Search

BACKGROUND: Injectable and device-based treatments are used for medical dermatologic conditions, but understanding dermatologists' practices remains limited. OBJECTIVE: This study examines injectable and device-based treatments for medical dermatologic conditions to identify patterns and potential improvements. MATERIALS AND METHODS: A survey was distributed to Association of Academic Cosmetic Dermatology members, covering practice settings, conditions treated, pricing, and resident involvement. RESULTS: Thirty-four of 40 (85%) respondents practiced in academic teaching hospitals, primarily in urban settings. Conditions treated included acne vulgaris, alopecia, skin cancers, disorders of pigmentation, follicular disorders, gender-affirming care, birthmarks, oncodermatology, rosacea, scars, tattoos, and vascular lesions. Treatments were offered at various prices, with clinical trials and insurance used in some cases. Resident involvement ranged from 72% to 94% of cases. Respondents also reported laser usage, with 100% using lasers for treating scars, 98% for treating vascular lesions, 98% for treating rosacea, and 88% for treating disorders of pigmentation. For acne vulgaris and associated scarring, the top treatments were chemical peels (86%), lasers (83%), and mechanical modalities (48%). With gender-affirming care, respondents used lasers (100%), filler (55%), and neurotoxins (48%). CONCLUSION: Academic dermatologists treat medical dermatologic conditions and involve residents. [ABSTRACT FROM AUTHOR]

(1) Background: Ultraviolet radiation takes part in photoaging and pigmentation disorders on skin. Epigallocatechin gallate (EGCG) is a well-known brightening and photoprotective compound but it faces limitations in terms of stability and solubility. (2) Methods: A more stable and water-soluble glucoside called EGCG-G1 was obtained by enzymatic glucosylation of EGCG. In vitro and ex vivo experiments evaluated EGCG-G1 skin penetration, antioxidant activity, and antimelanogenic properties compared to EGCG. This gene expression study characterized the pathways impacted by EGCG-G1. Four clinical studies covering phototypes I to V, at various ages, and different skin areas, using several tools, were conducted to assess the effect of EGCG-G1 on skin hyperpigmentation and tone. The impact of glucoside on skin microbiota, especially Lactobacillus sp., was assessed through in vitro and in vivo investigations. (3) Results: EGCG-G1 better penetrated the epidermis than EGCG due to a possible interaction with GLUT1. EGCG-G1 presented similar antioxidant activity to that of EGCG and decreased melanogenesis through the inhibition of 13 genes, including MITF. The skin Lactobacillus population increased with EGCG-G1, which promoted bacterial growth in vitro as prebiotic, and induced the release of a microbial brightening metabolite. Clinical trials demonstrated EGCG-G1 to decrease hyperpigmented spots and increase skin brightness and homogeneity in a large panel of phototypes, outperforming EGCG and vitamin C. (4) Conclusions: Glucosylation of EGCG maintained its photoprotective antioxidant properties and enhanced penetration across the epidermis. EGCG-G1 demonstrated brightening properties on all skin types by down-regulation of melanogenesis pathways and indirectly by skin microbiota stimulation. [ABSTRACT FROM AUTHOR]

Pediatric dermatologists are frequently consulted to evaluate children for cutaneous signs of systemic disorders. Numerical thresholds of significance have been described in the dermatologic literature for various skin findings where the likelihood of an associated extracutaneous abnormality or known genetic syndrome increases significantly. Knowledge of these numerical thresholds facilitates diagnosis and management, which improves clinical outcomes and avoids severe complications. This review highlights the clinical presentation, complications, evaluation, and numerical significance, when applicable, for the following skin findings: infantile hemangiomas, capillary malformations, café‐au‐lait macules, hypopigmented macules, juvenile xanthogranulomas, pilomatricomas, and angiofibromas. [ABSTRACT FROM AUTHOR]

Successful embryonic development depends on the interaction between genetic factors and environmental variables. Congenital malformations in sea turtles can result from extreme conditions during the incubation period, reducing hatching success and potentially impeding population recovery. We aimed to characterize the congenital malformations found in green turtle nests, determine their prevalence and severity, and understand their drivers during the 2022 nesting season on Samandağ beach on northern Mediterranean nesting beaches. A total of 2986 examples of congenital malformations were observed in 362 out of 907 green turtle nests. The prevalence of congenital malformations per nest was 39%, and the severity (the number of malformed individuals per nest) was 3.8%. Nests with congenital malformations exhibited a lower mean distance from the sea, a shorter incubation duration (a proxy for incubation temperature), lower hatching success, a larger clutch size, and higher mortality at late embryonic and hatchling stages than nests without congenital malformations. There was no significant difference in total mortality between these two nest types. A total of 52 different congenital malformations were recorded, 2 of which were observed for the first time in sea turtles and 28 for the first time in green turtles. The results suggest that congenital malformations may be related to nest temperature and clutch size, while overall mortality may be independent of malformations. Pigmentation disorders and craniofacial malformations typically coexist in cases of multiple malformations. Long‐term monitoring of congenital malformations is crucial, as it can provide clues about the health status of the nesting beach and nesting colony. Research Highlights: We aimed to examine and characterize the congenital malformations observed in green turtle nests.We conducted the study in 2022 and examined 907 green turtle nests on Samandağ beach, eastern Mediterranean.We recorded a total of 2986 instances of congenital malformations, with a prevalence of 39% and a severity rate of 3.8%.We documented a total of 52 distinct congenital malformations, with 2 of them first documented in sea turtles and 28 in green turtles.The results indicate that both nest temperature and clutch size could have an impact on the occurrence of congenital malformations. [ABSTRACT FROM AUTHOR]

The article in the Australasian Journal of Dermatology discusses the dermatoscopic features of pigmentary changes in systemic sclerosis, an autoimmune connective tissue disorder. The study examined 17 patients with pigmentary changes, detailing various patterns such as salt and pepper pigmentation, reticulate pigmentation, and vitiligo-like depigmentation. The research found associations between certain pigmentation types and systemic involvement, highlighting the importance of early diagnosis through pigmentary changes. Dermoscopy was shown to aid in distinguishing pigmentary changes in systemic sclerosis from other disorders. [Extracted from the article]

The increasing use of e-cigarettes (ECs) has raised public health concerns due to the observed cytotoxic effects in both in vitro and in vivo studies. Infants and young children, being particularly vulnerable groups, exhibit heightened susceptibility to potential hazards arising from maternal use of ECs, as well as exposure to second-hand and third-hand aerosols emitted by ECs. Melanocytes are neural-crest-derived cells that regulate multiple biological functions. Melanocyte death, triggered by chemical exposure, is a known etiological cause of pigmentation abnormalities and neurodevelopmental disorders. Prior reports have demonstrated nicotine-induced differential cytotoxicity to neonatal human melanocytes derived from lightly pigmented (LP) and darkly pigmented (DP) donors. We recently reported that the vehicle base propylene glycol (PG) in e-liquid can alter the functions of LP melanocytes. However, to date, the effects of e-liquid flavors on LP and DP cells remain unexplored. Hence, in this preliminary study, a panel of twenty EC refill liquids comprising ten popular flavors (strawberry, grape, banana, vanilla, butterscotch, cinnamon, menthol, chocolate, cola, and tobacco), where each flavored e-liquid contained either 0 or 18 mg/mL nicotine, was examined for in vitro cytotoxicity to neonatal human melanocytes derived from LP and DP donors. Our results reveal that of the ten flavors, five (menthol, cinnamon, vanilla, tobacco, and banana) were highly cytotoxic, with their half-maximal inhibitory concentration (IC50) values within the tested concentration ranges. Moreover, the cytotoxicity of the specific flavors menthol, cinnamon, and vanilla was enhanced in the presence of nicotine, indicative of interactive effects, with nicotine and flavor contributing to greater melanocyte injury. The cytotoxicity of menthol (both with and without nicotine) and cinnamon (without nicotine) e-liquids was found to be higher in LP cells as compared to DP cells. In contrast, nicotine-containing vanilla e-liquid induced higher cytotoxicity in DP cells than LP cells. Only three flavors, cola (without nicotine), strawberry (without nicotine), and chocolate (without nicotine), were non-cytotoxic to both LP and DP cells. The findings that popular flavors in e-liquids induced moderate to high degree of melanocytotoxicity even in the absence of nicotine suggests that ECs are not harmless. This information may assist EC users identify particular flavors in refill liquids that may be detrimental to melanocytes. A first-screen identification of flavors in e-liquids that show a racial/ethnicity dependence can provide a baseline to identify cytotoxicity concentration ranges for popular flavors and help inform the regulatory guidelines for EC toxicity to young children and youth. [ABSTRACT FROM AUTHOR]

