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BackgroundDyschromia can be associated with increased production and/or reduced clearance of pigmentation in the skin. Multiple pathways are involved in causality. A novel topical product was recently developed, which contains actives that have been validated through in-vitro and clinical studies to counteract pigmentation related to photodamage, PIH, and melasma. This study further evaluates the safety and efficacy of this product for facial dyschromia during an additional 3-month extension period following the completion of the previous 12-week multi-center trial.  Study Design: Subjects from the previous multi-center trial with mild to severe facial dyschromia at baseline were eligible to participate in this 3-month extension study upon completion of that trial. This extension study evaluated the continued use of the novel topical product with PATH-3 Technology (Alastin Skincare, Carlsbad, CA) over a 3-month period. Subjects who were previously randomized to the novel topical product continued using it and for those previously randomized to hydroquinone 4% discontinued its use. Both cohorts continued daily sunscreen use. Blinded investigators assessed subjects at follow-up visits at 16, 20, and 24 weeks.ResultsTwenty-six (26) subjects completed the extension phase of the pivotal trial, with 13 subjects in each of the AL and HQ-BREAK cohorts. Significant improvements were seen within the AL cohort from weeks 12 to 24 for facial dyschromia (P=0.0158) and skin tone/clarity/evenness (P=0.0067), while there were no significant improvements seen in the HQ-BREAK cohort. The HQ-BREAK cohort had more subjects who worsened with facial dyschromia and skin tone/clarity/evenness. For the mMASI, the HQ-BREAK cohort demonstrated regression at week 24 compared to week 12, while the AL cohort instead experienced continued improvement. This difference was found to be significant (P=0.02). No study-related adverse events were reported for either cohort.  Conclusion: A novel topical product designed to counteract various steps in pigmentation pathways using PATH-3 Technology has been demonstrated to be safe and effective in treating facial dyschromia on a long-term basis. In contrast to the significant rebound experienced by subjects with HQ, the AL cohort continued to demonstrate ongoing improvement. J Drugs Dermatol. 2024;23(1):1266-1270.     doi:10.36849/JDD.7622.

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

The skin is the largest organ in the human body and is made up of various cells and structures. Over time, the skin will age, which is not only influenced by internal factors, but also by external environmental factors, especially ultraviolet radiation. Aging causes immune system weakening in the elderly, which makes them more susceptible to dermatosis, such as type 2 inflammatory mediated pruritus. The immune response in this condition is marked by senescent cells consistently releasing low amounts of pro-inflammatory cytokines through a senescence-associated secretory phenotype (SASP). This continuous inflammation may accelerate immune system aging and establish a connection between immune aging and type 2 inflammatory skin diseases. In addition, two chronic pigmentation disorders, vitiligo and chloasma, are also associated with skin aging. Aged cells escape the immune system and accumulate in tissues, forming a microenvironment that promotes cancer. At the same time, "photoaging" caused by excessive exposure to ultraviolet radiation is also an important cause of skin cancer. This manuscript describes the possible links between skin aging and type 2 inflammation, chronic pigmentation disorders, and skin cancer and suggests some treatment options. [ABSTRACT FROM AUTHOR]

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

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

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

Background: Melasma is a persistent and recurrent pigmentation disorder. It is a skin condition that affects facial skin esthetics and can lower self-esteem, causing emotional distress, which can lower a person's quality of life (QoL). Aims and Objectives: To study the correlation of Hindi-Melasma Quality of Life Index (Hi-MELASQOL) in relation with Melasma Area and Severity Index (MASI) and to analyze the different patterns and influence of melasma on life quality. Materials and Methods: This was a cross-sectional study involving 100 subjects. Hi-MELASQOL questionnaire comprising 10 items was used to assess the patient's QoL. MASI score was used to determine the severity of melasma. All the collected data were recorded, processed, and statistically analyzed using Epi Info 2000 and SPSS Inc., 20.0. Results: A significant association was observed between the Hi-MELASQoL and MASI scores. It was evident that melasma had an adverse impact on the patients' QoL. The association between MASI score and type of melasma had P < 0.05 and hence showed a statistically significant association between them. However, the association between Hi-MELASQOL score (individually and total) and the type of melasma was statistically insignificant. The most common type was centrofacial (71%), followed by malar (25%) and mandibular (5%). Conclusion: There was a significant impairment in the QoL in our study population due to melasma as assessed by Hi-MELASQOL and MASI score. Utilization of Hi-MELASQOL scale should be considered in the evaluation of QoL of patients affected with melasma. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

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

Introduction: Vitiligo is an acquired skin pigmentation disorder, the cause of which is poorly understood. Researchers in this field are dedicated to exploring novel treatments for achieving re-pigmentation. Methods: Mice were randomly selected and divided into control, model, and model+laser groups. Evaluate the impact of different levels of carbon dioxide laser irradiation on tyrosinase activity, melanocyte viability, and melanin content. Results: In this study, it was found that the cell viability and melanin content were significantly enhanced in human melanocytes after treatment with different energy densities of fractional carbon dioxide laser. In addition, laser-treated vitiligo mouse models showed mild pathological changes. Discussion: Therefore, we believe that fractional carbon dioxide laser may be a potential adjunctive modality for treating vitiligo. [ABSTRACT FROM AUTHOR]

