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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]

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 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]

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]

This article discusses the prevalence and characteristics of melasma in men with skin of color, specifically focusing on Hispanic men. Melasma is a hyperpigmentation disorder that primarily affects women and individuals with skin of color. However, its impact on the quality of life of both men and women is significant. The study found that melasma in Hispanic men is underresearched, and the prevalence in men is unclear. The article provides demographic data, clinical presentation, and related factors of melasma in Hispanic men, highlighting the need for further research to enhance therapeutic and quality of life outcomes. [Extracted from the article]

Tirbanibulin is a topical agent primarily used for the treatment of actinic keratosis (AK), a precancerous skin condition. It inhibits tubulin polymerization and Src kinase signaling and has a simple administration and limited adverse events. In a case study, a 78-year-old male with AK and solar lentigos (benign pigmented lesions) on his scalp experienced complete clearance of both conditions after using tirbanibulin ointment for five consecutive days. While solar lentigos are typically treated for cosmetic purposes, tirbanibulin may be a potential therapeutic choice for patients with both AK and benign melanocytic lentigos due to its efficacy and aesthetic advantages. [Extracted from the article]

Background: Highly pigmented African skin and hair have distinct characteristics because of their unique physiology and structure. Twenty years ago, despite an increasing number of dermatology specialists in some African countries, there remained a paucity of collaborative research and workshops on African hair and skin, and there was a need for an inclusive African society to represent dermatologists from all English and French‐speaking countries in sub‐Saharan Africa. Methods: We documented significant research advances between 2000 and 2021 on African hair and skin physiology, as well as clinical dermatology, in sub‐Saharan Africa. Results: The main advances documented include the launch of annual African hair and skin workshops in 2004, the introduction of African research grants and the Africaderm web platform in 2013, and the registration of the African Society of Dermatology and Venereology (ASDV) in 2015, which led to the inaugural scientific meeting of ASDV in 2016. Conclusion: There have been significant research advances in African hair and skin over the past 20 years. As skin physiology and skin conditions are similar across sub‐Saharan Africa, scientific and clinical partnerships between companies, academia, and public health care sectors have played a key role in translating new scientific findings on African hair and skin to ensure knowledge is shared. This information has helped educate African specialists, health care workers, and consumers, with a particular focus on the preventable nature of certain dermatoses like skin bleaching‐related complications and traction alopecia. [ABSTRACT FROM AUTHOR]

Background: Partial unilateral lentiginosis (PUL) is a rare acquired circumscribed hyperpigmentation characterized by multiple simple lentigines involving half of the body. Since the previous studies of PUL were mostly based on case reports and the current literature lacks well‐designed retrospective studies that involve a large number of cases, PUL is not a well‐defined entity, and differential diagnosis with nevus spilus is still difficult. This study aims to evaluate clinical and histopathological characteristics and treatment outcomes of PUL on head and neck area of Koreans. Methods: Thirty‐two patients with PUL on head and neck area were diagnosed clinicohistopathologically at the Asan Medical Center from 2004 to 2017. Their medical records, photographs, and biopsy specimens were reviewed, and immunohistochemical staining for protein kinase C (PKC)‐βΙΙ was evaluated for melanogenic activity. Results: Four patients (12.5%) of PUL had congenital lesions, and 24 (75.0%) had age of onset younger than 10 years. Confluency of lentiginous lesions (100%) and mild to moderate background interlesional hyperpigmentation (90.6%) were observed. The lentiginous lesions showed increased melanocytes, melanophages, basal melanins, lentiginous hyperplasia, and perivascular inflammatory cells compared with background interlesional hyperpigmentation, and PKC‐βΙΙ was focally positive in 7 of 12 stained PUL lesions. Among the 16 patients who received laser treatments, 10 (62.5%) showed more than 50% of improvement. Conclusions: The findings of this study will allow for improved diagnosis of PUL and understanding of its features, which may facilitate proper management in the future. [ABSTRACT FROM AUTHOR]

Terra firma‐forme dermatosis (TFFD) is an acquired pigmentation disorder that promptly regresses after applying isopropyl alcohol 70%. The clinical presentation ranges from patches of brownish discoloration to velvety hyperkeratotic plaques. Critical analyses of current data are lacking, so etiologies, pathogenesis, and disease associations are still debated in the literature. A literature search was done in the PubMed and Google Scholar databases to identify the published papers reporting clinical cases of TFFD. Of 102 papers screened, 64 met the including criteria. Overall, the records of 256 patients presenting a mean age of 18.34 years and a female:male ratio of 1:37 were reviewed. The present article aims to provide a key point‐summary regarding the clinical outcome, associated comorbidities, pathogenesis, histopathology, dermoscopy, and therapeutic modalities of TFFD. [ABSTRACT FROM AUTHOR]