The assessment of skin changes in the context of possible child abuse is an important task in forensic medicine. This requires knowledge of pigmentation variants and pigmentation disorders such as congenital dermal melanocytosis, which includes Mongolian spots. Particularly in the case of atypical localization and dark pigmented skin, the differentiation from hematomas can be challenging. A case of two Nigerian siblings with extensive and atypically localized Mongolian spots is reported. The 1.5-year-old girl showed Mongolian spots on her back and the right side of her trunk. The 8-year-old boy showed Mongolian spots only on the back of his thighs. The authors are not aware of any case in which so called Mongolian spots were present exclusively on the back of the thighs and this case is all the more noteworthy as the back of the thigh is a common localization of blunt force trauma. [ABSTRACT FROM AUTHOR]

Loss and absence of melanocytes due to a number of factors is responsible for vitiligo; known to be the commonest disorder of pigmentation. The aim of the current work was to compare the efficacy and safety of excimer light with topical tacrolimus ointment 0.1% versus excimer light with topical bimatoprost gel 0.01% in treatment of facial vitiligo. The study was carried out on 48 patients presented with facial vitiligo. The patients were divided randomly using sealed envelope method into two groups (24 patients each). Group 1 were treated with excimer light plus topical tacrolimus ointment 0.1% and group 2 treated with excimer light plus topical bimatoprost gel 0.01%. Clinical improvement based on the quartile grading scale at the end of treatment did not show any statistically significant difference between groups. The majority of subjects in both groups experienced good to excellent improvement. Only 20.9% of patients in group 1 and 33.3% of subjects in group 2 achieved less than 50% repigmentation (p = 0.889). Our study demonstrated that 0.01% topical bimatoprost gel in combination with excimer light is considered safe and effective as treatment of nonsegmental facial vitiligo with comparable results to 0.1% tacrolimus. [ABSTRACT FROM AUTHOR]

Background: Clobetasol has demonstrated remarkable results in treating melasma within a short time frame; however, its use is limited because of the risk of local side effects. To date, there is no controlled trial on sequential clobetasol/hydroquinone for melasma. This study aimed to investigate the tolerability and efficacy of 0.05% clobetasol followed by 4% hydroquinone (CLOB‐HQ) in comparison to the isolated use of 4% hydroquinone (HQ). Methods: A double‐blinded, randomized clinical trial involving 50 women with facial melasma was performed. They were directed to apply 0.05% clobetasol every night for 14 days, followed by 4% hydroquinone for 46 days (CLOB‐HQ group), or the use of hydroquinone for 60 days (HQ group). Evaluations were carried out at inclusion, and after 14 and 60 days of treatment, measuring modified Melasma Area and Severity Index (mMASI), Melasma Quality of Life scale (MELASQoL), and colorimetry. The Global Aesthetic Improvement Scale (GAIS) was assessed by a blinded evaluator. Results: There was no difference in the main outcomes at D14 and D60 (P > 0.1). For CLOB‐HQ, the mean (CI 95%) reduction in mMASI was 13.2% (5.1–21.3%) and 43.1% (32.2–54.0%) at D14 and D60, and for HQ, they were 10.6% (5.9–27.5%) and 44.8% (33.2–52.3%). The MELASQoL, colorimetric luminosity, and GAIS showed a progressive improvement for both groups despite no difference between them. No severe side effects were identified. No cases of telangiectasias, atrophy, or perioral dermatitis were associated with the use of CLOB. Conclusion: The sequential CLOB‐HQ regimen was safe and well tolerated, even though its efficacy was not different from HQ after 14 or 60 days of treatment. Based on these findings, the use of clobetasol 14 days before hydroquinone is not advisable for the treatment of melasma. [ABSTRACT FROM AUTHOR]

Skin pigmentation typically arises from the excessive secretion and accumulation of melanin, resulting in a darker complexion compared to normal skin. Currently, the local application of chemical drugs is a first-line strategy for pigmentation disorders, but the safety and efficacy of drugs still cannot meet clinical treatment needs. For long-term and safe medication, researchers have paid attention to natural products with higher biocompatibility. This article begins by examining the pathogenesis and treatment approaches of skin pigmentation diseases and summarizes the research progress and mechanism of natural products with lightening or whitening effects that are clinically common or experimentally proven. Moreover, we outline the novel formulations of natural products in treating pigmentation disorders, including liposomes, nanoparticles, microemulsions, microneedles, and tocosomes. Finally, the pharmacodynamic evaluation methods in the study of pigmentation disorder were first systematically analyzed. In brief, this review aims to collect natural products for skin pigmentation treatment and investigate their formulation design and efficacy evaluation to provide insights for the development of new products for this complex skin disease. [ABSTRACT FROM AUTHOR]

Dermoscopy aids in the diagnosis and management of pigmented growths and disorders of pigmentation in children. However, there is limited literature on the dermoscopic appearance of café‐au‐lait macules (CALMs) and congenital melanocytic nevi in patients with dark skin. We report two cases of young children with dark skin and many hyperpigmented patches in whom dermoscopy was utilized to accurately diagnose CALMs and facilitate testing for neurofibromatosis. [ABSTRACT FROM AUTHOR]

Pigmentary mosaicism is a term that describes various patterns of segmental pigmentation disorders based on genetic heterogenicity of skin cells. Pigmentary mosaicism is a collective term, which comprises phenotypes represented by mosaic hypo- and/or hyperpigmentation in the form of whorls, patchy, streaks or more bizarre skin configurations. Melanocyte precursors are neural crest derived and migrate through the Dorso-lateral pathway during embryogenesis. This group of disorders may be associated with or without systemic abnormalities. In a considerable number of cases, pigmentary mosaicism is observed alongside extracutaneous oddities generally affecting the musculoskeletal system and central nervous system. Pigmentary mosaicism includes a variety of inherited, patterned pigmentary dermatoses which have been described using various terms such as hypo melanosis of Ito, linear and whorled nevoid hypermelanosis, phylloid hypo- and hypermelanoses and pigmentary mosaicism of both hypopigmented and hyperpigmented type. Here, we present a series of 5 cases of pigmentary mosaicism in a single report. [ABSTRACT FROM AUTHOR]

