1
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Tisack A, Mohammad TF. Drug-Induced Pigmentation: A Review. Drugs 2024:10.1007/s40265-024-02062-z. [PMID: 39085684 DOI: 10.1007/s40265-024-02062-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2024] [Indexed: 08/02/2024]
Abstract
Drug-induced pigmentation (DIP) is estimated to account for 20% of all cases of acquired hyperpigmentation. Over 50 agents have been implicated, including antibiotics, antimalarials, antiretrovirals, antipsychotics, prostaglandin analogs, heavy metals, and chemotherapeutic agents. The skin, mucosal surfaces, nails, and hair can all be affected, with the color, distribution, onset, and duration of pigmentation varying between offending agents. Both a thorough physical examination and medication history are necessary to determine the offending agent. In terms of mechanism, DIP occurs most frequently through the accumulation of melanin within the dermis but also by drug accumulation, pigment synthesis, and iron deposition. Photoprotection, including applying a broad-spectrum sunscreen, wearing photoprotective clothing, and seeking shade, plays an important role in the prevention of exacerbation of DIP. Multiple lasers, including the picosecond alexandrite, Q-switched Nd:YAG, Q-switched alexandrite, and Q-switched ruby lasers, have been successful in obtaining clearance of DIP. In this review, we examine the unique characteristics of each of the inciting agents in terms of incidence, clinical presentation, time to onset and resolution, and pathogenesis.
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Affiliation(s)
- Aaron Tisack
- Department of Dermatology, Henry Ford Health, 3031 W Grand Blvd, Detroit, MI, 48202, USA
| | - Tasneem F Mohammad
- Department of Dermatology, Henry Ford Health, 3031 W Grand Blvd, Detroit, MI, 48202, USA.
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2
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Fernandez-Flores A, Colmenero I, Torrelo A. Pigmented Keratin Granuloma: A Rare Event. Am J Dermatopathol 2023; 45:777-779. [PMID: 37712939 DOI: 10.1097/dad.0000000000002534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Affiliation(s)
- Angel Fernandez-Flores
- Department of Histopathology, University Hospital El Bierzo, Ponferrada, Spain
- Department of Cellular Pathology, Hospital de la Reina, Ponferrada, Spain
- Research Department, Institute for Biomedical Research of A Coruña (INIBIC), University of A Coruña (UDC), A Coruña, Spain
| | - Isabel Colmenero
- Department of Histopathology, Hospital Universitario Niño Jesús, Madrid, Spain
| | - Antonio Torrelo
- Department of Dermatology, Hospital Universitario Niño Jesús, Madrid, Spain
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3
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Akash MSH, Yaqoob A, Rehman K, Imran M, Assiri MA, Al-Rashed F, Al-Mulla F, Ahmad R, Sindhu S. Metabolomics: a promising tool for deciphering metabolic impairment in heavy metal toxicities. Front Mol Biosci 2023; 10:1218497. [PMID: 37484533 PMCID: PMC10357477 DOI: 10.3389/fmolb.2023.1218497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 06/21/2023] [Indexed: 07/25/2023] Open
Abstract
Heavy metals are the metal compounds found in earth's crust and have densities higher than that of water. Common heavy metals include the lead, arsenic, mercury, cadmium, copper, manganese, chromium, nickel, and aluminum. Their environmental levels are consistently rising above the permissible limits and they are highly toxic as enter living systems via inhalation, ingestion, or inoculation. Prolonged exposures cause the disruption of metabolism, altered gene and/or protein expression, and dysregulated metabolite profiles. Metabolomics is a state of the art analytical tool widely used for pathomolecular inv22estigations, biomarkers, drug discovery and validation of biotransformation pathways in the fields of biomedicine, nutrition, agriculture, and industry. Here, we overview studies using metabolomics as a dynamic tool to decipher the mechanisms of metabolic impairment related to heavy metal toxicities caused by the environmental or experimental exposures in different living systems. These investigations highlight the key role of metabolomics in identifying perturbations in pathways of lipid and amino acid metabolism, with a critical role of oxidative stress in metabolic impairment. We present the conclusions with future perspectives on metabolomics applications in meeting emerging needs.
