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Ceresnie MS, Gonzalez S, Hamzavi IH. Diagnosing Disorders of Hypopigmentation and Depigmentation in Patients with Skin of Color. Dermatol Clin 2023; 41:407-416. [PMID: 37236710 DOI: 10.1016/j.det.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Skin hypopigmentation and depigmentation disorders are a top concern for patients with skin of color seeking care from a dermatologist. The visual contrast between involved and uninvolved skin in these disorders makes them particularly burdensome for patients with skin of color. These disorders may have a wide differential of diagnosis, as patients with skin of color may present differently or more frequently than White patients for certain conditions. Clues from a comprehensive history and physical examination with standard lighting and a Wood's light are essential for clinching the diagnosis, although a biopsy may be warranted in special cases.
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Affiliation(s)
- Marissa S Ceresnie
- Department of Dermatology, Multicultural Clinic, Henry Ford Health, 3031 West Grand Boulevard, Suite 700, Detroit, MI 48202, USA
| | - Sarah Gonzalez
- Wayne State University College of Medicine, 540 East Canfield Avenue, Detroit, MI 48201, USA
| | - Iltefat H Hamzavi
- Department of Dermatology, Multicultural Clinic, Henry Ford Health, 3031 West Grand Boulevard, Suite 700, Detroit, MI 48202, USA.
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Halo Nevi in the Pediatric Population. JOURNAL OF THE DERMATOLOGY NURSES' ASSOCIATION 2023. [DOI: 10.1097/jdn.0000000000000719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Ocular findings in patients with vitiligo: A single-center experience. J Fr Ophtalmol 2022; 45:1004-1011. [DOI: 10.1016/j.jfo.2022.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/20/2022]
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Bjerke DL, Wu S, Wakamatsu K, Ito S, Wang J, Laughlin T, Hakozaki T. A framework to mitigate the risk of chemical leukoderma: Consumer products. Regul Toxicol Pharmacol 2022; 131:105157. [DOI: 10.1016/j.yrtph.2022.105157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/10/2022] [Indexed: 11/16/2022]
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Oh SH. Classification and diagnosis of vitiligo. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2020. [DOI: 10.5124/jkma.2020.63.12.731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Vitiligo is a relatively common, acquired hypopigmentary disorder caused by the loss of epidermal melanocytes. It is characterized by asymptomatic, well-circumscribed round to oval-shaped whitish patches that vary in size. Depending on various clinical features, vitiligo is classified into several types, that is, non-segmental, segmental, and undetermined/unclassified vitiligo. The uniform classification of vitiligo is very important in predicting its clinical course and prognosis and communication among researchers. In particular, segmental vitiligo is a highly distinctive subtype of vitiligo considering its clinical features and prognosis. It usually has an onset early in life and spreads rapidly within the affected area limited to one segment of the integument. Signs of vitiligo activity such as Koebnerʼs phenomenon, trichrome vitiligo, inflammatory vitiligo, and confetti-like lesions give useful information to start treatments to block the progression of the disease. Lastly, other hypopigmentary disorders should be distinguished from vitiligo to make the correct diagnosis and prescribe the right treatment. In this report, I review the clinical features of vitiligo, various subtypes according to classification, and the importance for differential diagnosis of hypopigmentary disorders from vitiligo.
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Weigelt MA, Herbst AT, Tosti A, Lev-Tov H. Thymol-Induced Chemical Leukoderma Successfully Treated with 308-Nanometer Excimer Laser. Skin Appendage Disord 2020; 6:244-246. [PMID: 32903934 DOI: 10.1159/000507899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/06/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Chemical leukoderma (CL) is an acquired depigmenting disorder caused by repeated exposure to chemical compounds. Thymol is a phenol derivative used as a preservative or antiseptic in many commercially available products. Here, we present the second reported case of CL caused by a thymol-containing compound. Case Presentation A 48-year-old woman presented with a 4-month history of depigmentation of the nail folds of all ten fingers. This occurred after 1 month of twice-daily application of a thymol-containing compound intended for the removal of gel nails. No improvement was noted after the product was discontinued. There was no family history of vitiligo or other autoimmune disorders. On physical exam, depigmentation of all ten proximal and lateral nail folds was seen, with accentuation on Wood's lamp exam. Partial re-pigmentation was achieved after 32 treatments with 308-nm excimer laser. Discussion A thorough history and physical exam are instrumental in differentiating CL from other causes of depigmentation. Avoidance of the offending agent is an essential part of management. It is important to note that many cosmetic products are not tightly regulated by the FDA. Excimer laser is an effective treatment for CL with a favorable side-effect profile.
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Affiliation(s)
- Maximillian A Weigelt
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami - Miller School of Medicine, Miami, Florida, USA
| | - Alexander T Herbst
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami - Miller School of Medicine, Miami, Florida, USA
| | - Antonella Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami - Miller School of Medicine, Miami, Florida, USA
| | - Hadar Lev-Tov
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami - Miller School of Medicine, Miami, Florida, USA
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Botsali A, Caliskan E. Management of recalcitrant vitiligo in Vogt-Koyanagi-Harada syndrome: Adjuvant ablative fractional laser. Pediatr Dermatol 2020; 37:514-516. [PMID: 32131141 DOI: 10.1111/pde.14108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The course of dermatologic findings in Vogt-Koyanagi-Harada disease is variable. Herein, we report the remarkable repigmentation of widespread facial vitiligo lesions in an adolescent girl with Vogt-Koyanagi-Harada disease. The patient was treated with a combination of fractional erbium:YAG laser, topical tacrolimus, and phototherapy.