Background Diagnostic accuracy ratings of different dermatological disorders are helpful in critical evaluation of correct diagnosis and hence timely management of condition to reduce morbidity and mortality. The objective of this study was to assess diagnostic accuracy in dermatological outpatient department in a tertiary care hospital in Kathmandu, Nepal. Methods Patients whose clinical diagnosis was not clear or needed further confirmation were subjected to biopsies and were included in the study after history and clinical examination. The clinician was asked to rank three clinical diagnoses in order priority. The first three clinical diagnoses were compared with the final histopathological diagnosis and diagnostic accuracy was calculated in terms of percentage. A comparison of diagnostic accuracy was done between different skin lesions and rashes. Results Thirty-eight patients (76%) presented with rash and 12 (24%) patients presented with lesions. It was seen that 34 clinical diagnoses (68%) correlated well with final diagnoses. Alopecia, papulo squamous diseases, panniculitis, disorder of pigmentation and urticaria had the highest accurate diagnostic ratings (100% each) followed by eczemas (87.5%), immunobullous diseases (75%), connective tissue diseases (75%), infections (60%), and tumors (57.1%). Vasculitis (0%) and melanocytic disorders (33.3%) had the least diagnostic ratings. The difference between correct and incorrect diagnoses between lesions and rashes was not significant (P >0.05). Conclusion The diagnostic accuracy of skin lesions in this study is 68%, with the highest accuracy seen with alopecia, papulosquamous diseases, panniculitis, disorder of pigmentation and urticaria. There is no difference in the diagnostic accuracy between lesion and rashes. [ABSTRACT FROM AUTHOR]

Treating facial pigmentation disorders has become controversial, with patients requesting less invasive and more effective treatments that minimize side effects. Microneedling, combined with platelet-rich plasma (PRP), has recently emerged as a common treatment in the field of aesthetic medicine, with numerous articles highlighting its use in restorative treatments and its effectiveness. However, there have been no reports to date on the use of this technique for addressing facial pigmentation disorders. In this article, we present a successful case study utilizing microneedling in combination with PRP to eliminate facial pigmentation. Based on the available evidence, it appears that this treatment approach is highly effective and carries minimal risk of side effects when used to address facial pigmentation. [ABSTRACT FROM AUTHOR]

Dermatological disorders constitute a significant proportion of primary health care (PHC) setups. The pattern of dermatological disorders varies among different countries and different parts of the same country owing to climatic and geographical variations, level of education, access to health care, etc. To study the clinical spectrum of patients presenting with dermatological disorders at an urban health center (UHC) in East Delhi. To identify the various risk factors associated with dermatological disorders in study subjects. A total of 1,148 patients who reported skin diseases for the first time at the Dermatology Outpatient Clinic at UHC in East Delhi were recruited. Detailed demographic data, history, and examination and potential risk factors of skin diseases (socioeconomic status, level of education, occupation, comorbidities, and addictions) were recorded on a predesigned proforma. A total of 616 (53.7%) patients had infectious dermatoses and 532 (46.3%) had non-infectious dermatoses. Among the infectious dermatoses, fungal diseases (44.8%) were the most common followed by parasitic infections (31.17%) and bacterial infections (9.74%). Among the non-infectious group, eczematous disorders (28.01%) were the most common, followed by pigmentary disorders (21.62%) and acne (19.55%). A significant association between level of education, occupation, and comorbidities with the distribution of infectious and non-infectious dermatoses was found. As a significant proportion of patients with a vivid spectrum of dermatological disorders present at the PHC setups, therefore dermatologists supervise that specialty clinics should be held regularly at these centers along with the availability of all the basic investigations to aid diagnosis and management. [ABSTRACT FROM AUTHOR]

Microemulsions (MEs) and nanoemulsions (NEs) are dispersions of two immiscible liquids which are usually transparent/translucent. Several reports are available on uses of MEs/NEs to increase efficacy of the loaded active ingredient(s) in topical dosage forms. This review aims to describe brief applications of MEs/NEs in common skin diseases as well as skincare products. Advantages of MEs/NEs in comparison with the traditional bulk form, including their improved efficacy and safety, have been discussed to highlight the importance of use of such delivery systems. The review briefs mechanism of action of MEs/NEs in enhancing delivery of the cargo. Furthermore, applications of MEs/NEs in common skin diseases including infectious rashes, pigmentation disorders (hyperpigmentaion and hypopigmentation), wound healing, skin cancers and scaling patches and plaques/papulosquamous disorders (psoriasis, atopic dermatitis and acne) have been discussed. MEs/NEs in skin care products have also been reviewed here. [ABSTRACT FROM AUTHOR]

The article "Dermoscopic features of the normal vermilion in skin of colour" published in the Australasian Journal of Dermatology explores the dermoscopic features of normal vermilion in patients with skin of color. The study included 84 patients with skin colors IV and V, analyzing the dermoscopic details of normal vermilion. The research found variations in dermoscopic features depending on the color of the vermilion, highlighting the importance of understanding normal characteristics to identify alterations in dermatoses. The study's limitations included a small sample size and the inclusion of only skin phototypes IV and V. [Extracted from the article]

Introduction: Vitiligo is a skin pigmentation disorder caused by the selective degradation of melanocytes. This study investigates the therapeutic effects of microneedling with and without N‐acetylcysteine (NAC) in patients with persistent and limited vitiligo. Method: This research employed a clinical trial design with double‐blind randomization. Individuals affected by vitiligo and seeking treatment at Rasool Akram Medical Complex were divided into two separate treatment groups. In the intervention group, 24 affected areas underwent meso‐microneedling using 5% NAC ampoules over six sessions, in addition to the application of 4.7% NAC cream once daily on the specified area. Conversely, the control group, consisting of 22 lesions, underwent microneedling using distilled water during six sessions. The severity of lesions and the extent of repigmentation were gauged using the Modified VETI Score. Assessment of treatment efficacy was determined through both physician evaluations and patient feedback. Results: Twenty patients with a mean age of 36.4 years were recruited. The mean percentage of lesions and their intensity were significantly improved 2 weeks after the third session and 1 month after the end of the treatment (p < 0.01). There was no statistically significant difference between the intervention and control groups. Gender, age, family history, duration of disease, duration of disease stability, and history of hypothyroidism had no statistically significant relationship with patients' treatment outcomes (p > 0.05). Conclusion: Microneedling with or without the application of NAC appears to be an effective treatment option for persistent vitiligo lesions. However, despite the higher improvement rate with the application of NAC, the difference was not significant. [ABSTRACT FROM AUTHOR]

Epidermal melanin synthesis determines an individual's skin color. In humans, melanin is formed by melanocytes within the epidermis. The process of melanin synthesis strongly depends on a range of cellular factors, including the fine-tuned interplay with reactive oxygen species (ROS). In this context, a role of cold atmospheric plasma (CAP) on melanin synthesis was proposed due to its tunable ROS generation. Herein, the argon-driven plasma jet kINPen® MED was employed, and its impact on melanin synthesis was evaluated by comparison with known stimulants such as the phosphodiesterase inhibitor IBMX and UV radiation. Different available model systems were employed, and the melanin content of both cultured human melanocytes (in vitro) and full-thickness human skin biopsies (in situ) were analyzed. A histochemical method detected melanin in skin tissue. Cellular melanin was measured by NIR autofluorescence using flow cytometry, and a highly sensitive HPLC-MS method was applied, which enabled the differentiation of eu- and pheomelanin by their degradation products. The melanin content in full-thickness human skin biopsies increased after repeated CAP exposure, while there were only minor effects in cultured melanocytes compared to UV radiation and IBMX treatment. Based on these findings, CAP does not appear to be a useful option for treating skin pigmentation disorders. On the other hand, the risk of hyperpigmentation as an adverse effect of CAP application for wound healing or other dermatological diseases seems to be neglectable. [ABSTRACT FROM AUTHOR]