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Affiliation(s)
| | - Azka Yaqoob
- Department of Pharmaceutical Chemistry, Government College University Faisalabad, Faisalabad, Pakistan
| | - Kanwal Rehman
- Department of Pharmacy, The Women University, Multan, Pakistan
| | - Muhammad Imran
- Research Center for Advanced Materials Science (RCAMS), King Khalid University, Abha, Saudi Arabia
- Department of Chemistry, Faculty of Science, King Khalid University, Abha, Saudi Arabia
| | - Mohammed A. Assiri
- Research Center for Advanced Materials Science (RCAMS), King Khalid University, Abha, Saudi Arabia
- Department of Chemistry, Faculty of Science, King Khalid University, Abha, Saudi Arabia
| | - Fatema Al-Rashed
- Immunology and Microbiology Department, Dasman Diabetes Institute, Dasman, Kuwait
| | - Fahd Al-Mulla
- Research Division, Dasman Diabetes Institute, Dasman, Kuwait
| | - Rasheed Ahmad
- Immunology and Microbiology Department, Dasman Diabetes Institute, Dasman, Kuwait
| | - Sardar Sindhu
- Immunology and Microbiology Department, Dasman Diabetes Institute, Dasman, Kuwait
- Animal and Imaging Core Facilities, Dasman Diabetes Institute, Dasman, Kuwait
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4
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Ison J, Clark A. Pigmented Lesions of the Oral Cavity. Oral Maxillofac Surg Clin North Am 2023; 35:153-158. [PMID: 37019502 DOI: 10.1016/j.coms.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Pigmented lesions are a common finding in the oral cavity. Oral pigmented lesions may range from solitary to multiple, pinpoint to diffuse, and have a variety of clinical implications. Nearly all solitary pigmented lesions require a biopsy to rule out mucosal melanoma. Oral mucosal melanoma has a grim prognosis and early discovery is of utmost importance. Multiple pigmented lesions in the oral cavity may indicate a systemic condition about which the patient may not be aware. The presentation and management of these various lesions is the focus of this article.
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5
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Wawrzyk-Bochenek I, Rahnama M, Stachura M, Wilczyński S, Wawrzyk A. Evaluation of the Reduction of Skin Hyperpigmentation Changes under the Influence of a Preparation Containing Kojic Acid Using Hyperspectral Imaging—Preliminary Study. J Clin Med 2023; 12:jcm12072710. [PMID: 37048793 PMCID: PMC10094916 DOI: 10.3390/jcm12072710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/22/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Aim: The aim of this study was to demonstrate the effects of using a preparation containing kojic acid on skin hyperpigmentation using hyperspectral imaging, which enables a quantitative assessment of the effect of the preparation used on the reduction of skin discoloration. Materials and methods: Preliminary studies were carried out on 12 patients with post-acne skin. A hyperspectral camera with a spectral range of 400–1000 nm was used to image skin hyperpigmentation before and after the application of 3% kojic acid. Hyperspectral profiles were analyzed, and image analysis and processing methods were applied. Results: Studies performed using a hyperspectral camera have shown that kojic acid reduces skin discoloration by increasing skin brightness in 75% of patients tested, reducing skin contrast in approximately 83% and increasing skin homogeneity in approximately 67% of patients.