Skin diseases are considered to be common in Nyala, Sudan. This study was carried out to verify the prevalence of skin diseases in Nyala. This prospective observational study included skin examination of a total of 1802 people: 620 patients who were evaluated in the outpatient clinics (OC) and 1182 people from orphanages and refugee camps (ORC) in Nyala, Sudan. χ2 test was used. The total prevalence of skin disorders in the sample was 92.6% (1670/1802). One thousand and fifty of 1182 (88.8%) people from ORC had a skin disorder. The most common skin diseases in this community were: fungal infections (32.6%), dermatitis/eczema (10.5%), bacterial skin infections (10.3%), disorders of skin appendages (8.7%), parasitic infestations (7.7%), atrophic skin disorders (7.4%), disorders of pigmentation (7.4%), hypertrophic skin disorders (6.4%), viral infections (5.8), benign neoplasm (1.9%), dermatoses due to animal injury (0.4%), bullous dermatoses (0.1%), and malignant neoplasm (0.1%). Hypertrophic and atrophic disorders of the skin were mainly lesions of scarification (mostly atrophic) (5.7%) and keloids (5.6%). Fungal infection, bacterial infection, and parasitic infestation were more common in the ORC group, while dermatitis and eczema, disorders of skin appendages, hypertrophic and atrophic disorders of the skin, disorders of pigmentation, and benign neoplasm were more common in the OC group. The prevalence of skin diseases in the rural Nyala was more than our expectation and was dominated by infectious skin diseases. In addition, infectious skin diseases were more common in ORC rather than OC. [ABSTRACT FROM AUTHOR]

Background: Vitiligo is an acquired pigmentation disorder characterized by melanocyte loss via autoimmune mechanisms triggered by oxidative stress. Gene polymorphisms in antioxidant enzymes and immunomodulators such as catalase (CAT) and vitamin D receptor (VDR), respectively, have been linked to vitiligo in European and Asian populations. Our aim was to evaluate the role of CAT and VDR gene polymorphisms as well as CAT and vitamin D in nonsegmental vitiligo in Northwestern Mexicans. Methods: A total of 357 subjects, 173 nonsegmental vitiligo patients and 184 age‐gender matched healthy controls, were genotyped by PCR‐restriction fragment length polymorphism. CAT activity was determined in 39 patients and in 39 controls and vitamin D (VitD) levels in 35 individuals per group. Results: CAT 419 C/T gene polymorphism was not informative, ‐89 A/T was associated with risk (P = 0.02), and 389 C/T conferred protection against vitiligo along with AT haplotype (P < 0.01 in both cases). VDR BsmI, ApaI, and TaqI gene polymorphisms were not associated with vitiligo, but BsmI was more prevalent in patients with Koebner phenomenon (P = 0.02). Serum CAT activity and VitD levels were lower in patients than in controls, but they showed no association with any vitiligo clinical characteristics neither with their gene polymorphisms. Conclusions: Our results suggest a role for CAT gene polymorphisms in vitiligo susceptibility in the Mexican population and a lack of association with VDR gene polymorphisms. [ABSTRACT FROM AUTHOR]

Objective: This systematic review provides a comprehensive analysis of the efficacy of autologous cell transplant as a therapeutic approach for stable segmental vitiligo. Vitiligo poses significant challenges for healthcare professionals in terms of treatment selection. Autologous cell transplant has emerged as a promising modality for managing vitiligo, with cultured and noncultured transplants being considered when determining the patient's treatment approach. There is little knowledge and literature on the subject, so we analyze the different studies., Method: Using online medical literature databases and the PRISMA guidelines, six out of 60 articles met the acceptance criteria to be analyzed, emphasizing the lack of current literature on this subject., Results: Autologous cell transplant achieves excellent pigmentation rates for many body parts. We found that cultivated cells had better results than noncultivated ones. Both types of treatments could pigment 80% or more where needed., Conclusion: This review highlights the importance of autologous cell transplant as a new and reliable tool for the treatment of stable segmental vitiligo, cultured transplants being the most effective. By employing autologous cell transplant, the repigmentation rate is notably high and consistently achievable. Although its cost and logistical complexities hinder the current accessibility to this therapy, efforts are being made to enhance its availability, and its scope is expected to expand further. More studies are needed to understand this therapy method in other kinds of vitiligo., (© 2023 the International Society of Dermatology.)

Abstract: Background: Pigmented lesions on the lips can be caused by physiological or pathological factors, along with exogenous or endogenous factors. Many patients with atopic dermatitis (AD) and labial pigmentation are seen in clinical practice. The aim of our study was to further explore the association of labial pigmentation and AD. Methods: We performed a retrospective chart review of patients who visited the Department of Dermatology at Kyung Hee Medical Center, Seoul, Korea, from January 1 to December 31, 2016. The study consisted of 178 patients with AD and a control group of 178 age‐ and sex‐matched patients without AD. Results: The patients with AD had both a significantly higher prevalence of labial pigmented lesions and a significantly higher number of labial pigmented lesions than was observed in the control group. Moreover, the pigmented lesions were found mainly in the middle section of the upper lip and showed multifocal distribution. The patients with AD and labial pigmentation were significantly younger at the onset of AD, showed a greater association with allergic disorder, and had a higher immunoglobulin E (IgE) level than patients without labial pigmentation. Conclusion: Our findings strongly suggest that labial pigmentation occurs in patients with AD. Although labial pigmentation was not present in all patients with AD, this might be a particularly helpful diagnostic feature of AD in Asian patients. [ABSTRACT FROM AUTHOR]

Abstract: Background: Patients with vitiligo present with different repigmentation patterns in the early recovery stage. Objectives: To analyze the relationships between early repigmentation patterns in vitiliginous patches, their clinical characteristics, and therapeutic choices. Methods: Patients with vitiligo seen in the Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University from 2010 to 2015, were included, and their clinical records, especially photographs and medical treatments, were reviewed. Results: One hundred and sixteen patients were included in this study, and 326 lesions with different degrees of depigmentation, locations, stages, distributions, therapies, and repigmentation patterns were included and analyzed. Perifollicular repigmentation occurred more frequently in lesions with complete depigmentation (P = 0.005), in non‐sun exposed areas (P < 0.001), a stable stage (P = 0.008), and lesions treated with narrow band ultraviolet B (NB‐UVB) (P < 0.001, despite lesion distributions). Marginal repigmentation is more frequent in lesions with complete depigmentation (P = 0.016), lesions treated without NB‐UVB (P = 0.002), and facial lesions treated with topical vitamin D analogs (TVDAs) monotherapy (P = 0.022). Diffuse repigmentation is the predominant pattern in lesions with incomplete depigmentation (P < 0.001), in sun‐exposed areas (P < 0.001), progressive stage (P = 0.044), and truncal lesions treated with TVDAs (P < 0.001). Conclusions: The different repigmentation patterns of vitiligo lesions depend on the different source and status of melanocytes and their abilities to produce melanin on the choice of therapy. [ABSTRACT FROM AUTHOR]

