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Serpentine supravenous hyperpigmentation (SSH) describes increased skin pigmentation that develops in the area immediately overlying the vessels through which chemotherapeutic drugs are administered. While SSH can be cosmetically distressing and there are no definitive management options, the literature is severely limited and the variations in clinical presentation, risk factors, and histopathology of SSH across patients are not well understood. We aimed to systematically summarize characteristics from current available data, and thus improve SSH awareness and management. A literature search was conducted in PubMed using specific eligibility criteria through the end of December 2022. Included articles focused on patients who experienced SSH after chemotherapy infusion. Study quality was assessed using a modified Oxford Centre for Evidence-Based Medicine quality rating scheme. Of the 41 articles identified by literature search, 24 met eligibility criteria. Two additional articles were identified through the reference sections of retrieved articles, for 26 articles total. All articles were case reports, representing 28 patients total. Locations of SSH were mostly in the forearm near the site of injection (85%), and the most common associated symptom was erythema. Histopathologic analysis was available for half of cases, the majority of which were inflammatory in nature. The most common inflammatory pattern observed was a vacuolar/lichenoid interface dermatitis. Duration of SSH ranged from days to > 1 year after the chemotherapy was stopped. Six (21%) patients were managed with topical steroids and oral vasodilators, six (21%) patients switched to central venous infusion rather than peripheral infusion, five (18%) patients received only supportive care, three (11%) patients received venous washing with chemotherapy, three (11%) patients stopped chemotherapy, and one (4%) patient reduced the chemotherapy dosage. Ten (36%) patients attained complete resolution, seven (25%) had SSH that was near resolution/fading, and three (11%) had persistent hyperpigmentation. Although SSH often spontaneously resolves once the chemotherapeutic agent is stopped, it can persist in some patients and cause significant distress. As the literature is severely limited and there are no definitive treatments, additional research using more standardized definitions and methods of assessments is necessary to improve characterization of SSH and evaluate potential interventions.

Context: Hyperpigmentation, a common skin condition marked by excessive melanin production, currently has limited effective treatment options. Objective: this study explores the effects of Tao-Hong-Si-Wu decoction (THSWD) on hyperpigmentation and to elucidate the underlying mechanisms. Materials and methods: We employed network pharmacology, Mendelian randomization, and molecular docking to identify THSWD's hub targets and mechanisms against hyperpigmentation. the cell counting Kit-8 (CCK-8) assay determined suitable THSWD treatment concentrations for PiG1 cells. these cells were exposed to graded concentrations of THSWD-containing serum (2.5%, 5%, 10%, 15%, 20%, 30%, 40%, and 50%) and treated with α-MSH (100 nM) to induce an in vitro hyperpigmentation model. assessments included melanin content, tyrosinase activity, and Western blotting. Results: ALB, IL6, and MAPK3 emerged as primary targets, while quercetin, apigenin, and luteolin were the core active ingredients. the CCK-8 assay indicated that concentrations between 2.5% and 20% were suitable for PIG1 cells, with a 50% cytotoxicity concentration (CC50) of 32.14%. THSWD treatment significantly reduced melanin content and tyrosinase activity in α-MSH-induced PIG1 cells, along with downregulating MC1R and MITF expression. THSWD increased alB and p-MAPK3/MAPK3 levels and decreased IL6 expression in the model cells. Discussion and conclusion: THSWD mitigates hyperpigmentation by targeting alB, IL6, and MAPK3. this study paves the way for clinical applications of THSWD as a novel treatment for hyperpigmentation and offers new targeted therapeutic strategies. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aims Methods Results Conclusions Tranexamic acid (TXA) is a promising active to treat hyperpigmentation disorders, such as melasma and acne scars. However, TXA is highly hydrophilic and its penetration into the skin is poor and formulation dependent.In this study, our aim was to evaluate the in vivo skin penetration of an ester‐modified TXA, TXVector, directly on the skin of volunteers.For the analysis of in vivo skin penetration of TXVector, we used in vivo confocal Raman spectroscopy (CRS). The use of CRS on live skin allows us to study directly how a compound affects skin composition at different depths and how this compound penetrates into the skin in real time.Our results showed that the TXA absorption into the skin via TXVector was 2.1‐fold and 3.8‐fold higher compared to free TXA 3% and TXA 1% formulations, respectively. Most importantly, upon application of TXVector, the TXA penetration flux into the skin was 107% and 280% higher than that of the free TXA 3% and TXA 1% formulations, respectively.In summary, this study shows that the esterification‐based TXVector formulation enhances the penetration flux of TXA and increases its bioavailability in the skin. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aims Methods Results Conclusions Isotretinoin is widely used for moderate to severe acne vulgaris. Despite its broad application, isotretinoin carries a risk of permanent scarring and keloid formation following various skin procedures. As a result, a delay of at least 6–12 months after completing or discontinuing isotretinoin treatment is commonly recommended before undergoing skin procedures.This study aims to evaluate the necessity of delaying skin procedures performed concurrently with or soon after isotretinoin treatment at different dosages in patients with acne vulgaris, based on the dermatological side effects associated with combination therapy.A literature search was conducted using PubMed, Scopus, Web of Science, and Embase databases for original studies up until June 2023.A total of 34 eligible studies, including 1563 patients treated with isotretinoin, were reviewed to assess the timing of various skin procedures, safe dosages, and potential adverse effects, such as keloid formation and persistent hyperpigmentation which were reported in a few cases.Based on our review, there is insufficient evidence to support delaying laser hair removal, ablative fractional lasers, nonablative fractional lasers, superficial to medium‐depth chemical peels, manual dermabrasion, cutaneous surgeries, fractional microneedling radiofrequency, microdermabrasion, and dermaroller treatments. However, fully ablative lasers, mechanical dermabrasion, and ablative radiofrequency procedures are not recommended during isotretinoin use. Further studies are needed to establish the safety and optimal interval for these procedures. For all skin procedures, especially more aggressive and deeper ones, a lower dose of isotretinoin is recommended. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Objective Methods Conclusion Botulinum toxin A (BTX‐A) is a widely utilized protein derived from the bacterium Clostridium botulinum, known for its effectiveness in treating various medical conditions involving muscle spasticity, involuntary muscle movements, and pain disorders. Beyond its therapeutic applications, BTX‐A is also commonly used in cosmetic procedures to address dynamic wrinkles, hyperhidrosis, sebum production, pore size, and overall skin texture. While the use of neurotoxins like BTX‐A for treating conditions such as UVB‐induced hyperpigmentation, specifically melasma, is an emerging area of interest, it is not yet a widely recognized treatment for this dermatologic condition. This literature review serves to provide a consolidated overview of the current therapeutic implications of BTX‐A treatment for melasma and explore its proposed mechanisms of action.This review aims to provide a comprehensive analysis of the current evidence base for the efficacy of BTX‐A treatment on melasma.To gain a comprehensive understanding on the current theories regarding BTX‐A treatment on melasma, a literature review was conducted on all the available information using PubMed. A combination of keywords was used to maximize the search results, including “botulinum toxin,” “melasma,” “melanogenesis,” “neurotoxin,” “cholinergic system,” “BTX‐A,” and “UV‐induced melasma.” The search was not restricted by date, allowing for the inclusion of articles offering historical context and those providing the most recent findings. Ninety‐eight articles were reviewed to provide a consolidated update on the effectiveness of botulinum toxin A in reducing the appearance of melasma and potential mechanisms of action involved in doing so.Melasma is a challenging dermatologic condition due to its chronicity and various intrinsic and extrinsic factors that influence its pathogenesis. While current treatment options for melasma include topical, oral, and light‐based therapies, recent studies suggest that BTX‐A may hold potential as a viable treatment modality for melasma. Despite the mechanism of action remaining unclear, it is hypothesized that BTX‐A inhibition of Ach receptors on melanocytes could play a role in the reduction of melanogenesis. BTX‐A treatment in melasma‐affected skin demonstrates statistically significant reduction in hyperpigmented lesions associated with melasma. [ABSTRACT FROM AUTHOR]