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Affiliation(s)
- Ayşenur Botsali
- Dermatology Department, Gülhane School of Medicine, Health Sciences University, Ankara, Turkey
| | - Ercan Caliskan
- Dermatology Department, Gülhane School of Medicine, Health Sciences University, Ankara, Turkey
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Amico S, Barnetche T, Dequidt L, Fauconneau A, Gérard E, Boursault L, Boniface K, Darrigade AS, Seneschal J. Characteristics of postinflammatory hyper- and hypopigmentation in patients with psoriasis: A survey study. J Am Acad Dermatol 2020; 83:1188-1191. [PMID: 32068039 DOI: 10.1016/j.jaad.2020.02.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Séverine Amico
- Department of Dermatology, National Reference Center for Rare Skin Disorders, Hôpital Saint-André, Centre Hospitalo-Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Thomas Barnetche
- Department of Rheumatology, National Reference Center for Severe Systemic Autoimmune Diseases, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
| | - Laure Dequidt
- Department of Dermatology, National Reference Center for Rare Skin Disorders, Hôpital Saint-André, Centre Hospitalo-Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Antoine Fauconneau
- Department of Dermatology, National Reference Center for Rare Skin Disorders, Hôpital Saint-André, Centre Hospitalo-Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Emilie Gérard
- Department of Dermatology, National Reference Center for Rare Skin Disorders, Hôpital Saint-André, Centre Hospitalo-Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Lucile Boursault
- Department of Dermatology, National Reference Center for Rare Skin Disorders, Hôpital Saint-André, Centre Hospitalo-Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Katia Boniface
- Inserm U1035, Biothérapie des Maladies Génétiques, Inflammatoires et Cancers (BMGIC), Immunodermatology team, University of Bordeaux, Bordeaux, France
| | - Anne-Sophie Darrigade
- Department of Dermatology, National Reference Center for Rare Skin Disorders, Hôpital Saint-André, Centre Hospitalo-Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Julien Seneschal
- Department of Dermatology, National Reference Center for Rare Skin Disorders, Hôpital Saint-André, Centre Hospitalo-Universitaire (CHU) de Bordeaux, Bordeaux, France; Inserm U1035, Biothérapie des Maladies Génétiques, Inflammatoires et Cancers (BMGIC), Immunodermatology team, University of Bordeaux, Bordeaux, France.
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Vitiligo Associated with Melanoma in a Malagasy Woman. Case Rep Dermatol Med 2019; 2019:7925785. [PMID: 31827944 PMCID: PMC6885251 DOI: 10.1155/2019/7925785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 09/18/2019] [Accepted: 10/01/2019] [Indexed: 11/24/2022] Open
Abstract
Malignant melanoma is the first fatal skin cancer. Vitiligo is a leukoderma or a multifactorial depigmentation acquired but especially of autoimmune origin. We report the first Malagasy case affected by both melanoma and Vitiligo. The appearance of Vitiligo during a melanoma could testify to an immunological response against melanocytes. Despite the association of melanoma and Vitiligo, the prognosis of melanoma is still fatal.
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Melanoma and Vitiligo: In Good Company. Int J Mol Sci 2019; 20:ijms20225731. [PMID: 31731645 PMCID: PMC6888090 DOI: 10.3390/ijms20225731] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/10/2019] [Accepted: 11/13/2019] [Indexed: 12/24/2022] Open
Abstract
Cutaneous melanoma represents the most aggressive form of skin cancer, whereas vitiligo is an autoimmune disorder that leads to progressive destruction of skin melanocytes. However, vitiligo has been associated with cutaneous melanoma since the 1970s. Most of the antigens recognized by the immune system are expressed by both melanoma cells and normal melanocytes, explaining why the autoimmune response against melanocytes that led to vitiligo could be also present in melanoma patients. Leukoderma has been also observed as a side effect of melanoma immunotherapy and has always been associated with a favorable prognosis. In this review, we discuss several characteristics of the immune system responses shared by melanoma and vitiligo patients, as well as the significance of occurrence of leukoderma during immunotherapy, with special attention to check-point inhibitors.
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Vogt-Koyanagi-Harada Syndrome in a Ugandan: Diagnostic and Therapeutic Challenges. Case Rep Med 2019; 2019:5192754. [PMID: 31636673 PMCID: PMC6766141 DOI: 10.1155/2019/5192754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/19/2019] [Accepted: 09/04/2019] [Indexed: 12/03/2022] Open
Abstract
Background Vogt–Koyanagi–Harada (VKH) syndrome is a multisystemic autoimmune disease of uncertain pathogenesis. Infectious aetiology has been proposed which is suggested to lead to the loss of melanocytes in the skin, inner ear, meninges, and uvea in those who are genetically predisposed. Information regarding VKH syndrome is scanty among the African population. Case Presentation We report a 28-year-old HIV-uninfected Ugandan woman who had previously been well and presented with chronic bilateral panuveitis; symmetrical vitiligo patches on the head, trunk, and upper limbs; tinnitus; and poliosis of the scalp hair, eyelashes, and eyebrows. A flu-like syndrome preceded this. Several weeks of prednisolone and azathioprine therapy resulted in remarkable improvement of the ocular and inner ear symptoms. Conclusion A high index of suspicion is required in diagnosing VKH syndrome, even in sub-Saharan Africa where the disease is reported to be rare. Initiation of prompt and appropriate treatment prevents blindness and other complications.
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