Background: Facial hyperpigmentation can negatively affect an individual's emotional and psychosocial well‐being. Aims: Assess safety and tolerability of a combination of microdermabrasion (DG) procedures using a novel brightening pro‐infusion serum (EC‐DG) with a targeted at‐home treatment regimen in subjects with mild to severe facial hyperpigmentation, including melasma, post‐inflammatory hyperpigmentation, and dark spots. Patients/Methods: This 12‐week, open‐label study enrolled 18 subjects (Fitzpatrick skin types I–IV) who underwent 6 in‐office DG procedures with EC‐DG (one procedure administered biweekly), along with daily topical application of a brightening treatment serum and dark spot cream. End points included change from baseline across multiple skin quality attributes and the Melasma Area and Severity Index (MASI), self‐assessment questionnaires, and tolerability assessments. Results: The combination treatment was well tolerated and resulted in significant (p ≤ 0.05) improvements from baseline in radiance, tactile roughness, and moisturization/hydration immediately after the first treatment, in MASI score at day 3, and in overall hyperpigmentation at week 4. Most (94.1%) subjects were satisfied with treatment. Conclusions: DG procedures using EC‐DG combined with a targeted at‐home skincare regimen are effective and tolerable for treating facial hyperpigmentation across a broad range of skin types. [ABSTRACT FROM AUTHOR]

Melanocyte stem cells (MSCs), melanocyte lineage‐specific skin stem cells derived from the neural crest, are observed in the mammalian hair follicle, the epidermis or the sweat gland. MSCs differentiate into mature melanin‐producing melanocytes, which confer skin and hair pigmentation and uphold vital skin functions. In controlling and coordinating the homeostasis, repair and regeneration of skin tissue, MSCs play a vital role. Decreased numbers or impaired functions of MSCs are closely associated with the development and therapy of many skin conditions, such as hair graying, vitiligo, wound healing and melanoma. With the advancement of stem cell technology, the relevant features of MSCs have been further elaborated. In this review, we provide an exhaustive overview of cutaneous MSCs and highlight the latest advances in MSC research. A better understanding of the biological characteristics and micro‐environmental regulatory mechanisms of MSCs will help to improve clinical applications in regenerative medicine, skin pigmentation disorders and cancer therapy. Key points: This review provides a concise summary of the origin, biological characteristics, homeostatic maintenance and therapeutic potential of cutaneous MSCs.The role and potential application value of MSCs in skin pigmentation disorders are discussed.The significance of single‐cell RNA sequencing, CRISPR‐Cas9 technology and practical models in MSCs research is highlighted. [ABSTRACT FROM AUTHOR]

Melanins are biopolymeric pigments formed by a multi-step oxidation process of tyrosine in highly specialized cells called melanocytes. Melanin pigments are mainly found in the skin, iris, hair follicles, and inner ear. The photoprotective properties of melanin biopolymers have been linked to their perinuclear localization to protect DNA, but their ability to scavenge metal ions and antioxidant properties has also been noted. Interactions between drugs and melanins are of clinical relevance. The formation of drug–melanin complexes can affect both the efficacy of pharmacotherapy and the occurrence of adverse effects such as phototoxic reactions and discoloration. Because the amount and type of melanin synthesized in the body is subject to multifactorial regulation—determined by both internal factors such as genetic predisposition, inflammation, and hormonal balance and external factors such as contact with allergens or exposure to UV radiation—different effects on the melanogenesis process can be observed. These factors can directly influence skin pigmentation disorders, resulting in hypopigmentation or hyperpigmentation of a genetic or acquired nature. In this review, we will present information on melanocyte biology, melanogenesis, and the multifactorial influence of melanin on pharmacological parameters during pharmacotherapy. In addition, the types of skin color disorders, with special emphasis on the process of their development, symptoms, and methods of treatment, are presented in this article. [ABSTRACT FROM AUTHOR]

This document is an editorial from the Journal of Clinical Medicine that provides an overview of current treatments for skin pigmentation disorders. It focuses on vitiligo, a condition characterized by the loss of skin pigmentation, and discusses various treatment options such as topical corticosteroids, phototherapy, and surgical interventions. The editorial also addresses hyperpigmentation disorders, specifically melasma, and highlights the challenges in its treatment. It mentions the use of topical applications, oral therapies, chemical peels, and laser procedures as treatment options. The document concludes by discussing the future of treating skin hyperpigmentation with lasers, emphasizing advancements in laser technologies and the potential use of machine learning and artificial intelligence. [Extracted from the article]

Linear atrophoderma of Moulin (LAM) is a rare dermatological condition characterized by unilateral hyperpigmented and atrophic band-like skin lesions following Blaschko's lines. The exact cause of LAM is unclear, but it is believed to be related to either autoimmunity or genetic mosaicism. This article describes a case of LAM in a 27-year-old man, highlighting a granulomatous reaction and antinuclear-antibody (ANA) positivity. The patient's chronic lesions met the diagnostic criteria for LAM, except for a thinner dermis and subcutaneous tissue. The article also discusses the dermoscopic features, treatment options, and the potential link between LAM and autoimmunity or connective tissue diseases. [Extracted from the article]

This article discusses a case of recurrent asymptomatic reddish-brown pigmented macules on the palms of a furniture retailer. Despite thorough examination and testing, a definitive diagnosis was not established. The author suggests that the pigmentation may be related to Cydnidae pigmentation, a condition caused by burrowing bugs that produce a malodorous chemical secretion. The lesions disappeared spontaneously within two weeks. Dermoscopy was used to evaluate the pigmentation and revealed certain dermoscopic features consistent with previously reported cases. The article emphasizes the importance of awareness among dermatologists about this self-limiting condition and highlights the need for further research on the nature and characteristics of the species involved. [Extracted from the article]

This article explores the relationship between psychological stress and vitiligo, a skin condition characterized by the destruction of melanocytes. The authors propose that psychological stress can influence melanocyte destruction through pathways involving cytokines and neuropeptides. They provide evidence from laboratory and clinical studies, including animal studies that show a link between stress and reduced pigmentation. The authors suggest that psychological stress may induce oxidative stress, making melanocytes susceptible to attack by immune cells. They also discuss the role of neuropeptides released in response to stress in damaging melanocytes. The article concludes by highlighting the need for further research to better understand the interconnectedness of these systems in vitiligo. [Extracted from the article]

Terpenes and their derivatives comprise a diverse group of natural compounds with versatile medicinal properties. This article elucidates the general characteristics of fungal terpenes and terpenoids, encompassing their structure and biogenesis. The focal point of this work involves a comprehensive overview of these compounds, highlighting their therapeutic properties, mechanisms of action, and potential applications in treating specific skin conditions. Numerous isolated terpenes and terpenoids have demonstrated noteworthy anti-inflammatory and anti-microbial effects, rivalling or surpassing the efficacy of currently employed treatments for inflammation or skin infections. Due to their well-documented antioxidant and anti-cancer attributes, these compounds exhibit promise in both preventing and treating skin cancer. Terpenes and terpenoids sourced from fungi display the capability to inhibit tyrosinase, suggesting potential applications in addressing skin pigmentation disorders and cancers linked to melanogenesis dysfunctions. This paper further disseminates the findings of clinical and in vivo research on fungal terpenes and terpenoids conducted thus far. [ABSTRACT FROM AUTHOR]

