1/5. dermabrasion: a curative treatment for melasma.Melasma is fairly common in Asian patients with a dark skin tone. It has long been known for its recalcitrance to any form of treatment. The objective of this article is to propose mechanical dermabrasion as a curative treatment for this entity. Five hundred and thirty-three patients with melasma were treated by mechanical dermabrasion using a rotatory diamond fraise. Four hundred and ten patients were available for long-term follow-up (mean follow-up time 5 years, range 1-9 years). Out of 410 patients, 398 (97%) achieved persistent clearance of melasma; in the remaining cases, there was partial recurrence after initial clearance. The common temporary sequelae were postoperative erythema or hyperpigmentation, pruritus, and milia formation. Two patients developed hypertrophic scars, one on the upper lip and one on the jawline, and one patient had permanent hypopigmentation on the forehead. In conclusion, mechanical dermabrasion is a relatively safe and highly effective means for curing melasma.- - - - - - - - - - ranking = 1keywords = hypopigmentation (Clic here for more details about this article) |
2/5. Leukomelanoderma following acute cutaneous graft-versus-host disease.Acute graft versus host disease (GVHD) is characterized by a selective epithelial inflammation that can affect the skin, digestive tract, and liver. Development of pigmentary abnormalities can be observed in sites where acute cutaneous GVHD has occurred, and usually consists of hyperpigmented spots. We observed atypical pigmetary changes consisting of a combination of hyper- and hypopigmentation, so called leukomelanoderma, in a young allogeneic bone marrow recipient who suffered repetitive acute GVHD. The histopathological examinations showed features of a post-inflammatory process. Because keratinocytes produce inflammatory cytokines including tumor necrosis factor (TNF)-alpha and interleukin (IL)-1alpha, which may be implicated in the inflammatory phenomena seen in acute GVHD, we studied whether these inflammatory cytokines might be implicated in these pigmentary changes. The cytokines tested were IL-1alpha, IL-2, TNF-alpha and IL-10. The expression of TNF-alpha increased in the hyperpigmented skin relative to normal and hypopigmented skin. While TNF-alpha was variably distributed in proportion to different degrees of pigmentation, other molecules were detected at minimal levels in all samples. This observation may indicate that the production of TNF-alpha by epidermal microenvironment may be involved in postinflammatory pigmentary changes.- - - - - - - - - - ranking = 1keywords = hypopigmentation (Clic here for more details about this article) |
3/5. 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) |
4/5. Hypomelanosis of Ito (incontinentia pigmenti achromians). Ophthalmological evidence for somatic mosaicism.The authors report on a ten-year-old boy with hypomelanosis of Ito. He suffered from epileptic seizures and exhibited typical generalized partial skin hypomelanosis in whorl-like and striated pattern following Blaschko's lines. The fundi showed patchy, mottled hypopigmentations becoming increasingly striated in the periphery with a general orientation to the optic nerve head. This pattern of affection reminds of the retinal findings in carrier women for X-linked ocular albinism. magnetic resonance imaging revealed multiple small areas of increased relaxation time scattered in the white matter of the brain, which are interpreted as porencephalic cysts. These clinical findings suggest somatic cell mosaicism even though the cytogenetic study was not conclusive.- - - - - - - - - - ranking = 1keywords = hypopigmentation (Clic here for more details about this article) |
5/5. chloroquine-induced hypopigmentation of hair and freckles. association with congenital renal failure.hypopigmentation of hair and freckles occurred in a patient receiving chloroquine sulfate therapy. This patient had a severe congenital renal failure that presumably increased plasma and tissue levels of the drug substantially, accounting for the hypopigmentation.- - - - - - - - - - ranking = 5keywords = hypopigmentation (Clic here for more details about this article) |