Background Although pityriasis versicolor ( PV) is a common fungal infection of the skin affecting up to 50% of the population in the tropics, little is known about what patients know, believe, or feel about the condition. Methods In a cross-sectional questionnaire study of 608 consecutive patients attending the General Outpatient Department and Skin Clinic of a public hospital in Kaduna, Nigeria, self-report of PV, knowledge about its causes, treatments used by patients, and perception and feelings about the condition were assessed. Results Overall 608 patients were studied (239/594 [40.2%] males, 355/594 [59.8%] females, age 11-49 years, mean ± SD age of 29.3 ± 10.1). Lifetime self-report prevalence of PV was 271/606 (44.7%) (males: 117/239 [50.0%] females: 148/355 [41.7%] P = 0.09). Three hundred and twenty-seven of 608 (53.8%) patients believed PV was transmitted from another person while 204/608 (33.6%) believed the condition was caused by poor personal hygiene. One hundred and thirty of 608 (21.4%) thought PV was caused by fungi living on the skin. Virtually all respondents who had PV had used at least one preparation with more than half visiting a healthcare facility. A total of 305/608 (50.2%), 189/608 (31.1%), and 142/608 (23.4%) respondents reported feeling or likely feeling uncomfortable, embarrassed, or ashamed, respectively, about PV. Being considered a dirty person (45.6%) and being avoided by other people (28%) were common concerns of respondents. Conclusion Most patients did not know what caused PV, and many were uncomfortable, embarrassed, and ashamed, and feared being considered dirty and avoided by others. [ABSTRACT FROM AUTHOR]

Currently available treatment options for melasma include prevention of UV radiation, topical lightening agents, chemical peels, and light-based and laser therapies. However, none have shown effective and sustained results, with incomplete clearance and frequent recurrences. There has been increasing interest recently in oral medications and dietary supplements in improving melasma. We sought to evaluate the efficacy and safety/tolerability of oral medications and dietary supplements for the treatment of melasma. Multiple databases were systematically searched for randomized clinical trials ( RCTs) evaluating the use of oral medication for treatment of melasma alone or in combination with other treatments. A total of eight RCTs met inclusion criteria. Oral medications and dietary supplements evaluated include tranexamic acid, Polypodium leucotomos extract, beta-carotenoid, melatonin, and procyanidin. These agents appear to have a beneficial effect on melasma improvement. In conclusion, oral medications have a role in melasma treatment and have been shown to be efficacious and tolerable with a minimal number and severity of adverse events. Therefore, dermatologists should keep oral medications and dietary supplements in their armamentarium for the treatment of melasma. [ABSTRACT FROM AUTHOR]

Background The Section of Dermatology of the University of the Philippines, Philippine General Hospital, reported a case of chronic arsenic poisoning from a community in Luzon island to the Department of Health resulting in the conduct of two health and environmental assessment missions in December 2014. Objective To describe the demographic profile and cutaneous manifestations of chronic arsenic poisoning among affected residents in Luzon, Philippines. Methods A review of the medical records of 116 residents screened during the health assessment missions in December 2014 was conducted. Results Among the 116 residents screened, 81 (70%) had clinically confirmed arsenic keratoses and hyperpigmentation. Among them, 52 were males and 29 were females with age range of 4-82 years. Two cases of squamous cell carcinoma in situ were detected through skin biopsy. High levels of arsenic in the tap water and topsoil supported the occurrence of an epidemic of chronic arsenic poisoning. Conclusion Specific dermatologic findings of arsenic keratoses and pigmentation were common among the residents screened. Significantly higher occurrence of arsenic keratoses was seen in adults. [ABSTRACT FROM AUTHOR]

In patients with vitiligo, the clinical and laboratory features of the disease may vary according to time of onset. This is addressed in the literature by only a few studies with conflicting results. The aim of this study was to determine the demographic and clinical features of patients with non-segmental vitiligo and to establish the association between vitiligo and autoimmune diseases with a focus on time of disease onset. A total of 224 vitiligo patients for whom complete medical records were available were evaluated retrospectively. Demographic data, scores on the Vitiligo Area Score Index ( VASI), clinical features, vitiligo disease activity, repigmentation status, presence of any accompanying autoimmune disease, antinuclear antibody ( ANA) titers, serum levels of glucose, thyroid-stimulating hormone ( TSH), thyroxine (T4) hormone, anti-thyroid peroxidase (anti- TPO), and anti-thyroglobulin (anti- TG) were recorded. The prevalence of halo nevi was significantly higher ( P < 0.001) among children than in other patient groups. The prevalence of leukotrichia was higher in adults with adult-onset disease than in either pediatric patients or adults with childhood-onset disease ( P = 0.002). Both anti- TG and anti- TPO levels were significantly higher in adults with adult-onset disease than in pediatric patients and adult patients with childhood-onset disease. The prevalence of autoimmune disease was 22.2%. Anti- TG levels were significantly higher in patients with treatment-related repigmentation than in those without repigmentation. This study shows that clinical features and associations with autoimmune disease may vary according to the age of onset of vitiligo. [ABSTRACT FROM AUTHOR]