Introduction: Melasma is a common acquired pigmentation disorder over the sun exposed areas found commonly in our country. Oral tranexamic acid and glutathione have been shown to have significant efficacy when given along with topical modified Kligman regimen. Aims: To compare the efficacy of oral tranexamic acid versus oral glutathione given in combination with modified Kligman regimen in the management of melasma. Settings and Design: An open label randomized controlled trial was conducted in the skin OPD of a tertiary level hospital in Northern India. Materials and Methods: The study group consisting of 96 patients was categorized into two groups; group A received oral tranexamic acid 250 mg twice daily in combination with a modified Kligman regimen and group B received oral Glutathione 500 mg once daily with a modified Kligman regimen. mMASI score was used to make the assessment. mMASI scores were measured at baseline, 4th, 8th, and 12th week. Intragroup and intergroup comparison was done using analysis of variance (ANOVA) and Chi‑square test statistical methods. Results: Ninety patients completed the study. Both the groups showed a significant fall in the mMASI score; group A showed a statistically significant fall in the score vis a vis the group B. Conclusion: Oral tranexamic acid with a modified topical Kligman regimen has a slight edge over oral glutathione given with topical modified Kligman’s regimen in the treatment of melasma. [ABSTRACT FROM AUTHOR]

Unusual colorations are rare in Didelphis, but records are important to understand genetic aspects of the species. Albino individuals have a total absence of pigmentation throughout the body (skin and hair) and have eyes without traces of pigmentation, but with a red or pink color. We draw attention to the first two confirmed records of albinism in white-eared opossum (Didelphis albiventris) and their karyotype. This is the first record of albinism in D. albiventris in Northeastern Brazil. This calls attention to develop future research on the genetic diversity and the risk of inbreeding and consanguinity in populations of this region. [ABSTRACT FROM AUTHOR]

Introduction: Infraorbital hyperpigmentation represents one of the most prevalent conditions in cosmetic dermatology. To treat this condition, many patients prefer natural remedies. This study explored the efficacy of topical castor oil cream in treating patients with infraorbital hyperpigmentation. Methods: We conducted an exploratory single‐arm clinical trial at the Shahid Faghihi Dermatology Clinic and Molecular Dermatology Research Center of Shiraz University of Medical Sciences, Shiraz, Iran, during 2021–2022. Using the convenience sampling method, we enrolled 25 patients with infraorbital hyperpigmentation. We instructed the patients to apply topical castor oil cream twice daily for 2 months. The darkness, melanin, and erythema levels were evaluated by VisioFace® 1000 D and SkinColorCatch® devices. We used a visual analog scale to assess skin laxity, wrinkles, and patient satisfaction. Data analysis was done with Stata version 14.2. Results: The data of 22 patients with a mean age of 40.92 ± 7.33 years were analyzed. The VisioFace® scores decreased significantly by the end of the study [right eyes: mean difference (MD): ‐5.63 (95% CI: −7.12 to −4.15), p < 0.001; left eyes: MD: ‐5.91 (95% CI: −7.46 to −4.36), p < 0.001]. Moreover, castor oil cream significantly reduced the melanin level, wrinkles, and skin laxity in the infraorbital region (p < 0.05). Conclusions: Castor oil cream seems to be an effective alternative for treating infraorbital hyperpigmentation. Randomized clinical trials are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Melasma is a common acquired skin pigmentation disorder. The treatment is urgent but challenging. Ablative fractional laser (AFL) can improve pigmentation, but the efficacy and potential side effects are still debatable. This study aimed to evaluate the efficacy and safety of ablative fractional lasers in the treatment of melasma. A comprehensive systematic search of literature published before June 20, 2023, was conducted on online databases, including PubMed, Embase, Cochrane Library, and Web of Science. The data obtained were analyzed using Review Manager 5.4 software. Fourteen randomized controlled trials, comprising 527 patients, were included. Compared to the drug alone, the combination of AFL and the drug showed improved therapeutic efficacy in the melasma area and severity index (MASI) (MD = 1.54, 95% CI [0.16, 2.92], P = 0.03) and physician global assessment (RR = 1.61, 95% CI [1.08, 2.41], P = 0.02). However, no statistically significant results were found in patient self-assessment (RR = 1.56, 95% CI [0.88, 2.76], P = 0.12). As an individual therapy, AFL is not superior to any other lasers in terms of MASI (MD = 2.66, 95% CI [-1.32, 6.64], P = 0.19) or melanin index (MD = -7.06, 95% CI [-45.09, 30.97], P = 0.72). Common adverse events included transient erythema, burning, edema, and superficial crusting. Only a few patients experienced reversible post-inflammatory hyperpigmentation, herpes labialis, and acne breakouts. These results support the application of AFL as a viable treatment option for melasma, particularly in refractory and severe cases. Rational parameterization or combination therapy may lead to significant clinical improvement with fewer complications. [ABSTRACT FROM AUTHOR]

Introduction: Melasma is an acquired hypermelanosis and occurs in areas exposed to sunlight. Aim: To investigate the effectiveness of Danggui Shaoyao powder (DSP) as a complementary drug in the treatment of melasma. Material and methods: A total of 40 melasma patients over the age of 18 who met the inclusion criteria entered the study randomly in two DSP + Hydroquinone (DSP + H) and Hydroquinone (H) groups. Results: At the beginning of the study, the average MASI score of the two groups of patients had no statistical difference (DSP + H: 15.79 ±1.01 vs. H: 15.37 ±1.17, p = 0.23). But from the eighth week of treatment, the MASI score of the patients decreased significantly and in the DSP + H group it decreased statistically significantly compared to the H group (DSP + H: 5.83 ±0.97 vs. H: 8.29 ±2.23, p < 0.001 for the eighth week and DSP + H: 3.60 ±0.58 vs. H: 5.52 ±1.73, p < 0.001 for the twelfth week of the treatment). It means after 12 weeks of treatment, the average MASI score of patients in the DSP + H group decreased by 77.26 ±2.70%, but in the grroup H, it decreased by 64.31 ±9.68% (p < 0.001). Dynamic PGA showed that excellent treatment occurred in 65% of the + H group H, but only 20% of the H group (p = 0.01). Conclusions: Oral DSP for 12 weeks along with hydroquinone cream can significantly reduce the MASI score of melasma patients and increase the patients' recovery and satisfaction. [ABSTRACT FROM AUTHOR]

Dermatoscopy is a non-invasive and cost-efficient imaging technique augmenting clinical examination in neoplastic and non-neoplastic dermatoses. Recently, novel dermatoscopic techniques based on principles of reflectance/absorption and excited fluorescence have been developed. However, comprehensive data on their applications are sparse, and terminology is inconsistent. In this systematic review, we addressed the principles of ultraviolet (UV) imaging and proposed categorization based on spectral characteristics and signal acquisition, as well as discussed documented and potential clinical applications, safety measures during examination, and limitations associated with reflectance and fluorescence dermatoscopy. A literature search was conducted in the PubMed medical database until 2 December 2023 according to PRISMA guidelines, and 28 papers fit the scope of this review, whereas additional relevant articles were included to provide broader context regarding the chosen terminology, chromophores described, safety of sub-UV/UV, and regulations for light-emitting devices. UV and sub-UV dermatoscopy, categorized into different methods on the basis of the emitted wavelength and signal acquisition process (reflectance versus fluorescence), augment conventional dermatoscopy by optimizing safety margins in melanoma, facilitating early detection of tumor recurrence, and enhancing visualization in non-neoplastic conditions, including pigmentation disorders, intertrigo, papulo-desquamative dermatoses, and beyond. The review highlights the limitations of these techniques, including difficulty in differentiating melanin from hemoglobin, challenges in evaluating uneven surfaces, and artifacts. Although UV dermatoscopy complements conventional dermatoscopy, clinicians should be aware of their peculiarities, artifacts, limitations, and safety concerns to optimize their diagnostic accuracy and ensure patient's safety. [ABSTRACT FROM AUTHOR]