Background: Melaleuca species (family Myrtaceae) are characterized by their wide-ranging applications as antimicrobials and in skin-related conditions. Herein, we estimated the volatile profile and biological significance of M. rugulosa (Link) leaves for the first time supported by a dereplication protocol. Materials and methods: Volatile components were extracted using hydrodistillation (HD), supercritical fluid (SF), and headspace (HS) techniques and identified using GC/MS. The variations among the three extracts were assessed using principal component analysis and orthogonal partial least square discriminant analysis (OPLS-DA). The extracted volatiles were tested for radical scavenging activity, anti-aging, and anti-hyperpigmentation potential. Finally, disc diffusion and broth microdilution assays were implemented to explore the antibacterial capacity against Streptococcus pyogenes, Staphylococcus aureus, Clostridium perfringens, and Pseudomonas aeruginosa. Results: The yield of the SF technique (0.8%) was three times higher than HD. GC/MS analysis revealed that the oxygenated compounds are the most proponents in the three extracts being 95.93% (HD), 80.94% (HS), and 48.4% (SF). Moreover, eucalyptol (1,8-cineol) represents the major component in the HD-EO (89.60%) and HS (73.13%) volatiles, while dl-α-tocopherol (16.27%) and α-terpineol (11.89%) represent the highest percentage in SF extract. Regarding the bioactivity profile, the HD-EO and SF-extract showed antioxidant potential in terms of oxygen radical absorbance capacity, and β- carotene assays, while exerting weak activity towards DPPH. In addition, they displayed potent anti-elastase and moderate anti-collagenase activities. The HD-EO exhibited potent anti-tyrosinase activity, while the SF extract showed a moderate level compared to tested controls. OPLS-DA and dereplication studies predicted that the selective antibacterial activity of HD-EO to S. aureus was related to eucalyptol, while SF extract to C. perfringens was related to α-tocopherol. Conclusions: M. rugulosa leaves are considered a vital source of bioactive volatile components that are promoted for controlling skin aging and infection. However, further safety and clinical studies are recommended. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We sought to analyze the effectiveness, recurrence, safety, and patient satisfaction rates following xanthelasma palpebrarum (XP) treatment with trichloroacetic acid (TCA) 80%. METHODS: This was a retrospective review of patients treated with TCA 80% for XP between January 2012 and August 2022. A prospective telephone questionnaire was administered to the same patient population to evaluate recurrence, patient satisfaction, and side effects. RESULTS: In total, 77 patients were included in this retrospective review. Most patients received one treatment (n=38; 49.4%) and had XP located bilaterally (n=59; 76.6%) on either the lower eyelids only (n=18; 23.4%) or both the upper and lower eyelids (n=18; 23.4%). Following treatment, 94.2 percent (n=49) of patients expressed satisfaction and 97.2 percent (n=70) displayed a clinician-reported improvement in XP. In the prospective patient questionnaire, the reoccurrence of XP was self-reported in 24.7 percent (n=19) of all patients. The adverse events, reported by the clinician during the retrospective review and the patient during the prospective questionnaire, included erythema (n=2; 2.6%), hyperpigmentation (n=4; 5.2%), hypopigmentation (n=3; 3.9%), and scarring (n=2; 2.6%). LIMITATIONS: Limitations may exist due to the retrospective nature of the chart review, missing data, and lack of a comparator cohort. Thus, further studies are required to validate this study's preliminary results. CONCLUSION: XP has a strong likelihood of recurrence. However, TCA 80% for XP management should be considered as a treatment option due to high patient satisfaction, mild side effects, low cost, and long-term cosmetic results. [ABSTRACT FROM AUTHOR]