Background Vitiligo is unsightly on darkly pigmented skin and leads important stigmatization because of the mix-up with leprosy. Patients and methods We analyzed retrospectively the epidemiological and clinical patterns of vitiligo on darkly pigmented skin between 1988 and 2008 in the Department of Dermatology in Cotonou (Benin). The diagnosis was made based on the clinical characteristics of vitiligo. Results Two hundred and forty-six patients were seen, representing 0.9% of new consultations. The gender ratio was 1 : 1, and the mean age of patients was 25.9 years. The mean duration of the lesions was 30.9 months. Among the 246 patients, an associated pathology was found in 26% of cases. These included atopy (23.2%), diabetes (1.6%), thyroid disease (0.8%), and alopecia (0.4%). A family history of vitiligo was present in 1.2% of cases. The sites of the lesions were in descending order of frequency: head (60.6%), lower limbs (40.2%), upper limbs (33.3%), trunk (22.4%), genitals (13.0%), and neck (8.9%). On the head, the most common sites affected were the lips (65.1%), cheek (20.8%), and ears (16.8%). According to the different clinical forms, vitiligo was achromic (76%), speckled (12.6%), and trichromic (11.4%). Vitiligo vulgaris was the commonest form of the disease (52.4%), followed by localized vitiligo (36.2%), segmental vitiligo (9.8%), and vitiligo universalis (1.6%). Triggering factors were identified in 4.5% of patients. Conclusion Our survey shows that the patterns of vitiligo are similar to that reported from other African countries with a few distinguishing particularities. [ABSTRACT FROM AUTHOR]

Background Vitiligo is an autoimmune depigmentation disorder. Polymorphisms in the vitamin D receptor ( VDR) have been found to be associated with vitiligo. Objectives To evaluate the potential association between VDR gene polymorphisms ( ApaI, TaqI, and FokI) and vitiligo susceptibility, and to detect if there is correlation between serum 25-hydroxyvitamin D [25( OH)D] levels and vitiligo and between VDR gene polymorphisms and 25( OH)D levels in vitiligo. Materials and methods Seventy-five patients with vitiligo and 75 age and sex-matched controls were subjected to detailed history taking and dermatological examination to determine the extent and clinical type of vitiligo. A blood sample (5 ml) was retrieved to investigate VDR gene polymorphisms and serum 25( OH)D level. Results Our results showed that the serum level of vitamin D is statistically significantly lower in patients than controls. The frequency of the ApaI variant a allele, the variant genotype (aa), and the variant genotype (tt) were significantly higher among the vitiligo cases than among controls. Our study also showed that the serum 25( OH)D levels were not significantly different among the different ApaI, TaqI, and FokI genotypes. Conclusion The present study showed that serum level of 25( OH)D is statistically significantly lower in patients than controls, so screening for vitamin D deficiency seems of value in patients with vitiligo for the possibility of vitamin D supplementation. We also report that VDR gene polymorphisms may be a risk for the development of vitiligo in an Egyptian population. [ABSTRACT FROM AUTHOR]

Background To examine the relative prevalence, types, and clinical features of pigmented lesions of the oral mucosa in 1275 patients attending a university hospital for dental care. Methods Patients attending dental clinics at The University of Jordan Hospital over a 1-year period were examined for the presence of oral pigmentations. Histopathological examination was performed on focally pigmented lesions with a suspicious or uncertain clinical diagnosis. Results A total of 386 (30.2%) patients were found to have oral pigmentations. Of these, racial pigmentation (39.9%) and smokers' melanosis (32.9%) were the most common causes of oral pigmentations. Other causes included amalgam tattoo (18.9%), focal melanotic macules (5.7%), postinflammatory pigmentation (1.6%), pigmentation due to medications or systemic disease (0.52%), heavy metal deposits (0.26%), and oral nevus (0.26%). Gingivae and buccal mucosae were the most common sites for oral pigmentations. Conclusion Pigmentations of the oral mucosa are common. Gingivae and buccal mucosae are the most common sites for oral pigmentations. Proper history and recognition of clinical features are important for effective management. [ABSTRACT FROM AUTHOR]

To evaluate the effects of segmental vitiligo (SV) on nerve conduction velocity (NCV) in different nerves, we compared the patient's lesional side of their body to the contralateral normal side. The 106 participants were selected from outpatients visiting the dermatological clinics of Huashan Hospital, Fudan University, from November 2011 to March 2014. NCVs were measured on the limbs and the face, including both motor and sensory nerves. The parameters for NCVs included motor nerve conduction velocity ( MCV) and its distal conduction latency, sensory nerve conduction velocity, sensory nerve action potentials amplitude, and compound muscle action potential amplitude. MCV on the limbs was compromised by SV state, which was significantly slower on the lesional side of the body compared with the normal contralateral side ( P = 0.006). Furthermore, SV at the stable stage significantly impaired MCV compared with the SV at progressive stage. There was no significant difference in the other parameters of NCV between lesional and normal sides of the body. Compound muscle action potentials in the face did not differ between lesional and healthy sides. Motor nerves in the limbs were compromised by SV, particularly when the disease was at the stable stage. [ABSTRACT FROM AUTHOR]

The article presents the case study of the 72-year-old male patient who had maculopapular pruritic eruption that leaves reticular hyperpigmentation in his skin. The topics discussed include his medical history of recurring maculopapular and itchy eruption, the results of physical and histopahtological examinations, and the medication given to treat the disease.