There are growing numbers of significant skin disorders, including skin pigmentation. It states that skin color is determined by the amount of melanin produced by the body. The two main categories of skin pigmentation are hyperpigmentation, in which pigment seems to overflow, and hypopigmentation, in which pigment appears to decrease. However, many skin conditions share characteristics, making it difficult for dermatologists to correctly early diagnose their patients. Consequently, the accurate detection of skin disorders and the diagnosis of dermatoscopy pictures can be greatly aided by machine learning and deep learning approaches. The most effective deep learning technique for picture identification was investigated to diagnose hyperpigmented skin diseases. YOLO, DenseNet201, GoogLeNet, InceptionResNetV2, and MobileNet were among the pretrained models used to classify four most common hyperpigmented skin disorders. Using assessment metrics like accuracy and AUC (Area Under Curve), it was determined which deep learning method would work best for creating a clinical diagnostic system. The study analyzed the accuracy rates of five pretrained models, including GoogleNet, MobileNet, DenseNet201, InceptionResNetV2, and YOLO, after 50 iterations. Using metrics such as accuracy and Area Under the Curve (AUC), the study evaluated the models' performance on a small dataset split into 80% for training and 20% for testing. Training accuracy rates were 93.8%, 100%, 100%, 98.77%, and 97.43%, respectively, while test accuracy rates were 87.18%, 79.49%, 87.18%, 89.74%, and 97.56%. DenseNet201 showed strong performance, particularly for cafe-au-lait spots (CS), melasma (ML), and nevi (MN), but struggled with congenital nevus (CN). Despite DenseNet201′s strong traditional CNN capabilities and generalization, YOLO emerged as the top model due to its stable accuracy and AUC values, as confirmed by confusion matrices. While these models show promise as diagnostic tools for dermatologists, further research, including expanding the dataset and exploring hybrid models, is needed to enhance their clinical accuracy and effectiveness. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

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

Piebaldism is a rare, autosomal dominant dyschromia characterized by circumscribed poliosis and triangular achromia in the frontal region in 90% of affected individuals, with no other systemic involvement. The incidence of dyschromia in this Dermatology Department, in a short space of time, and with plenty of images, motivated the presentation of this series of cases. We show two families with piebaldism, treated at the same Dermatology Department in 2021: the first family, with a mother and son presenting achromic macules on the trunk and poliosis in the frontal region since birth; the second family, with a grandmother, aunt, mother, and son showing the same characteristics described.

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

Proposed as a non-invasive alternative to address a variety of patient concerns including cellulite, body sculpting, weight reduction and skin rejuvenation, mesotherapy remains a controversial therapy, with some arguing that it is ineffective at best and potentially dangerous at worst. However, other practitioners and researchers swear by its efficacy. Francesca Ramadan dives into the current evidence base, safety profile and applications of mesotherapy. [ABSTRACT FROM AUTHOR]

This article aims to share our experience of using intense pulsed light (IPL) technology safely and effectively in our clinic. We aimed to provide valuable insights for other cosmetic practitioners interested in incorporating IPL technology into their practices. In this article, we elaborate on the various challenges faced while using IPL technology, such as ensuring the safety of clients and educating them on proper aftercare. We will explain the precautions taken, such as conducting a thorough consultation and patch testing, to mitigate the risk of adverse side effects. We also describe several interesting cases where IPL was used to treat post-inflammatory hyperpigmentation of different origins. We also explain how we tailor our treatments to suit individual clients’ needs and provide them with detailed instructions on how to care for their skin after treatment. In conclusion, IPL technology is a safe and effective way to treat various cosmetic concerns and improve the overall appearance of the skin. With proper safety measures and tailored treatments, we hope that our experience and insights will be valuable to other cosmetic practitioners.

Background: Hyperpigmentation results in uneven skin tone, with darker skin types disproportionately affected. Objective: Assess efficacy and safety of a novel, hydroquinone (HQ)-free, multimodal pigment-correcting serum (Advanced Brightening Treatment [ABT]) versus 4% HQ in moderate to severe hyperpigmentation, including melasma. Methods: In this split-face study, ABT and 4% HQ were applied topically on randomly assigned facial sides twice daily for 12 weeks. Hyperpigmentation, skin tone evenness, modified Melasma Area and Severity Index (mMASI), Melasma Quality of Life Questionnaire (MelasQoL), self-assessment questionnaires, and tolerability were assessed. Results: Subjects (n = 113; melasma subgroup, n = 44) were Asian (22%), Black/African American (27%), Hispanic (22%), and White/Caucasian (28%). ABT achieved comparable results to 4% HQ. ABT was well tolerated and resulted in improvement versus baseline at all visits in mean overall hyperpigmentation (−11.7% at week 12; P ≤ .001), skin tone evenness (−8.8%, P ≤ .005), and, in the melasma subgroup, mMASI (−50.6%; P ≤ .011) and MelasQoL scores (33.0 vs 46.6 for week 12 vs baseline, respectively; P ≤ .011), with similar results across racial subgroups. ABT was preferred over 4% HQ, with high satisfaction rate (≥89%). Limitations: Quality of life improvements per treatment were not evaluated separately. Conclusion: Efficacy and safety of ABT is comparable to 4% HQ in individuals with facial hyperpigmentation, including melasma, across multiple racial/ethnic backgrounds.

Purpose: The skin and mucous membrane of cancer patients can be directly or indirectly impaired during the treatment of cancers, bringing about not physical but also psychological damages to cancer patients. A practical guideline is of great significance to improve the quality of life for patients suffered from cutaneous adverse events. Methods: This guideline was generated based on up-to-date evidence and the consensus of experts specialized in dermatology. Results: The current guideline include the baseline screening of skin and mucosal membranes, the manifestations of injuries on skin, mucosa and appendages, along with the treatment of them. The causal anti-tumor management include chemotherapy, radiotherapy, immune therapy and surgery. Conclusion: This guideline can be helpful to reduce the risk of cutaneous adverse events during anti-cancer treatment and improve the quality of life of patients suffered from these adverse events. [ABSTRACT FROM AUTHOR]

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