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Affiliation(s)
- Iga Wawrzyk-Bochenek
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Kasztanowa 3, 41-205 Sosnowiec, Poland
| | - Mansur Rahnama
- Chair and Department of Oral Surgery, Medical University of Lublin, Chodźki 6, 20-093 Lublin, Poland
| | - Martyna Stachura
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Kasztanowa 3, 41-205 Sosnowiec, Poland
| | - Sławomir Wilczyński
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Kasztanowa 3, 41-205 Sosnowiec, Poland
| | - Anna Wawrzyk
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Kasztanowa 3, 41-205 Sosnowiec, Poland
- Silesian Park of Medical Technology Kardio-Med Silesia in Zabrze, M. Curie Skłodowskiej 10C, 41-800 Zabrze, Poland
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6
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Wang RF, Ko D, Friedman BJ, Lim HW, Mohammad TF. Disorders of hyperpigmentation. Part I. Pathogenesis and clinical features of common pigmentary disorders. J Am Acad Dermatol 2023; 88:271-288. [PMID: 35151757 DOI: 10.1016/j.jaad.2022.01.051] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/22/2021] [Accepted: 01/10/2022] [Indexed: 01/17/2023]
Abstract
Disorders of hyperpigmentation are common and, depending on the extent and location of involvement, can affect the quality of life and pose a significant psychologic burden for patients. Given the similarities in presentation of the various causes of hyperpigmentation, it is often difficult to elucidate the etiology of these conditions, which is important to guide management. Furthermore, certain disorders, such as lichen planus pigmentosus and ashy dermatosis, have similar clinical and/or histologic presentations, and their classification as distinct entities has been debated upon, leading to additional confusion. In this review, the authors selected commonly encountered disorders of hyperpigmentation of the skin, subdivided into epidermal, dermal, or mixed epidermal-dermal disorders based on the location of pigment deposition, along with disorders of hyperpigmentation of the mucosa and nails. Melanocytic nevi, genetic disorders, and systemic causes of hyperpigmentation were largely excluded and considered to be outside the scope of this review. We discussed the pathogenesis of hyperpigmentation as well as the clinical and histologic features of these conditions, along with challenges encountered in their diagnosis and classification. The second article in this 2-part continuing medical education series focuses on the medical and procedural treatments of hyperpigmentation.
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Affiliation(s)
- Rebecca F Wang
- From the Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Dayoung Ko
- From the Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Ben J Friedman
- From the Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Henry W Lim
- From the Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Tasneem F Mohammad
- From the Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.
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7
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Esmaeili S, Shahbazi S, Asnaashari M. Gingival Melanin Depigmentation Using a Diode 808-nm Laser: A Case Series. J Lasers Med Sci 2022; 13:e41. [PMID: 36743137 PMCID: PMC9841391 DOI: 10.34172/jlms.2022.41] [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: 11/02/2021] [Accepted: 07/18/2022] [Indexed: 01/27/2023]
Abstract
Introduction: Gingival hyperpigmentation is caused by an increase in the amount of melanin production or the number of melanocytes in the epithelium, which can impair smile esthetics. The current study aimed to report the experience of using a diode laser for gingival depigmentation of three different patients. Case Presentation: Three adult patients are presented with hyperpigmentation in labial gingivae of both jaws. The depigmentation was done using a diode laser at a wavelength of 808 nm, fiber diameter of 300 μm, and power of 1 W and in continuous mode. All three patients showed proper resolution of hyperpigmented areas in short- and long-term follow-up sessions. However, degrees of recurrence were noticeable in two cases. Conclusion: The 808-nm diode laser can be utilized safely and efficiently in gingival depigmentation, resulting in an acceptable cosmetic outcome.
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Affiliation(s)
| | | | - Mohammad Asnaashari
- Correspondence to Mohammad Asnaashari, Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Daneshjoo Blvd., Tehran, Iran. Tel: + 989121145860; ,
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Enkhtaivan E, Lee CH. Role of Amine Neurotransmitters and Their Receptors in Skin Pigmentation: Therapeutic Implication. Int J Mol Sci 2021; 22:ijms22158071. [PMID: 34360837 PMCID: PMC8348573 DOI: 10.3390/ijms22158071] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/09/2021] [Accepted: 07/24/2021] [Indexed: 12/27/2022] Open
Abstract
Skin pigmentation can occur due to increased melanin, including melanocyte proliferation, melanin biosynthesis, or melanocyte migration. There are many factors that influence the melanin production process, but the role of neurotransmitters in this process is still unclear. We found that histamine and serotonin influence the different stages of melanogenesis and melanogenesis, which increase melanogenesis. Since then, several related papers have been published, and from these papers, it has been recognised that the role of neurotransmitters in skin-pigment-related diseases needs to be summarised. By introducing the role of neurotransmitters in the regulation of various pigment disorders, including vitiligo and melasma, through this review, many researchers can be expected to try to apply neurotransmitter-related agonists and antagonists as treatments for skin pigment disorders.