The article presents a case study of a 31-year-old female patient with history of intravenous heroin drug use and developed linear hyperpigmented streaks on the bilateral forearms. Discussion about the histopathology of heroin linear track hyperpigmentation and treatment with Q-switched Nd:YAG 1064nm laser is offered.

The article describes the case of a 3-year-old female child with xeroderma pigmentosum (XP). He developed photophobia and had an increased pigmentation on the face, arms and eyes with an absence of eyelashes. The article also discussed XP as an autosomal recessive disorder and how prenatal diagnosis was performed from cultured amniotic fluid cells.

Background Total body photography may aid in melanoma screening but is not widely applied due to time and cost. We hypothesized that a near-simultaneous automated skin photo-acquisition system would be acceptable to patients and could rapidly obtain total body images that enable visualization of pigmented skin lesions. Methods From February to May 2009, a study of 20 volunteers was performed at the University of Virginia to test a prototype 16-camera imaging booth built by the research team and to guide development of special purpose software. For each participant, images were obtained before and after marking 10 lesions (five 'easy' and five 'difficult'), and images were evaluated to estimate visualization rates. Imaging logistical challenges were scored by the operator, and participant opinion was assessed by questionnaire. Results Average time for image capture was three minutes (range 2-5). All 55 'easy' lesions were visualized (sensitivity 100%, 90% CI 95-100%), and 54/55 'difficult' lesions were visualized (sensitivity 98%, 90% CI 92-100%). Operators and patients graded the imaging process favorably, with challenges identified regarding lighting and positioning. Conclusions Rapid-acquisition automated skin photography is feasible with a low-cost system, with excellent lesion visualization and participant acceptance. These data provide a basis for employing this method in clinical melanoma screening. [ABSTRACT FROM AUTHOR]

Background In recent years, the following four patterns have been defined in intraoperative dermoscopy of the nail matrix and bed in longitudinal melanonychia ( LM): (i) a regular gray pattern; (ii) a regular brown pattern; (iii) a regular brown pattern with globules or blotches; and (iv) an irregular pattern. Histopathological findings in these patterns are, respectively: (i) melanocyte activation; (ii) mostly melanocytic hyperplasia (melanocytic activation and melanoma can also be seen); (iii) only melanocytic nevi; and (iv) only melanoma. Objective This study was conducted to compare these patterns with intraoperative dermoscopic findings in another series of five patients with LM. Methods Nail plate dermoscopy, intraoperative nail matrix and bed dermoscopy, and histopathological examinations in five patients with LM were retrospectively reviewed. Results Intraoperative dermoscopy of the nail bed and matrix in patients in whom nail plate dermoscopy demonstrated regular brown lines showed a regular brown pattern with globules in two cases, only globules in one case, and a regular gray pattern in one case. An irregular pattern with globules and blotches was observed in one patient who exhibited irregular brown lines in nail plate dermoscopy. Histopathological examinations showed only hypermelanosis in one case with a regular gray pattern, hypermelanosis and melanophages in cases with a regular brown pattern with globules, blue nevus in one case with an irregular brown pattern with globules and blotches, and only melanophages in one case with globules only. Conclusions Histopathological findings that differ from the patterns previously reported were found. An irregular pattern may also be seen in benign melanocytic nevi such as subungual blue nevus. A globular pattern may be defined as a new pattern corresponding to melanophages only. Additional dermoscopic and histopathological images should be shared to facilitate the development of further understanding and the standardization of the intraoperative dermoscopy of LM. [ABSTRACT FROM AUTHOR]

Background The contribution of tumor necrosis factor- α ( TNF- α)-308 G/A gene polymorphism (rs1800629) to risk for vitiligo is subject to controversy. Objectives The fundamental purpose of the present meta-analysis was to investigate large-scale evidence to determine the overall association between TNF- α-308 G/A polymorphism and susceptibility to vitiligo. Methods A literature search of the PubMed, EMBASE, Web of Science, and China National Knowledge Infrastructure ( CNKI) databases was conducted to identify all studies referring to an association between TNF- α-308 G/A polymorphism and vitiligo published to June 1, 2014. The principal outcome measure for evaluating the strength of the association was the crude odds ratio ( OR) along with the corresponding 95% confidence interval ( CI). Data were extracted, and statistical analyses were implemented using stata Version 12.0. Results Data for a total of 1505 vitiligo cases and 2253 controls from five case-control studies concentrating on the association between TNF- α-308 G/A polymorphism and vitiligo were included in this meta-analysis. Combined analysis revealed there to be no association between this polymorphism and susceptibility to vitiligo in five genetic models under random-effects models. A subgroup analysis by clinical type also demonstrated the absence of any association between TNF- α-308 G/A polymorphism and generalized vitiligo. However, a significant association was detected in the miscellaneous subgroup under the dominant model (fixed-effects model: OR 5.69, 95% CI 4.70-6.88; P = 0.000) and overdominant model (random-effects model: OR 5.24, 95% CI 2.26-12.17; P = 0.000). Conclusions This meta-analysis indicates that TNF- α-308 G/A polymorphism is not a genetic risk factor for vitiligo. [ABSTRACT FROM AUTHOR]