Background Lipid metabolism has essential roles in skin barrier formation and the regulation of skin inflammation. Lipid homeostasis regulates skin melanogenesis, although the underlying mechanism remains largely unknown. Sterol regulatory element binding protein 1 (SREBP-1) is a key transcription factor essential for cellular lipid metabolism. Loss-of-function variants in SREBF1 are responsible for autosomal-dominant ichthyosis follicularis, alopecia and photophobia syndrome, emphasizing the significance of lipid homeostasis in skin keratinization. Objectives To identify the genetic basis of a new entity featuring diffuse skin hyperpigmentation with congenital cataracts, and to unravel the underlying mechanism for the pathogenesis of the SREBF1 variant. Methods Whole-exome sequencing was performed to identify underlying genetic variants. Quantitative polymerase chain reaction, Western blot and immunofluorescence staining were used to assess the expression and the subcellular localization of the SREBF1 variant. The transcriptional activity of mutant SREBP-1 was determined by a luciferase reporter assay. A transgenic zebrafish model was constructed. Results Two unrelated patients presented with generalized skin hyperpigmentation with skin xerosis, congenital cataracts and extracutaneous symptoms. We identified a de novo nonsense variant c.1289C>A (p.Ser430*) in SREBF1 in both patients. The variant encoded a truncated protein that showed preferential nucleus localization, in contrast to wild-type SREBP-1 which – in sterol-sufficient conditions – is mainly localized in the cytoplasm. The luciferase reporter assay revealed that the p.Ser430* mutant exhibited enhanced transcriptional activity. Cultured patient primary melanocytes showed increased melanin synthesis vs. those from healthy controls. At 35 days postfertilization, the p.Ser430* transgenic zebrafish model exhibited more black spots, along with upregulated expression of melanogenic genes. Conclusions We demonstrated that a gain-of-function variant of SREBF1 causes a previously undescribed disorder characterized by generalized skin hyperpigmentation and congenital cataracts. Our study reveals the involvement of SREBP-1 in melanogenesis and lens development, and paves the way for the development of novel therapeutic targets for skin dyspigmentation or cataracts. [ABSTRACT FROM AUTHOR]

ABSTRACT Post‐inflammatory hyperpigmentation (PIH) is a very common disorder of cutaneous hyperpigmentation, which poses a persistent management challenge in the fields of dermatology and esthetics. This study was designed to explore the anti‐melanogenic and anti‐inflammatory effects of Bay 11‐7082, an NF‐κB inhibitor, using small‐molecule screening, to determine its potential application for PIH prevention. The molecular mechanisms were investigated in vitro and ex vivo in epidermis‐humanized mice using melanin content, RT‐PCR, and immunoblotting. Bay 11‐7082 suppressed proinflammatory cytokines and ameliorated 2,4‐dinitrofluorobenzene (DNFB)‐induced contact dermatitis on day 15. The suppression of melanin synthesis by Bay 11‐7082 was attributed to the reduction of MITF, which was induced by extracellular signal‐regulated kinase activation. Bay 11‐7082 reduced epidermal melanin accumulation in UVB‐stimulated ex vivo human epidermis as well as in the ear and tail skin of K14‐stem cell factor (SCF) transgenic mice. Topical administration of Bay 11‐7082 improved PIH on day 35 in the post‐DNFB dorsal skin of K14‐SCF transgenic mice. In conclusion, Bay 11‐7082 can be considered a promising candidate for the development of a preventive topical agent for PIH. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aims Methods Results Conclusions Many people are interested in addressing visible signs of aging with non‐invasive cosmetic treatments. Development of effective topical products will provide options to delay or support cosmetic procedures.This study assessed and compared the efficacy and tolerance of a topical product used over the course of 16 weeks to a single ablative laser treatment on women with moderate global photodamage on the face.Subjects in Cell 1 (Laser Cell) were treated over the entire face with a fractional CO2 laser system. Subjects in Cell 2 (Topical Serum Cell) were treated with a topical serum containing hydroxypinacolone retinoate and peptides over the entire face, twice per day for 16 weeks. The study was composed of 71 women, with 29 in the Laser Cell (mean age 56.2) and 42 in the Topical Serum Cell (mean age 55.0), between 40 and 65 years old. Expert grading was used to determine efficacy parameters.Participants in the Topical Serum Cell achieved more significant improvement (p < 0.05) in Marionette lines, fine lines (global face), wrinkles (global face), wrinkles (crow's feet), nasolabial folds, texture, smoothness (tactile), global hyperpigmentation, lift, and photodamage compared to participants in the Laser Cell. Participants in the Topical Serum Cell achieved parity in the look of fine lines (crow's feet), forehead lines, glabella, firmness/bounce (tactile), skin tone evenness, radiance.While no statistically significant differences in tolerability were observed, treatment with the topical cosmetic product achieved parity or statistically better improvement in parameters compared to laser treatment at 16 weeks. [ABSTRACT FROM AUTHOR]