Background: Facial dark spots remain a significant challenge for the cosmetic industry, in terms of providing effective treatment. Using Line‐field Confocal Optical Coherence Tomography (LC‐OCT), we investigated the internal structural features of photo‐aging spot areas and evaluated the efficacy of a skin‐brightening cosmetic product. Materials and Methods: Twenty‐six Asian female volunteers, aged between 29 and 65 years, applied a cosmetic product on their entire face twice a day for 2 months. LC‐OCT was used to evaluate the dermal‐epidermal junction (DEJ) undulation and the volume density of melanin in the epidermis at D0 and D56. Skin brightening and redness were also assessed by photography (SkinCam). Results: Using LC‐OCT technology, various microscopic dark spot morphologies, spanning from minimally deformed DEJ to complex DEJ patterns, were identified. Dark spots characterized by slight deformities in the DEJ were predominantly observed in the youngest age group, while older volunteers displayed a wavier pattern. Furthermore, a total of 44 spots were monitored to evaluate the brightening product efficacy. A statistically significant reduction in melanin volumetric density of 7.3% in the spots and 12.3% in their surrounding area was observed after 56 days of product application. In line with these results, an analysis of color parameters using SkinCam reveals a significant increase in brightening and decrease in redness in both pigmented spots and the surrounding skin following application. Conclusions: LC‐OCT proves to be a valuable tool for in‐depth dark spots characterization and assessment of skin brightening products, enabling various applications in the field of dermatological sciences. [ABSTRACT FROM AUTHOR]

Background: Ocular melanocytosis was originally described as pigmentary glaucoma and reported in seven dogs of the Cairn Terrier breed. Subsequently, the occurrence of this condition was reported in other breeds of dogs among them a Shih Tzu, recently described. With progression, black pigment spots in the sclera and episclera cover the ciliary cleft. Pigment particles can often be seen suspended in the aqueous and, as they sediment, cover the ventral drainage angle, causing secondary glaucoma. The aim of this study was to describe the clinical and sonographic findings of a Shih Tzu dog with melanocytosis and unilateral secondary glaucoma. Case: A 8-year-old, male, Shih Tzu dog, with a history of progressive darkening of the sclera for 5 years, was referred to the ophthalmological service. The patient underwent routine ophthalmic examination. Slit lamp biomicroscopy revealed anisocoria. In the right eye, diffuse pigmentation of the sclera was observed in almost the entire perilimbal region, and in the iris signs of advanced atrophy with tissue loss between 9 h and 12 h. Nevertheless, zonular ligaments could be observed in this region, as well as a large amount of pigment deposits in the ventral region of the ciliary cleft. Applanation tonometry showed intraocular pressure (IOP) of 14 mmHg. Fundoscopic examination did not reveal abnormal pigmentation, but attenuation of the retinal vessels and in the optic disc was observed. In the left eye, no change was observed to demonstrate the bilaterality of the disease. One month later, the patient returned to the ophthalmology service complaining of an increase in the size of the right eye. Ophthalmic examination revealed moderate buftalmia in the right eye, IOP of 30 mmHg and increased ocular melanosis. Treatment was instituted to control intraocular pressure. Fifteen days after the start of treatment, the IOP decreased to 18 mmHg and it was found that the ophthalmic signs had improved, with a decrease in ocular discomfort. Ultrasound examination showed an increase in the anteroposterior axis and expansion of the anterior chamber, with scattered hyperechogenic spots in the periphery. Ultrasound biomicroscopy (UBM) was performed, in which the presence of obstruction in the ciliary fissure and the presence of punctate echoes between the ciliary fissure and the iris were observed. Four months later, the ophthalmic signs were stable, as well as the IOP (20 mmHg). Currently, the animal is visual in both eyes and with a stable condition in the progression of the disease. Discussion: This condition also known as melanocytosis, pigmentary glaucoma or abnormal pigment deposition, involves the gradual accumulation of pigment-laden cells mainly, melanocytes but also melanophages, in the anterior segment structures including the iris and ciliary body. It is seen in dogs of the Cairn Terriers breed as a hereditary defect, but has been reported in other breeds. Recently the condition was reported in a Shih Tzu, however differently from our work where the condition was unilateral and with a controllable glaucoma. The disorder initially manifests clinically with a progressive bilateral dark peripheral thickening of the iris base, followed by scleral/episcleral plaques of pigment adjacent to the limbus. Signs increase slowly, with pigment clusters in the aqueous and pigmentation in the ventral iridocorneal angle and peripheral endothelium, symptoms are usually bilateral, although not always symmetrical. This is the 1st case of a Shih Tzu with melanocytosis and controlled secondary glaucoma, unilateral, reported in the literature. This is a disease that should be considered as a differential diagnosis of uveal melanomas and melanocytomas. [ABSTRACT FROM AUTHOR]

Linear and whorled nevoid hypermelanosis is a rare skin pigmentation disorder, characterized by linear streaks and whorls of hyperpigmented macules along Blaschko's lines. Lesions are commonly restricted to the trunk, neck, and extremities, sparing the face, palms, soles, and mucosae. Associated with this, certain cardiovascular, musculoskeletal, neurological, and developmental anomalies have been reported in the literature. Herein, we present a rare case of linear and whorled nevoid hypermelanosis involving the face, with musculoskeletal, genital, aural, and ocular abnormalities. [ABSTRACT FROM AUTHOR]

Waardenburg Syndrome (WS) is a rare genetic disorder that leads to congenital hearing loss and pigmentation defects. Microphthalmia‐associated transcription factor (MITF) is one of its significant pathogenic genes. Despite the comprehensive investigation in animal models, the pathogenic mechanism is still poorly described in humans due to difficulties accessing embryonic tissues. In this work, we used induced pluripotent stem cells derived from a WS patient carrying a heterozygous mutation in the MITF gene c.626A>T (p.His209Leu), and differentiated toward melanocyte lineage, which is the most affected cell type involved in WS. Compared with the wild‐type cell line, the MITFmut cell line showed a reduced expression of the characteristic melanocyte‐related genes and a lesser proportion of mature, fully pigmented melanosomes. The transcriptome analysis also revealed widespread gene expression changes at the melanocyte stage in the MITFmut cell line. The differentially expressed genes were enriched in melanogenesis and cell proliferation‐related pathways. Interestingly, ion transport‐related genes also showed a significant difference in MITFmut‐induced melanocytes, indicating that the MITF mutant may lead to the dysfunction of potassium channels and transporters produced by intermediate cells in the cochlea, further causing the associated phenotype of deafness. Altogether, our study provides valuable insights into how MITF mutation affects WS patients, which might result in defective melanocyte development and the related phenotype based on the patient‐derived iPSC model. [ABSTRACT FROM AUTHOR]

Amyloidosis cutis dyschromica is a very rare form of primary cutaneous amyloidosis characterized by prepubertal onset of hyper and hypopigmented spots and amyloid deposits in the papillary dermis. We report two cases of this condition highlighting its dermoscopic findings. [ABSTRACT FROM AUTHOR]

The article presents a case study of a rare subtype of primary cutaneous amyloidosis known as amyloidosis cutis dyschromica (ACD) involving three patients aged 24, 28, and 34. Topics discussed include the clinical presentation and diagnostic challenges of ACD, its dermoscopic and histopathological features, and the various treatment options and their effectiveness.