Background Bullous dermolysis of the newborn (BDN), an extremely rare clinical type of dystrophic epidermolysis bullosa (DEB), is characterized by subepidermal blistering at birth or shortly thereafter, followed by rapid improvement with minimal scarring or pigmentation. A total of 38 cases have been reported in the literature since the disease was initially described in 1985, but only 14 mutations in COL7A1, the gene responsible for the disease, have been detected in families with BDN. Objectives We report a Chinese male infant with BDN and indirect inguinal hernia, in whom a novel de novo mutation in COL7A1 was demonstrated. Methods DNA was obtained from the blood of the patient and his parents. The coding exon and flanking regions of COL7A1 gene were amplified by polymerase chain reaction and subjected to sequence analysis. Results Sequencing showed a heterozygous substitution of guanine by adenine at nucleotide position 6136 of exon 73 in the triple helical domain of type VII collagen, which predicts a change of glycine by serine at position p.G2046S. The mutation was considered to be a pathogenic and de novo mutation. Conclusions The coexistence of BDN and indirect inguinal hernia may simply be coincidental. These data contribute to the expanding database of COL7A1 mutations in DEB and should be useful for genetic counseling and prenatal diagnosis in affected families. [ABSTRACT FROM AUTHOR]

Background Reactive oxygen species are known to mediate skin photoaging, which results in the formation of pigmented spots and wrinkles. Coffee is the largest source of polyphenols, which supplies a large number of antioxidants in one's daily life. However, little is known about how much coffee and polyphenol consumption influences skin health. In this study, a cross-sectional survey of the diet, environmental factors, and skin conditions was conducted in healthy Japanese females to explore the influence of coffee and polyphenol consumption on skin conditions. Materials and methods Non-smoking, healthy female subjects with moderate sun exposure in their daily lives were recruited for this study ( n = 131, age range: 30-60 years old) and recorded their food and beverage intake and life circumstances using questionnaires. The skin water content, transepidermal water loss, and elasticity were measured on the cheek of each subject using non-invasive methods: a Corneometer, a Tewameter, and a Cutometer, respectively. Wrinkles and pigmented spots were evaluated using digital photograph images. Results Consumption of coffee and total polyphenols from all sources and from coffee showed a statistically significant correlation towards a decrease in pigmented spot scores ( P < 0.05). Subjects with high total polyphenol consumption from coffee or chlorogenic acids (the third tertile group) showed the lowest score of ultraviolet pigmented spots ( P < 0.05). Conclusion Coffee and polyphenol consumption was associated with low facial pigmented spots in Japanese middle-aged females. We speculated that coffee helps protect human skin from photoaging, and polyphenols, including chlorogenic acids, may contribute to the decreased hyperpigmentation of pigmented spots. [ABSTRACT FROM AUTHOR]

Background Melasma is a common pigmentary disorder that remains resistant to available therapies. Objectives The aim of the present study was to evaluate the efficacy of erbium: YAG lasers in the treatment of refractory melasma and investigate the histopathological and ultrastructural changes between melasma skin and adjacent control skin before and after surgery. Methods Fifteen Egyptian female patients with melasma unresponsive to previous therapy of bleaching creams and chemical peels were included in this study. Full-face skin resurfacing using an erbium: YAG laser was performed. Clinical parameters included physician and patient assessment, and melasma area and severity index score were done. Adverse effects after laser resurfacing were recorded. Biopsies of lesions and adjacent healthy skin were stained using hematoxylin-eosin, immunohistochemically marked for Melan- A, and evaluated by electron microscopy. Results The amount of melanin, staining intensity, and number of epidermal melanocytes are increased in melasma lesions as compared to normal skin. Electron microscopic analysis revealed an increased number of mature melanosomes in keratinocytes and melanocytes, with more marked cytoplasmic organelles in melasma skin than in biopsy specimens from normal skin, suggesting increased cell activity. After surgery, the number of melanocytes and concentration of melanin decreased in melasma skin, and the mean melasma area and severity index score decreased dramatically. Conclusions Erbium: YAG laser resurfacing effectively improves melasma; however, the almost universal appearance of transient postinflammatory hyperpigmentation necessitates prompt and persistent intervention. [ABSTRACT FROM AUTHOR]

Introduction Vitiligo is a skin disorder characterized by achromic macules (white) on the skin and/or mucous membranes, which affects 0.5-2% of the population. Few publications address a vitiligo epidemiological profile worldwide. In Brazil there are only studies in children. Objective To assess the clinical and epidemiological profile of individuals affected by vitiligo and to evaluate behavior of the disease in different age groups. Materials and methods We conducted a retrospective cross-sectional study in 669 patients with vitiligo from January 2001 to May 2006, who attended the Faculty of Medicine of ABC, located in the metropolitan region of São Paulo, Brazil. Results There was a predominance of females (62.2%) and adult age group (62.5%), with higher prevalence peaks between the second and third decades of life (18.3% and 16.9%, respectively). The most frequent phototype in skin was III (49.9%). Lesions began on the face most commonly in children and adolescents (32.6%) and the elderly (23.3%), and on hands in adults (24.0%). There was a higher prevalence of segmental vitiligo in children and adolescents (36.4%), compared with adults (11.3%) and the elderly (6.7%), and vitiligo with stable evolution was proportionately more frequent in childhood and adolescents (46.2%) than in adults (32.5%) and elderly (36.7%). Conclusions Our findings are similar to other countries, mainly regarding the higher prevalence of segmental vitiligo and vitiligo with stable development among children and adolescents. [ABSTRACT FROM AUTHOR]