Background: A fractional carbon dioxide (CO2) laser can improve the appearance of burn scars. In addition, tranexamic acid (TXA) inhibits melanin production for whitening effects. Laser-assisted drug delivery (LADD) technology utilizes lasers to enhance the percutaneous absorption of drugs. Objectives: The purpose of this study was to investigate whether the use of a fractional CO2 laser in combination with TXA can further improve pigmentation in burn scars. Methods: This prospective, randomized, single-blinded, split-body study included patients aged 20 years and older who had burn scars with associated hyperpigmentation for more than 6 months. A total of 12 patients were included between September 1, 2019, and August 31, 2020. For each patient, their pigmented burn scar was divided into two sides along the midline. One scar side received fractional CO2 laser alone, and the other combined fractional CO2 laser and topically applied TXA solution. Treatment sessions were conducted monthly for a total of three times. Photographs were captured at baseline and 3 months after completing the 3 monthly treatment sessions. Four plastic surgeons, blinded to the treatment sides, compared the improvement on both sides of each patient based on the photographs. The patients' reported satisfaction levels were also recorded. Results: In the physician assessments, both methods showed a noticeable improvement in scar appearance and pigmentation. On a scale of 1 to 10, physicians rated the overall improvement in scar appearance between 4.6 and 5.6 points, while the improvement in overall hyperpigmentation ranged from 6.0 to 6.9 points. The average patient satisfaction score was 8.4 ± 1.6 points. However, there was no significant difference in the improvement of outcomes between the two methods, with or without the addition of TXA treatment. Conclusion: This study shows that fractional CO2 laser treatment significantly improves burn scars and hyperpigmentation. However, adding TXA shows no clear additional benefits. Before making the final conclusion based on the results from the small patient sample size, further research is encouraged to clarify the delivery pathways in applying TXA and explore the mechanisms behind LADD. [ABSTRACT FROM AUTHOR]

Autofluorescence is a remarkable property of human skin. It can be excited by UV and observed in the dark using special detection systems. The method of fluorescence photography (FP) is an effective non-invasive tool for skin assessment. It involves image capturing by a camera the emission of light quanta from fluorophore molecules in the skin. It serves as a useful tool for cosmetic and skincare research, especially for the detection of pathological skin states, like acne, psoriasis, etc. To the best of our knowledge, there is currently no comprehensive review that fully describes the application and physical principles of FP over the past five years. The current review covers various aspects of the skin FP method from its biophysical basis and the main fluorescent molecules of the skin to its potential applications and the principles of FP recording and analysis. We pay particular attention to recently reported works on the automatic analysis of FP based on artificial intelligence (AI). Thus, we argue that FP is a rapidly evolving technology with a wide range of potential applications. We propose potential directions of the development of this method, including new AI algorithms for the analysis and expanding the range of applications. [ABSTRACT FROM AUTHOR]

Simple Summary: Cutaneous T-cell lymphomas (CTCLs) represent a heterogeneous group of rare extranodal non-Hodgkin lymphomas with variable clinical presentation. In the Middle East and North Africa (MENA region), where darker skin colors are more common than in the West, CTCL generally presents at a younger age and with distinct clinical features that necessitate special expertise and management across disciplines: rare forms of CTCL are more common (hypo- and hyperpigmented mycosis fungoides (MF)) and a higher prevalence of pediatric MF is noticed. The high cancer burden in the Middle East and North Africa (MENA region) is coupled with an increasing cancer incidence. While the MENA region constitutes 6% of the world's population, it remains underrepresented in clinical trials. Cutaneous T-cell lymphomas (CTCLs) represent a heterogeneous group of rare extranodal non-Hodgkin lymphomas with variable clinical presentation. In the MENA region, where darker skin colors are more common than in the West, CTCL generally presents at a younger age and with distinct clinical features that necessitate special expertise and management across disciplines: rare forms of CTCL are more common (hypo- and hyperpigmented MF) and a higher prevalence of pediatric MF is noticed. The multidisciplinary approach to cancer management is growing worldwide and is necessary for the comprehensive management of CTCL. The MENA CTCL group was established with the aim of creating a collaborative environment for the diagnosis and treatment of CTCL in the region. Its first meeting was held in May 2023. The group plans to increase the global representation of the MENA region and establish CTCL registries and patient advocacy groups in the region. [ABSTRACT FROM AUTHOR]

The article focuses on terra firma-forme dermatosis (TFFD), a benign and often unrecognized skin condition in children characterized by brown-grayish patches that resemble dirt. Topics include the common occurrence of skin disorders in pediatric exams, the presentation and distribution of TFFD, and the unknown pathogenesis and clinical features of this condition.