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9
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Mota L, Dinis-Oliveira RJ. Clinical and Forensic Aspects of the Different Subtypes of Argyria. J Clin Med 2021; 10:2086. [PMID: 34068024 PMCID: PMC8152497 DOI: 10.3390/jcm10102086] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/29/2021] [Accepted: 05/11/2021] [Indexed: 11/16/2022] Open
Abstract
Argyria encompasses the different cosmetic alterations that can develop if enough silver particles deposit in a specific tissue, typically in the skin, ranging from localized dark-blue macules to a generalized slate-gray/bluish tinge following systemic absorption. This work aims to fully review the state of the art regarding pathophysiology, diagnosis, treatment, and relevant clinical and forensic features of argyria. Argyria has been diagnosed in a wide range of ages, both sexes and varied ethnicities, with no known individual predisposing factors. Ultraviolet radiation with subsequence increases of melanin production aggravates the discoloration due to a reduction in the silver deposits. Physical examination and silver exposure in the anamnesis can be highly suggestive of the diagnosis, but a histopathological analysis with Energy-Dispersive X-ray Spectroscopy is required to unequivocally determine the discoloration etiology. Safe and effective treatment has only been accomplished with laser techniques, though only a few cases have been reported and with limited follow-up time. In conclusion, argyria typically has an occupational or iatrogenic etiology. It should be suspected when a patient presents with typical skin or eye lesions. A seemingly viable treatment modality, with laser technology, is finally within the horizon.
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Affiliation(s)
- Luís Mota
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Ricardo Jorge Dinis-Oliveira
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- IINFACTS-Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS), Advanced Polytechnic and University Cooperative (CESPU), CRL, 4585-116 Gandra, Portugal
- UCIBIO-REQUIMTE-Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
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10
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Systemic toxicity of chloroquine and hydroxychloroquine: prevalence, mechanisms, risk factors, prognostic and screening possibilities. Rheumatol Int 2021; 41:1189-1202. [PMID: 33893862 PMCID: PMC8064887 DOI: 10.1007/s00296-021-04868-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/13/2021] [Indexed: 02/07/2023]
Abstract
Chloroquine (CQ) and its hydroxylated analog, hydroxychloroquine (HCQ), are 4-aminoquinoline initially used as an antimalarial treatment. CQ and HCQ (4-aminoquinoline, 4-AQ) are today used in rheumatology, especially to treat rheumatoid arthritis and systemic lupus erythematosus. Their mechanism of action revolves around a singular triptych: 4-AQ acts as alkalizing agents, ionized amphiphilic molecules, and by binding to numerous targets. 4-AQ have so pleiotropic and original mechanisms of action, providing them an effect at the heart of the regulation of several physiological functions. However, this broad spectrum of action is also at the origin of various and original side effects, notably a remarkable chronic systemic toxicity. We describe here the 4-AQ-induced lesions on the eye, the heart, muscle, the nerves, the inner ear, and the kidney. We also describe their prevalence, their pathophysiological mechanisms, their risk factors, their potential severity, and the means to detect them early. Most of these side effects are reversible if treatment is stopped promptly. This 4-AQ-induced toxicity must be known to prescribing physicians, to closely monitor its appearance and stop treatment in time if necessary.
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11
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Saha B, Gupta I, Dayal S, Chhabra S. A Rare Case of Risperidone Induced Reticular Palmar Pigmentation. Indian Dermatol Online J 2021; 12:183-184. [PMID: 33768051 PMCID: PMC7982035 DOI: 10.4103/idoj.idoj_315_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/12/2020] [Accepted: 06/22/2020] [Indexed: 11/21/2022] Open
Affiliation(s)
- Barnita Saha
- Department of Skin and VD, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Isha Gupta
- Department of Skin and VD, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Surabhi Dayal
- Department of Skin and VD, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Sonia Chhabra
- Department of Pathology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
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12
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Arenbergerova M, Arenberger P, Gkalpakiotis S, Sticova E, Hulkova H, Trhlikova O, Sikora J. Palladium causes bizarre skin hyperpigmentation in long-term dihydrocodeinone 'Braun' abusers. J Eur Acad Dermatol Venereol 2019; 34:188-191. [PMID: 31494978 DOI: 10.1111/jdv.15930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 07/25/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND 'Braun' is an illegal injectable dihydrocodeinone-enriched drug mixture of semi-synthetic opioids. It is prepared by palladium-catalysed hydrogenation from codeine-containing tablets. OBJECTIVE We aimed to characterize the dermatologic consequences of long-term abuse of 'Braun'. METHODS Skin biopsies of two long-term 'Braun' abusers were evaluated histopathologically, immunohistochemically and ultrastructurally. Palladium skin content was assessed by X-ray fluorescence (XRF) spectrometry. RESULTS Both patients showed generalized diffuse dark blue-grey hyperpigmentation of the skin. In both, an abnormal population of cells containing intracytoplasmic brownish granular material was identified in the papillary dermis by light microscopy. Electron microscopy revealed a dense and minimally structured material that predominantly accumulated in macrophages, fibroblasts and vascular endothelial cells. XRF analysis confirmed elevated levels of palladium in the patient's skin in comparison to healthy controls. CONCLUSION Long-term abuse of palladium-contaminated dihydrocodeinone ('Braun') results in excessive accumulation of granular material in various dermal cell types and causes generalized diffuse skin hyperpigmentation.