Background For longitudinal melanonychia, clinical and dermoscopic criteria for differentiating malignant melanoma in situ from benign nevus/lentigo/functional melanonychia have not been fully established. Objective To propose a clinical classification of longitudinal melanonychia that is useful in judging the need for follow-up. Methods A total of 137 patients with longitudinal melanonychia referred to our outpatient clinic in the most recent eight years were included. The mean and median lengths of follow-up for patients were 5.0 and 5.5 years, respectively. We classified the 137 lesions into three types by clinical and dermoscopic features of the nail and periungual skin, including Hutchinson sign, variation of color, and borders in the pigmentation band. We observed type I and II lesions with dermoscopy every six months and three months, respectively. Results After follow-up, all 72 lesions classified as type I were thought to be benign nevus/lentigo/functional melanonychia. Five of the 52 lesions classified as type II showed enlargement during follow-up, and biopsy was performed. Of these five lesions, three were diagnosed as nevus/lentigo, and the other two were diagnosed as malignant melanoma in situ. All 13 lesions classified as type III were diagnosed as malignant melanoma in situ. Conclusion We can expect a type I lesion to be a benign nevus/lentigo/functional melanonychia and a type III lesion to be a malignant melanoma in situ; however, type II lesions fall in a gray zone. We believe this classification is useful in deciding treatment and follow-up. [ABSTRACT FROM AUTHOR]

The article describes the case of a 25-year-old man who presented with asymptomatic pigmented macules. Symmetrically distributed reticulated, hyper- and hypopigmented macules over the patient's whole body were revealed by cutaneous examination. The patient was diagnosed with dyschromatosis universalis hereditaria (DUH) associated with oral keukokeratosis.

Background Dark eye circle ( DEC) is a common problem that usually lacks detailed classification in the etiology and structural variations. A newly-developed DEC Assessment Score using Wood's lamp and ultrasonogram will provide a more precise evaluation of DEC for improving treatment results. Materials and methods Sixty-five cases, including eight males and 57 females with a mean age of 38.9 years, were enrolled. DEC were classified into pigmented (brown), vascular (blue to purple), structural, and mixed type by Wood's lamp and ultrasonogram. A scoring system with nine parameters, including brown hue, pigmented lesions, blue/pink/purple hue, periorbital puffiness, shadow hue, infraorbital palpebral bags, infraorbital grooves, blepharoptosis, and skin type, was used for clinical evaluation. Results Pigmented, vascular, structural, and mixed types of DEC represented 5%, 14%, 3%, and 78%, respectively. Thirty-three cases with periorbital puffiness were found to have higher 'pre-septal thickness' than those of 20 controlled cases ( P = 0.032). Fourteen patients with infraorbital palpebral bags were proved to have protruded retroseptal fat pads by ultrasonography. Conclusion Pigmentation and vascular and structural components may play important roles in DEC. Detailed classification of DEC types will access physicians in the decision of appropriate therapeutic modalities. [ABSTRACT FROM AUTHOR]

Vitiligo and atopic dermatitis (AD) are two major cutaneous diseases that affect quality of life (QoL) by causing functional and psychosocial disorders. Our objective was to calculate Children's Dermatology Life Quality Index (CDLQI) scores in children with vitiligo and to compare these values with those in AD patients and healthy control subjects. The CDLQI was completed for 50 vitiligo and 50 AD patients presenting at the dermatology polyclinic, as well as for 50 age- and sex-matched healthy controls. All subgroups in the vitiligo patient group had significantly higher total CDLQI scores than healthy controls. Vitiligo patients were found to have increased scores on all parameters, except itch, clothes/shoes, and sleep, compared with the AD patient group. Scores on itch and sleep were significantly higher in the AD group than in the vitiligo patients. Quality of life in children with vitiligo is substantially lower than in children with AD. This decline in QoL is critical in the psychosocial development of the former group. [ABSTRACT FROM AUTHOR]

The article presents a 14-year-old boy with disfiguring, slowly enlarging cutaneous lesions on the face of six years' duration. Examination showed a large, hyperpigmented lichenified plaque on the right cheek which extended to the infraorbital fold and down to the mandible. It indicates that the patient was diagnosed with phaeohyphomycosis caused by Exophiala jeanselmei.

Introduction Vitiligo is an acquired progressive disorder characterized by destruction of melanocytes in the lesion and the lesional hair follicles. A number of new therapeutic options for vitiligo have become available over the last decade or so both on the medical as well as surgical side. One among them is the smashed skin grafting or simply smash grafting, which is a modification of split-thickness grafting. In this method, the graft undergoes 'smashing' before being applied to the recipient site. Though a simple and effective procedure, very few people are doing the procedure either due to lack of awareness or due to lack of published data. Materials and methods Smash skin grafting was performed in 26 patients with vitiligo in Mahatma Gandhi Institute of Medical Sciences, Sewagram, Maharashtra, India. Results Smashed skin grafting helped to achieve more than 90% repigmentation of the vitiligo patches in our patients. Conclusions Smashed skin grafting is a simple procedure with fewer side effects, better outcome, and high patient satisfaction or, in simple words, it can be considered as an alternative to various conventional surgical modalities like punch grafting and melanocyte cell culture methods. This article deals with the steps of the procedure, results of the surgery in a small group of patients, and the necessity of increasing the awareness of smash grafting. [ABSTRACT FROM AUTHOR]