This article discusses the use of a non-invasive scanning technique called cellular resolution full-field optical coherence tomography (CRFF-OCT) to analyze the features of melasma, a skin condition associated with photoaging. The study found that melasma lesions had significantly higher numbers and activities of activated melanocytes, resulting in spinous hyperpigmentation and increased vascularity compared to nearby perilesions. However, there were no significant differences in basal hyperpigmentation, basement membrane disruption, melanophages, inflammatory cells, or collagen degradation between the two. The findings suggest that photodamage is present in the facial skin of patients with melasma, and treatment should focus on rejuvenating the entire dermis. [Extracted from the article]

This study aimed to report the collective clinical characteristics of oral side effects associated with imatinib therapy according to age, sex, and clinical condition. A bibliographic review was performed using the PubMed, Web of Science, Scopus, Cochrane Library, and Embase databases. Forty-five cases of oral side effects due to imatinib therapy were identified in the literature. With the addition of five new cases seen at the authors' institution, a total of 50 cases were analysed. Of the five new cases, four with gastrointestinal stromal tumours developed oral lichenoid lesions (OLLs), and one with chronic myeloid leukaemia (CML) developed oral hyperpigmentation (OHP). Of the total 50 patients, 26 were male and 24 were female, and age ranged from 29 to 86 years. Most patients were ≥50 years old (80%); only three patients were jaw was the least common, with just five cases (10%). Among the patients with OHP, the predominant clinical condition was CML (22 cases, 91.7%). In conclusion, the possibility of oral side effects needs to be considered during the examination of patients receiving imatinib therapy. [ABSTRACT FROM AUTHOR]

Facial hyperpigmentation is a highly prevalent dermatological condition, characterized by dark spots on the skin resulting from excess melanin production. Hyperpigmentation significantly impacts patients' quality of life and self-esteem. Current treatments often present disadvantages linked to poor product tolerability. A topical cosmetic approach combining three lightening active ingredients (tranexamic acid, niacinamide, vitamin C) offers a new option for treating dark spots on the skin. The present in-use test under dermatological control evaluated the clinical safety and efficacy of a cream and serum containing these three ingredients, formulated with hyaluronic acid for enhanced delivery, stability, and efficacy. A total of 22 Caucasian patients with facial hyperpigmentation, both male and female, aged between 45 and 67 years, applied the cream and serum for 8 weeks. Clinical assessments, colorimetric evaluations, standardized photography, and self-assessment questionnaires were used to measure outcomes. No serious adverse effects were recorded, and the incidence of local adverse effects was low, highlighting good tolerability of the investigated test items. In most participants, significant improvements in hyperpigmented areas were recorded. Clinical scoring by the dermatologist investigator indicated a statistically significant 13% reduction in color intensity and a 6% reduction in the size of dark spots after 8 weeks of treatment. Colorimetric evaluation showed a statistically significant 1% increase in luminosity (L* parameter) and an 8% improvement in the Individual Typological Angle (ITA°) in endpoint, indicating lighter skin spots. Subjective assessments reflected high user satisfaction, with 95% of participants noting improvements in skin hydration and luminosity, and 77% reporting a reduced appearance of dark spots. Overall, the present work supports the use of tranexamic acid, niacinamide, and vitamin C as an effective and well-tolerated combined topical management option for hyperpigmentation. This combination offers a viable alternative to classical whiteners for individuals seeking to reduce facial skin coloration imbalance and improve skin tone. [ABSTRACT FROM AUTHOR]

Introduction: Pigmented gingiva is an aesthetic concern for many individuals. Various treatment modalities have been developed to address this condition, but each carries certain disadvantages. Recently, the use of herbal products has been considered as a treatment modality, as they are safe and readily available. P-Coumaric Acid (p-CA) and Quercetin are two plant-based chemicals that have shown depigmenting effects on the skin. Given the similar cellular structure of skin and gingiva, the present study aimed to test their depigmenting effects on the gingiva. Aim: To evaluate the effectiveness of two phytochemicals, p-CA (3 μM) and Quercetin (20 μM), in reducing the melanin content of pigmented gingival tissue. Materials and Methods: The study was an ex-vivo study conducted in the Department of Periodontology at Bharati Vidyapeeth Deemed to be University Dental College and Hospital, Pune, Maharashtra, India, from January 2024 to April 2024. A total of 10 patients with a Dummet Oral Pigmentation Index (DOPI) score of two were selected for the study. A surgical depigmentation procedure was performed and the excised tissue was divided into three parts. The first part of the excised tissue served as a control group (Group A), while the second and third parts were treated with p-CA (Group B) and Quercetin (Group C), respectively. Histological analysis was conducted using Haematoxylin and Eosin (H&E) staining and immunohistochemical analysis was performed using the Human Melanoma Black 45 (HMB-45) antibody test. The reduction in melanin content was recorded in all three groups and the results obtained were compared using a t-test. Statistical Package for the Social Sciences (SPSS) version 20.0 was used for statistical analysis, with a p-value of ≤0.05 considered statistically significant. Results: Both p-CA and Quercetin demonstrated a reduction in the level of pigmentation. Comparative analysis indicated that p-CA had a stronger effect than Quercetin. Conclusion: The p-CA and Quercetin can be considered potential depigmenting agents.

During the Pigmentation as an Urgent Problem of the XXI Century. Traditions and Innovations and Pigmentation: A Specialist's View research and practical conferences, leading experts in the field of dermatovenereology and cosmetology presented their reports and discussed global trends in the treatment of hyperpigmentation. The authors presented new data on cosmetic products and patient management approaches.