This article summarizes a study on the prevalence and factors associated with melasma in adult women. The study was conducted in Botucatu, Brazil, and included 303 women aged 20 to 60 years. The study found that melasma was prevalent in 36.3% of women, with an additional 1.7% detected through Wood's lamp inspection. Pregnancy was identified as the most common trigger factor, and the prevalence of melasma was higher in the 41-50 age group and among individuals with darker skin phototypes. The study also found associations between melasma and self-declared brown color, menopause, and the COVID-19 pandemic. The study acknowledges limitations and suggests further research is needed to understand the role of genetic ancestry in melasma. [Extracted from the article]

Background: Melasma is a highly prevalent disorder of acquired pigmentation that results in localized, chronic hypermelanosis of the skin, affecting the individual on personal and social fronts. Aim: The study aims to understand the epidemiology, etiology and clinical features of melasma. Materials and Methods: The present study was an observational study conducted on 300 patients of facial melasma presenting to the outpatient department of Dermatology, Venereology, and Leprology. Results: The most common age group affected was 21-30 years (48.6%), followed by 31-40years(23%), and the least affected group was 18-20 years (10%). The mean age of patients included in the present study was 26.5 years. The youngest age of presentation was 18 years, while the oldest was 48 years. Females were more commonly affected (77.3%) compared to males(24.6%) and the male to female ratio was found to be 1:3.14. Housewives were the most commonly affected by this condition (48.3%). Fitzpatrick type IV was the most commonly seen skin type (55.3%), followed by skin type V(41.6%), and type III (1.3%). The majority of patients(51.3%) in the present study had melasma lesions for less than1 year duration. Malar was the predominant clinical pattern(63%). Epidermal type of melasma was the most common (43.3%). The majority had no family history(55%) in the present study. Out of 300 patients, 21 (70%) had sun exposure for less than1 hour every day. The most common etiological factor was sun exposure, found in 120 patients(40%). Most of the patients (60%) reported aggravation of lesions with sun exposure, followed by cosmetic usage in 28.3% patients(fair and lovely, ponds, vicco, miltani mitti, borolin); the least commonly found aggravating factor was drug usage (tetracycline, steroids, phenytoin, cisplatin) reported in only 5% of patients. Only 105 (35%) out of 300 patients were treatment naïve. The rest of the patients included in the study had used some form of treatment before the presentation. Hypothyroidism was observed in 55 patients (18.3%) in the present study. Conclusion: The pathogenic mechanism causing melasma might be heterogeneous in various ethnic groups in the population. This study approaches towards recognizing the epidemiology and etiology of melasma which in turn can provide ideas to solve the therapeutic challenges in treatment of this condition. [ABSTRACT FROM AUTHOR]

Pigmentation patterns are ubiquitous in nature. Visually striking pigmentation patterns are not only aesthetically appealing, but also crucial to pollinator interaction and plant fitness. The formation of complex floral pigmentation patterns mainly relies on the spatiotemporal expression of R2R3-MYB transcription factors and is often associated with certain floral development programs, such as floral organ identity, symmetry, which likely provide key information to initiate the patterning. For a complex pigmentation pattern to form, at least a pair of activator and inhibitor is required, despite their interaction might vary depending on the system being investigated. The regulation of pigmentation pattern involves multiple molecular mechanisms, such as transcriptional regulation, small RNA, transposon-mediated gene silencing, and methylation of gene body. Identifying these regulators can be facilitated by using single-cell and spatial transcriptomics as well as innovative plant transformation technologies. Moreover, plant organ development and pigmentation patterns are often interdependent, but current methods of describing patterns are static. Therefore, more precise and quantitative measurements are needed to elucidate the developmental mechanisms underlying complex pigmentation patterns in flowers. [ABSTRACT FROM AUTHOR]

Simple Summary: Actinic keratosis (AK) is a very prevalent precancerous condition that can progress to an invasive form of squamous cell carcinoma. Photodynamic therapy (PDT) is a relatively new therapeutic method, and it has become widely used to treat skin cancer of non-melanoma type, particularly because of its good cosmetic outcome. New noninvasive imaging techniques, such as in vivo reflectance confocal microscopy (RCM) or (video)dermoscopy, can help practitioners make a diagnosis and assess the efficacy of the ongoing treatment. Nevertheless, there are no studies with in vivo RCM assessing the effect of PDT on characteristic features of different AK subtypes. Our objective was to evaluate the prevalence of specific (video)dermoscopy and RCM features of pigmented and classical subtypes of AK before and after photodynamic therapy (PDT) treatment. New noninvasive imaging techniques such as RCM and (video)dermoscopy can help practitioners better visualize the efficacy of the ongoing PDT treatment in either classical or pigmented AKs subtypes. Actinic keratosis (AK), due to its widespread prevalence, as well as the possibility of progression to an invasive form of squamous cell carcinoma, requires treatment regardless of the clinical stage. New imaging techniques, such as in vivo reflectance confocal microscopy (RCM), significantly increase the accuracy of diagnosis and allow noninvasive evaluation of the therapeutic efficacy of the ongoing treatment. Our objective was to evaluate the prevalence of specific (video)dermoscopy and RCM features of pigmented and classical subtypes of AK before and after photodynamic therapy (PDT) treatment. We included patients with facial grade II AKs (25 pigmented, 275 non-pigmented) were included in the study. Skin lesions were evaluated by (video)dermoscopy and RCM at the baseline and three months after PDT. In classic AK, the most frequent dermoscopic findings were fine wavy vessels (96%), scale (92%), microerosions (48%), and "strawberry" pattern (36%), while pigmented AK was characterized mostly by "rhomboidal pattern" (80%), scale (60%), white globules (48%), "jelly sign", and superficial pigmentation (40%). RCM's most characteristic classic AK findings were abnormal honeycomb pattern in the spinous layer, epidermal inflammatory infiltrate, and solar elastosis that were present in 96% of lesions. Pigmented AKs presented mostly with dark central areas of parakeratosis (72%), mottled pigmentation (72%), dermal inflammatory infiltrate (64%), solar elastosis (60%), and abnormal honeycomb pattern in the spinous layer (56%). Dermoscopically, PDT resulted in complete disappearance of the "rhomboidal pattern" in both classical and pigmented AKs, "starburst pattern" and "jelly sign" in classical AKs, and inner gray halo, "rosette sign" and central crust in pigmented AKs. Three months after one PDT session, RCM evaluation showed mostly solar elastosis in both classical and pigmented AK subtypes, epidermal inflammatory infiltrate in classical AKs, and dermal inflammatory infiltrate in pigmented AKs. New noninvasive imaging techniques such as RCM and (video)dermoscopy can help practitioners better visualize the efficacy of the ongoing PDT treatment in either classical or pigmented AK subtypes. [ABSTRACT FROM AUTHOR]