Background Vitiligo is an acquired, idiopathic, and worldwide common depigmentation disorder with an estimated prevalence from 0.1 to 8%. These numbers are based on clinical population studies and field research examining inhabitants of geographically enclosed areas. Our aim was to collect all available data on the prevalence of vitiligo in the general population, paying particular attention to children/adolescent groups and adults. Materials and methods Screening of available literature and online databases using several key words. Results We found more than 50 studies that used several methods and subgroups of the general population. The prevalence of vitiligo ranges from 0.06 to 2.28%, whereas this was 0.0-2.16% in children/adolescents populations. Conclusions The often cited prevalence of 8% could not be confirmed after excluding clinical patient populations. Accordingly, the worldwide prevalence of vitiligo ranges between 0.5 and 2%. [ABSTRACT FROM AUTHOR]

Hyperpigmentation of the lips is a common condition. It is associated with a wide variety of conditions that include physiologic changes, genodermatoses, inflammatory diseases, endocrinologic disorders, drugs and chemicals, benign and malignant neoplasm, and other non-melanotic conditions. The aim of this article is to provide a clinical approach to hyperpigmented lesions on the lips based on the extent of lesions, the age of onset, and associated systemic involvements. In this review, we present an algorithm to guide the diagnosis of and plan for therapeutic intervention for pigmented lesions of the lips. The algorithm is based on the typical clinical presentation of each entity and should not be taken as an absolute indicator of diagnosis. Although the differences in color can help to differentiate among pigmented lesions, the interpretation of color can be subjective and is influenced by the amount and location of the pigment within the mucosa. The limitations of this review are that some data are based on case reports and small case series that may not reflect true association. [ABSTRACT FROM AUTHOR]

Eyelash trichomegaly is defined as eyelashes which are found to be of increased length, thickness, and pigmentation. This unique finding can be present at birth as part of a variety of congenital syndromes or as a benign familial trait. There are also acquired conditions and drugs that are known to cause these changes. Case reports and clinical studies in the medical literature concerning eyelash trichomegaly were investigated and summarized to compile a comprehensive review of the etiology of eyelash trichomegaly. Previously published reviews and studies that report on the finding of increased generalized hair growth and which do not specifically mention eyelashes were not included. Trichomegaly of the eyelashes may occur as a key feature among rare congenital syndromes, develop in association with certain acquired diseases, or present as an intended or treatment-related adverse drug effect. Eyelash trichomegaly may be present from birth or manifest later in life in association with acquired diseases or drug therapy. The relevance of this finding may be benign, however eyelash trichomegaly in some individuals can be a symptom for immune dysfunction or a clinical measure of response to drug therapy. [ABSTRACT FROM AUTHOR]

Background Progressive cribriform and zosteriform hyperpigmentation (PCZH) is a disorder of pigmentation. Although several cases of PCZH have been reported, no clinicopathologic studies of the condition have been published in the English-language literature. Objectives The purpose of this study was to determine the clinical characteristics and histologic findings of PCZH. Methods Between 1999 and 2009, 30 patients were diagnosed with PCZH in our Department of Dermatology. Medical records, clinical photographs, and pathologic findings for each patient were retrospectively reviewed. Results The patients included 16 men and 14 women. The mean age at onset was 14.27 years. The trunk was the most common site of involvement. Microscopic examination showed an increased level of melanin pigment in the basal cell layer compared with adjacent normal skin, although no significant difference existed in the number of melanocytes. Pigmentary incontinence was observed in 13 of 30 cases. Conclusions There was no significant difference in prevalence, age at onset, and duration of lesions between male and female patients with PCZH. The lesions corresponded to the lines of Blaschko and were localized rather than exhibiting diffuse patterns. A common feature of the histopathologic findings was higher melanin content in the lesions than in normal skin but with no significant difference in the number of melanocytes. [ABSTRACT FROM AUTHOR]

Background Prurigo pigmentosa (PP) is an inflammatory dermatosis characterized by recurrent pruritic erythematous papules, mainly located on the trunk. It was first described by Nagashima in 1971 in Japan. Since then, more than 300 cases have been reported in Japan, but reports from other parts of the world are quite rare. Materials and methods We studied clinical and histopathological data from six patients with PP diagnosed in our hospital and 43 patients (18 reports) who were diagnosed with PP in Korea between 1988 and 2008. Results The number of Korean patients reported in recent years is higher than the number of other non-Japanese patients reported. Clinicopathological characteristics in Korean patients were not significantly different from those previously reported. Therapeutic results with minocycline were successful in our patients. Conclusions We suspect that PP is not uncommon in Korea, and the disease may be underestimated. Strict restriction of diet as well as known associated factors like wet condition are suggested as one of the important factors contributing to the occurrence of PP in Korea. [ABSTRACT FROM AUTHOR]

Hyperpigmentation disorders are common and diverse conditions that may require treatment for medical and/or cosmetic reasons. Hyperpigmented lesions can reduce patients' quality of life, self-perception, and social and vocational functioning. The most commonly used treatments for hyperpigmentation include topical agents, such as hydroquinone, retinoids and azelaic acid. Current topical treatments have significant limitations; they often do not produce adequate results and may be limited by adverse effects, such as dermatitis. Soy and soy-based products have demonstrated a wide range of potential benefits for health and nutrition, including a range of dermatological effects. Research from the last decade has identified multiple mechanisms by which soy-derived products may affect skin pigmentation, as well as photodamage and photoaging, overall skin health, and even the risk for and progression of skin cancer. Preclinical evidence has demonstrated that soy-derived serine protease inhibitors affect skin pigmentation by inhibiting protease-activated receptor-2-mediated phagocytosis of melanosomes by keratinocytes. Soy-based products containing these serine protease inhibitors may represent a new therapeutic option for dermatological treatment. Indeed, recent evidence from randomized clinical studies supports the safe and effective use of soy products for the treatment of hyperpigmentation. [ABSTRACT FROM AUTHOR]