Mayla Barbosa,1 Rebecca Perez de Amorim,1 Daniel Cassiano,2 Marina Dias,1 Ana Flávia de Abreu,1 Edileia Bagatin,2 Hélio Amante Miot,1 Ana Cláudia Cavalcante Espósito1 1Department of Dermatology, Faculdade de Medicina de Botucatu (UNESP), Botucatu, SP, Brazil; 2Department of Dermatology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, BrazilCorrespondence: Ana Cláudia Cavalcante Espósito, Department of Dermatology, Faculdade de Medicina de Botucatu, UNESP Medical School, Botucatu, SP, Brazil, Email anaclaudiaesposito@gmail.comBackground: Nicotinamide has demonstrated efficacy in the treatment of melasma. Topical antioxidants and humectants may enhance its performance. Currently, there is no controlled trial on the combination of 10% nicotinamide, 5% magnesium ascorbyl phosphate, and 5% hyaluronic acid, a dermo-cosmetic compound, in comparison to 4% hydroquinone for the treatment of melasma. This study aimed to explore the tolerability and efficacy of the association of the combined product versus hydroquinone.Methods: A randomized, double-blind trial involving women with facial melasma was conducted. Participants were instructed to apply the combined product (NIC group) twice daily or 4% hydroquinone for 60 days (HQ group) at night and placebo in the morning. Evaluations were performed at inclusion, after 14 and 60 days of treatment, measuring the modified Melasma Area and Severity Index (mMASI), Melasma Quality of Life Scale (MELASQoL), and colorimetric luminosity. The Global Aesthetic Improvement Scale (GAIS) was assessed by a blinded evaluator.Results: Both interventions led to a progressive improvement in mMASI, MELASQoL, and GAIS, without a difference between them on D14 and D60 (p> 0.2). For NIC, the mean reduction (95% CI) in mMASI was 16% (8– 24%) on D14 and 32% (23– 41%) on D60, while for HQ, it was 10% (7– 24%) on D14 and 43% (34– 52%) on D60. Reduction in colorimetric luminosity was greater in the HQ group at D60 (p=0.01). No serious side effects were identified. Of the initially included 50 patients, one was lost to follow-up in the HQ group on D60, and one withdrew consent from the NIC group, both unrelated to treatment.Conclusion: The association of 10% nicotinamide, 5% magnesium ascorbyl phosphate, and 5% hyaluronic acid was safe and well-tolerated, although its overall clinical efficacy was numerically inferior to 4% hydroquinone. This regimen can be considered for patients with poor tolerability to hydroquinone.Clinical Trial Registration: &num;RBR-4mkfmr8.Keywords: melasma, hyperpigmentation, nicotinamide, hydroquinone, antioxidants

Melasma is a widespread acquired symmetrical hypermelanosis characterised by irregularly shaped but clearly defined dark brownish maculae on photo-exposed areas, particularly the forehead, temples, nose, eyelids, chin, and upper lips. It is a major cosmetological issue that can also affect a person’s psychological well being. Melasma can be correlated with Vyanga in Ayurveda. Vyanga is one of many Kshudra Rogas and Raktapradoshaj Vikaras. According to modern medicine, local application of corticosteroids is preferred for the management of melasma. However, due to the relapse of the disease and the side effects of steroids, an Ayurvedic approach is beneficial. Ayurveda mentions Shaman Chikitsa in the form of Lepa, which has Vatapittahara, Varnya, Twachya, Kushthaghna, and Raktaprasadaka properties as the line of treatment. Hereby, the authors present a case report of a 46-year-old female who reported to the Outpatient Department (OPD) of Kayachikitsa, complained of brownish discolouration on her face for six months, which was diagnosed as Vyanga (melasma). Ayurvedic treatment was planned according to the classical principle of Shaman Chikitsa, with a local application of Lepa containing depigmenting and skin rejuvenating drugs, along with lifestyle modifications. Due to the recurring nature of the disease, a proficient treatment approach was required. Vyanganashak Lepa has skin resurfacing and revitalising properties that act efficiently on the disease. In present case, Vyanganashak Lepa was found to be highly effective and showed remarkable results with continuous usage in a short period.

Tianyu Chen,1 Jing Xue,2 Qian Wang2 1School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China; 2The Institute of Dermatology and Venereology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of ChinaCorrespondence: Jing Xue; Qian Wang, The Institute of Dermatology and Venereology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 32, Western 2nd Section, 1st Ring Road, Chengdu, Sichuan Province, 610072, People’s Republic of China, Email xuejings@sina.com; wqian1111@126.comAbstract: Tranexamic acid (TXA), a synthetic lysine analog, is a commonly used antifibrinolytic and procoagulant agent. Based on its good hemostatic efficacy, it is mainly used clinically for bleeding in trauma, various types of surgical and dental procedures and prevention of bleeding in patients with hemophilia. In recent years, studies have shown that TXA has the effects of anti-melanogenesis, anti-inflammation, anti-angiogenesis and promotes the recovery of the skin barrier, so it has been tried to be used as a treatment for hyperpigmentation and telangiectatic diseases. Oral, topical, intradermal injections and microneedling are all commonly used modes of administration. TXA for melasma is the most studied and has achieved indications in some countries, whereas it is still an off-label drug for many other dyschromia. We review the clinical use of TXA in hyperpigmentation and telangiectatic disorders other than melasma, such as post-inflammatory hyperpigmentation, Riehl’s melanosis, rosacea, and post-acne erythema, to provide more evidence for the use of TXA in these disorders, and to provide safer and more cost-effective alternatives for the treatment of these diseases.Keywords: tranexamic acid, hyperpigmentation, erythema, telangiectatic disorder

