hours of applying a temporary henna paint to her hands during a social occasion. Similar lesions were noted on her face. She had previously applied black henna only once, a year earlier without developing any lesions. Clinical diagnosis of acute allergic contact dermatitis (ACD) was made. After a short course of oral corticosteroids, topical mometasone furaote 1.0% cream, and oral antihistamines, the lesions healed completely over the next four weeks leaving post-inflammatory hypopigmentation. Patch testing done with standard European battery, PPD 1% in petrolatum, and commercially available natural henna powder revealed a 3 reaction to PPD at 48 hours. No reaction was seen at the natural henna site. awareness of the condition among physicians and the public and regulation regarding warnings of the risks of using such products is urgently warranted.- - - - - - - - - - ranking = 1keywords = hypopigmentation (Clic here for more details about this article) |
3/8. 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 = hypopigmentation (Clic here for more details about this article) |
4/8. Systemic toxicity from topically applied lidocaine in conjunction with fractional photothermolysis.BACKGROUND: Topical anesthetics, unlike injectable anesthetics, can be applied painlessly and can provide sufficient pain control to maintain patient comfort throughout a variety of laser procedures. Although the use of topical lidocaine is considered relatively safe, instances of cardiotoxic and neurotoxic adverse events have been reported to occur. OBSERVATIONS: A 52-year-old woman underwent fractional photothermolysis for management of severe hypopigmentation and scarring of several years' duration. Shortly after termination of treatment to her face and neck, which required prolonged exposure to a 30% lidocaine gel compound both before and during surgery, she developed clinical signs and symptoms consistent with systemic lidocaine toxicity. The results of laboratory studies confirmed serum lidocaine levels within the toxic range. We postulate that the combination of the high concentration of topical lidocaine required to achieve sufficient anesthesia, together with the laser-induced disruption in epidermal barrier function, may have been responsible for this phenomenon. CONCLUSIONS: Application of a 30% topical lidocaine gel to a limited area in conjunction with fractional photothermolysis may generate serum lidocaine levels high enough to elicit systemic toxicity. Laser surgeons should be alert to this phenomenon, particularly in patients with underlying hepatic, endocrine, cardiac, or central nervous system/psychiatric dysfunction; in patients with a low body mass index; and in patients who are taking medications that may interfere with hepatic lidocaine metabolism.- - - - - - - - - - ranking = 1keywords = hypopigmentation (Clic here for more details about this article) |
5/8. Raccoon-like periorbital leukoderma from contact with swim goggles.A 12-year-old girl developed a periorbital leukoderma from contact with swim goggles. She had worn the same goggles the preceding year and re-used them after the leukoderma had cleared without any ill effects. The hypopigmentation was believed to be caused by the leakage of breakdown products in the neoprene rubber or glue. These breakdown products may have caused a toxic rather than an allergic reaction on skin contact, inhibiting melanin production possibly by competitive inhibition of tyrosine oxidation. These chemical compounds probably leaked from the goggles and were eventually exhausted. This possibility may explain why the leukoderma did not recur after re-use of the goggles.- - - - - - - - - - ranking = 1keywords = hypopigmentation (Clic here for more details about this article) |
6/8. Perioral leukoderma simulating vitiligo from use of a toothpaste containing cinnamic aldehyde.Perioral leukoderma simulating vitiligo developed in a 25-year-old woman. A patch test to cinnamic aldehyde was positive; depigmentation was observed at the patch test site three months after initial application. No changes in pigmentation occurred from a concomitant allergic patch test reaction to neomycin sulfate; only hyperpigmentation occurred at the site of an irritant patch test reaction to nonanoic acid. A toothpaste containing cinnamic aldehyde was implicated; perioral hypopigmentation resolved when a toothpaste without cinnamic aldehyde was substituted. A repeated patch test to cinnamic aldehyde again showed depigmentation at the patch test site three months after application.- - - - - - - - - - ranking = 1keywords = hypopigmentation (Clic here for more details about this article) |
7/8. Preliminary experience with a flashlamp-pulsed tunable dye laser for treatment of benign pigmented lesions.The principle of selective photothermolysis has been extended from the treatment of vascular to benign pigmented lesions. Cafe au lait birthmarks, solar lentigines, and ephelides can now be removed with a new pulsed-dye laser, with a low risk of scarring or hypopigmentation.- - - - - - - - - - ranking = 1keywords = hypopigmentation (Clic here for more details about this article) |
8/8. minocycline-induced hyperpigmentation: treatment with the Q-switched Nd:YAG laser.BACKGROUND AND OBJECTIVE: Cutaneous hyperpigmentations are well-documented, but nevertheless rare side-effects of high-dose or long-term minocycline therapy. The pigmental changes, may last for years, even though therapy has been abrogated. To date, no safe and effective therapy has been described to target this cosmetically disturbing sequela. STUDY DESIGN/MATERIALS AND methods: A 57-year-old female patient with extensive pigmental changes of the face due to long-term minocycline therapy was treated in eight consecutive sessions with the Q-switched Nd:YAG-laser (1,064-nm wavelength, 5- to 7-nsec impulse length). RESULTS: A 90% resolution of the pigmentation could be achieved after five treatments. After the last session the lesions were completely gone; no hypopigmentation scars, or other side-effects were observed. CONCLUSION: Treatment with the Q-switched Nd:YAG laser seems to be an effective, safe, and easily applicable strategy for the therapy of minocycline-induced hyperpigmentations.- - - - - - - - - - ranking = 1keywords = hypopigmentation (Clic here for more details about this article) |