Background and Design: Nevus of Ota is a hamartoma that present since birth or within the first year of life. Most patients suffer from depression, and laser has become the first-line treatment for this difficult-to-treat condition. There are hardly any studies regarding dermoscopic changes of the Nevus of Ota treated with Nd: YAG laser from Eastern India. This study aimed to evaluate the effectiveness, safety and side effects of 1064 nm Q-button Nd:YAG laser treatment together with dermoscopic changes in patients with Nevus of Ota. Materials and Methods: This was a prospective observational descriptive study conducted for a period of one year in a tertiary care hospital. We included clinically diagnosed Nevus of Ota patients aged over 18 years. Exclusion criteria were acute infection or chronic diseases, pregnancy or lactation, and history of any treatment with laser or chemo-peeling. Thirty-two cases were included in the study. Photographs and dermoscopic examinations were done at every session for an average of six sessions at an interval of four to six weeks. The response to treatment was graded based on the physician's global assessment scale, and appropriate statistical tests were done using SPSS 18. Results: Very good results with >75% improvement were seen in 12.5% of patients, and a good response i.e., 50-74% was seen in 59.37% of patients. An average response (25-49%) was seen in 18.75% of patients, while a poor response with <25% improvement was found in 9.37% of patients. After completion of laser sessions, dermoscopy was done again to compare changes, but there were no significant changes except a slight lightening of the brown-grey patchy distribution and fewer brown-grey dots. There were no changes in terminal hair, serpentine vessels, and scaling. Conclusion: Most patients noted satisfying improvement after an average of six sessions of Nd: YAG laser therapy. Studies with a greater number of sessions can be conducted, and they may yield more improvement. [ABSTRACT FROM AUTHOR]

Patient expectations in cosmetic dermatology exhibit significant variations across countries, cultures, and ethnicities, thereby reflecting individual desires, concerns, and goals. While some individuals seek aesthetic enhancements, others prioritize addressing specific skin conditions within the context of beauty norms in their respective countries. The provision of personalized and culturally sensitive care plays a crucial role in meeting these diverse expectations. Skin characteristics and concerns differ among ethnicities, influencing treatment preferences. For instance, individuals with darker skin tones may prioritize the treatment of pigmentation disorders, whereas those with lighter skin tones may focus on achieving a fair complexion. Furthermore, differences in facial anatomy among various ethnicities necessitate tailored treatment approaches. This commentary aims to contribute to the effective understanding and management of patient expectations, ultimately leading to satisfactory outcomes. Additional research and regional studies are required to further deepen our understanding of patient expectations in cosmetic dermatology and enable the delivery of improved and culturally appropriate care on a global scale. [ABSTRACT FROM AUTHOR]

Background: Reflectance confocal microscopy (RCM) has quickly transitioned from a research tool to an adjunct diagnostic bedside tool, providing the opportunity for noninvasive evaluation of skin lesions with histologic resolution. RCM is an optical imaging technique that uses near‐infrared excitation wavelengths and safe low‐power lasers. En‐face images of different skin layers (up to the superficial dermis) are acquired in grayscale based on the reflective indices of tissue components. Melanin has the highest reflective index (contrast) and appears bright on RCM. Aims: We present a review of the current literature on the use of RCM in the diagnosis and management of pigmentary disorders. Methods: We reviewed PubMed and Ovid Medline databases from January 2000 to June 2021, using MeSH key terms: "reflectance confocal microscopy, confocal laser scanning microscopy, pigmentary disorders, treatment, melasma, vitiligo, freckles, solar lentigo, lentigo, tattoo, complications, melanoma, skin cancers, pigmented lesions, post inflammatory, melanin, photoaging" to identify studies and review articles discussing the use of RCM in the diagnosis and management of pigmentary disorders. Results: RCM findings of pigmentary disorders were divided into the following categories: (1) disorders of increased pigmentation (post‐inflammatory hyperpigmentation, melasma, Riehl's melanosis, solar lentigines, ephelides, hori nevus, naevus of Ota, café‐au‐lait macules, melanocytic nevus, melanoma, nevus spilus, labial mucosal melanosis, and mucosal melanoma), (2) disorders of decreased pigmentation or depigmentation (post‐inflammatory hypopigmentation, vitiligo, nevus depigmentosus, halo nevus), and (3) exogenous pigmentation (tattoo, ochronosis). Conclusion: RCM has been explored and proven valuable for the evaluation and management of pigmentary disorders including melasma, vitiligo, solar lentigines, tattoo, and tattoo‐related complications. [ABSTRACT FROM AUTHOR]

Background. Freckles and solar lentigines are epidermal pigmentation disorders that affect the face and impact the quality of life of affected individuals. Aims. We aimed to observe and evaluate the clinical effectiveness of a 730 nm picosecond laser for the treatment of freckles and solar lentigines. Methods. We retrospectively collected patient information on freckles and solar lentigines and observed and evaluated the clinical outcome of a 730 nm picosecond laser. These included lesion clearance and recurrence rates, adverse reactions, and patient satisfaction. Results. Fifty cases of freckles and solar lentigines reported between January 1, 2022, and July 1, 2022, were included. All patients received two 730 nm picosecond laser treatments. The lesion clearance rates after one and two treatments were 53.1% and 78.4%, respectively, and the rates after one and six months of treatment were 78.7% and 78.4%, respectively. 90% of the patients reported ≥95% clearance of lesions after six months via a questionnaire survey. Among the patients, 86.0% were satisfied with their treatment. Postinflammatory hyperpigmentation occurred in two patients, both of whom had Fitzpatrick skin type IV. There was no recurrence of lesions. Conclusions. The 730 nm picosecond laser treatment for freckles and solar lentigines has the advantages of a high clearance rate, low recurrence rate, and high patient satisfaction. This trial is registered with ChiCTR2200058573. [ABSTRACT FROM AUTHOR]

Background: This study presents a case series and scoping review of oral melanoacanthoma to examine its clinical, histopathological, and immunohistochemical characteristics. Methods: Nine cases of oral melanoacanthoma were included in the case series. Clinical data were collected from biopsy charts. Hematoxylin–eosin and immunohistochemistry for TRP2, CD3, and CD20 were done. For the scoping review, MEDLINE/PubMed, Web of Science, EMBASE, and Scopus were searched. Results: Case series: The mean age was 46.8 years (female‐to‐male ratio 2:1). Lesion's mean size was 11.0 mm (±9.3). Lesions were mainly macular (77.8%) with brown or black coloration (88.9%) and often affected multiple sites (44.4%). The evolution time ranged from 15 days to 96 months. Lesions commonly showed epithelial acanthosis (66.7%), spongiosis (55.6%), exocytosis (77.8%), melanin incontinence (88.9%), and inflammatory infiltrate in the lamina propria (77.8%), from which all showed lymphocytes. TRP2‐positive melanocytes were identified in the basal and spinous layer of all cases, and in the superficial layer of three cases. CD3‐positive cells predominate over the CD20‐positive. Scoping review: 85 cases of oral melanoacanthoma were retrieved from 55 studies. Patients were primarily female (female‐to‐male ratio 2.2:1), black‐skinned (64.1%), with a mean age of 36.13 (± 17.24). Lesions were flat (81.9%), often brown (62.4%). Buccal mucosa was the preferred site (32.9%), followed by multiple sites (28.2%). Conclusion: Oral melanoacanthoma mainly affects women across a wide age range, with lesions commonly appearing as brown/black macules, particularly on the buccal mucosa. TRP2‐positive melanocytes and T‐lymphocytes were consistently found and could participate in oral melanoacanthoma pathogenesis. [ABSTRACT FROM AUTHOR]