Abstract Background Lanping black-boned sheep (LPB) represent a distinctive mammalian species characterized by hyperpigmentation, resulting in black bone and muscle features, in contrast to their conventional counterparts exhibiting red muscle and white bone. The genetic basis underlying LPB hyperpigmentation has remained enigmatic. Methods In this study, we conducted whole-genome sequencing of 100 LPB and 50 Lanping normal sheep (LPN), and integrated this data with 421 sequenced datasets from wild and domestic sheep, shedding light on the genetic backdrop and genomic variations associated with LPB. Furthermore, we performed comparative RNA-Seq analysis using liver sample to pinpoint genes implicated in the pigmentation process. We generated a comprehensive dataset comprising 97,944,357 SNPs from 571 sheep, facilitating an in-depth exploration of genetic factors. Results Population genetic structure analysis revealed that the LPB breed traces its origin back to LPN, having evolved into a distinct breed. The integration of positively selected genes with differentially expressed genes identified two candidates, ERBB4 and ROR1, potentially linked to LPB hyperpigmentation. Comparative analysis of ERBB4 and ROR1 mRNA relative expression levels in liver, spleen, and kidney tissues of LPB, in comparison to Diqing sheep, revealed significant upregulation, except for ERBB4 in the liver. Gene expression heatmaps further underscored marked allelic frequency disparities in different populations. Conclusion Our findings establish the evolutionary lineage of the LPB breed from LPN and underscore the involvement of ERBB4 and ROR1 genes in melanin synthesis. These results enhance our comprehension of the molecular basis of hyperpigmentation and contribute to a more comprehensive depiction of sheep diversity.

Context: Ultraviolet B (UVB) light irradiation causes skin problems by increasing cellular oxidants, melanogenesis, and morphological changes of melanocytes. The use of active compounds derived from plants to mitigate these problems has been studied. Piceatannol (PCT), a phytochemical in the phenolic group contained in Passiflora edulis fruit seed (PFS), has gained interest for its anti-melanogenesis effects. However, the inhibitory effect on morphological differentiation related to melanin production of PFS extract is absent. Aims: To investigate the effect of PFS extract on the inhibition of morphological differentiation associated with microphthalmia-associated transcription factor (MITF) mRNA expression and F-actin polymerization in UVB-induced hyperpigmented B16F10 cells. Methods: Three fractions of PFS extract were analyzed for their total phenolics, PCT proportion, and antioxidant capacity. The fraction with the highest PCT proportion and antioxidant activity was investigated for its reductive effects on cellular oxidants, number of melanin-containing cells, melanin content, MITF mRNA expression, and tyrosinase activity in UVB-induced B16F10 cells. Morphological differentiation, as well as F-actin polymerization and arrangement, were analyzed. Results: The PFS-F3 extract showed the highest antioxidant effect related to the proportion of PCT and phenolic contents. It attenuated cellular oxidants, the number of melanin-containing cells, melanin content, MITF mRNA expression, and tyrosinase activity. Differentiation, polymerization, and the arrangement of F-actin of most UVB-irradiated cells were repressed after treatment with the extract. Conclusions: The PFS extract rich in PCT attenuated morphological differentiation by suppressing the functions of MITF mRNA and F-actin polymerization through the reduction of cellular oxidants, resulting in a decrease in melanin production.

Abstract Skin of colour, defined as Fitzpatrick skin types IV–VI, is especially susceptible to hyperpigmentation concerns such as melasma and postinflammatory hyperpigmentation (PIH). Treating hyperpigmentation in skin of colour is challenging due to increased risk of PIH, which can be induced by the treatments. Isobutylamido‐Thiazolyl‐Resorcinol (ITR), a tyrosinase inhibitor, has previously been identified as an effective and safe solution for hyperpigmentation, inhibiting melanin production without common side effects. This review evaluates available evidence on ITR's efficacy and safety for the management of hyperpigmentation in skin types IV–VI. Three publications reporting four studies were reviewed. Two randomised controlled trials assessed the efficacy and tolerability of ITR for the management of melasma in patients with skin of colour, whereas one randomised clinical trial and one observational real‐world study explored therapeutic benefits for patients with acne‐related PIH. A total of 234 participants completed the four reviewed studies, of which 232 were skin of colour. In a randomised vehicle‐controlled trial, ITR significantly improved Melasma Area and Severity Index scores and quality of life over 24 weeks of application compared to baseline and vehicle. A comparative clinical trial showed ITR, alone or with hyaluronic acid, effectively reduced melasma. A randomised vehicle‐controlled study in patients with acne‐related PIH showed ITR significantly reduced PIH visibility as compared to baseline and vehicle. An observational real‐world study confirmed effective PIH reduction by ITR in a real‐life setting. All studies showed good tolerability of the examined ITR‐containing formulations. The results collectively support ITR as a safe and effective cosmetic solution in skin of colour. ITR emerges as a reliable hyperpigmentation management option for this patients groups, backed by robust methodologies. Future research should include more patients with Fitzpatrick skin type VI and explore potential benefits of combining ITR and laser treatments in skin of colour to reduce PIH risk.

H syndrome is a rare autosomal recessive genodermatosis characterized by cutaneous manifestations and other systemic involvement. It presents with features like hyperpigmentation, hypertrichosis, hepatosplenomegaly, hearing loss, hallux valgus, hyperglycemia, low height, hypogonadism, and heart anomalies. Without a high index of suspicion, it is often misdiagnosed with other sclerodermatous cutaneous disorders. This case report highlights the clinical variability of H syndrome. An 8-year-old female child presented with hyperpigmented, hypertrichotic indurated patches with hyperglycemia and short stature. Histopathology showed dense lymphohistiocytic infiltrate and fibrosis in the dermis and subcutaneous tissue. The patient lacked features like heart anomalies, hearing loss, and hallux valgus, suggesting forme fruste presentation of H syndrome. An overlap between features of H syndrome and PHID syndrome is also suspected because of atypical presentation.

Abstract Background The SLC29A3 gene, which encodes a nucleoside transporter protein, is primarily located in intracellular membranes. The mutations in this gene can give rise to various clinical manifestations, including H syndrome, dysosteosclerosis, Faisalabad histiocytosis, and pigmented hypertrichosis with insulin-dependent diabetes. The aim of this study is to present two Iranian patients with H syndrome and to describe a novel start-loss mutation in SLC29A3 gene. Methods In this study, we employed whole-exome sequencing (WES) as a method to identify genetic variations that contribute to the development of H syndrome in a 16-year-old girl and her 8-year-old brother. These siblings were part of an Iranian family with consanguineous parents. To confirmed the pathogenicity of the identified variant, we utilized in-silico tools and cross-referenced various databases to confirm its novelty. Additionally, we conducted a co-segregation study and verified the presence of the variant in the parents of the affected patients through Sanger sequencing. Results In our study, we identified a novel start-loss mutation (c.2T > A, p.Met1Lys) in the SLC29A3 gene, which was found in both of two patients. Co-segregation analysis using Sanger sequencing confirmed that this variant was inherited from the parents. To evaluate the potential pathogenicity and novelty of this mutation, we consulted various databases. Additionally, we employed bioinformatics tools to predict the three-dimensional structure of the mutant SLC29A3 protein. These analyses were conducted with the aim of providing valuable insights into the functional implications of the identified mutation on the structure and function of the SLC29A3 protein. Conclusion Our study contributes to the expanding body of evidence supporting the association between mutations in the SLC29A3 gene and H syndrome. The molecular analysis of diseases related to SLC29A3 is crucial in understanding the range of variability and raising awareness of H syndrome, with the ultimate goal of facilitating early diagnosis and appropriate treatment. The discovery of this novel biallelic variant in the probands further underscores the significance of utilizing genetic testing approaches, such as WES, as dependable diagnostic tools for individuals with this particular condition.

Hyperpigmentation is a skin disorder characterized by excessive production of melanin in the skin and includes dyschromias such as post-inflammatory hyperchromias, lentigens, melasma and chloasma. Topical products containing depigmenting agents offer a less aggressive treatment option for hyperpigmentation compared to methods like chemical peels and laser sessions. However, some of these agents can cause side effects such as redness and skin irritation. Encapsulating these actives in nanosystems shows promise in mitigating these effects and improving product safety and efficacy. In addition, nanocarriers have the ability to penetrate the skin, potentially allowing for targeted delivery of actives to the affected areas. The most commonly investigated nanosystems are nanoemulsions, vesicular nanosystems and nanoparticles, in which different materials can be used to generate different compositions in order to improve the properties of these nanocarriers. Nanocarriers have already been widely explored, but it is necessary to understand the evolution of these technologies when applied to the treatment of skin hyperchromias. Therefore, this literature review aims to present the state of the art over the last 15 years on the use of nanosystems as a potential strategy for encapsulating depigmenting actives for potential application in cosmetic products for skin hyperchromia. By providing a comprehensive overview of the latest research findings and technological advances, this article can contribute to improving the care and quality of life of people affected by this skin condition. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aims Patients/Methods Results Conclusions Periorbital hyperpigmentation is a prevalent skin condition that represents a large quantity of cases seen in cosmetic dermatology. Patients tend to be left with pigmentation after Q‐switched ruby laser treatment, especially the perioribital area.The study is conducted to compare the effect of PRP injection combined with laser therapy versus laser alone for periorbital hyperpigmentation treatment.In this single‐center, case–control study, 30 patients with periorbital hyperpigmentation were allocated to receive PRP injection injection after Q‐switched ruby laser or Q‐switched ruby laser only, followed by a 12‐week and 24‐week follow‐up visit. Visual analogue scale, Sadick tear trough rating scale, and patients' self‐evaluation were used to evaluate the therapeutic effect.The combined group achieved a better improvement in long‐term effect and had effect on facial rejuvenation. Patient satisfaction was higher in the combined group. Erythema and mild pain were the most common adverse reactions of both groups.Combining with PRP injection can improve the therapeutic effect of Q‐switched ruby laser in treating periorbital hyperpigmentation and lessen the risk of post‐inflammatory hyperpigmentation, indicating a new option for POH treatment. [ABSTRACT FROM AUTHOR]