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Affiliation(s)
- M Arenbergerova
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University, and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - P Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University, and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - S Gkalpakiotis
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University, and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - E Sticova
- Department of Pathology, Third Faculty of Medicine, Charles University, and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - H Hulkova
- Department of Pediatrics and Adolescent Medicine, Research Unit for Rare Diseases, First Faculty of Medicine, General University Hospital, Prague, Czech Republic.,Institute of Pathology, First Faculty of Medicine, General University Hospital, Prague, Czech Republic
| | - O Trhlikova
- Institute of Macromolecular Chemistry, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - J Sikora
- Department of Pediatrics and Adolescent Medicine, Research Unit for Rare Diseases, First Faculty of Medicine, General University Hospital, Prague, Czech Republic.,Institute of Pathology, First Faculty of Medicine, General University Hospital, Prague, Czech Republic
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13
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Chiang TC, Koss B, Su LJ, Washam CL, Byrum SD, Storey A, Tackett AJ. Effect of Sulforaphane and 5-Aza-2'-Deoxycytidine on Melanoma Cell Growth. MEDICINES 2019; 6:medicines6030071. [PMID: 31252639 PMCID: PMC6789461 DOI: 10.3390/medicines6030071] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 06/21/2019] [Accepted: 06/24/2019] [Indexed: 12/12/2022]
Abstract
Background: UV exposure-induced oxidative stress is implicated as a driving mechanism for melanoma. Increased oxidative stress results in DNA damage and epigenetic dysregulation. Accordingly, we explored whether a low dose of the antioxidant sulforaphane (SFN) in combination with the epigenetic drug 5-aza-2’-deoxycytidine (DAC) could slow melanoma cell growth. SFN is a natural bioactivated product of the cruciferous family, while DAC is a DNA methyltransferase inhibitor. Methods: Melanoma cell growth characteristics, gene transcription profiles, and histone epigenetic modifications were measured after single and combination treatments with SFN and DAC. Results: We detected melanoma cell growth inhibition and specific changes in gene expression profiles upon combinational treatments with SFN and DAC, while no significant alterations in histone epigenetic modifications were observed. Dysregulated gene transcription of a key immunoregulator cytokine—C-C motif ligand 5 (CCL-5)—was validated. Conclusions: These results indicate a potential combinatorial effect of a dietary antioxidant and an FDA-approved epigenetic drug in controlling melanoma cell growth.
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Affiliation(s)
- Tung-Chin Chiang
- Department of Environmental and Occupational Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
| | - Brian Koss
- Department of Biochemistry & Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - L Joseph Su
- Winthrop P. Rockefeller Cancer Institute, Cancer Prevention and Population Sciences Program & Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Charity L Washam
- Department of Biochemistry & Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Arkansas Children's Research Institute, Little Rock, AR 72202, USA
| | - Stephanie D Byrum
- Department of Biochemistry & Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Arkansas Children's Research Institute, Little Rock, AR 72202, USA
| | - Aaron Storey
- Department of Biochemistry & Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Alan J Tackett
- Department of Biochemistry & Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
- Arkansas Children's Research Institute, Little Rock, AR 72202, USA.
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14
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Rerknimitr P, Kantikosum K, Chottawornsak N, Tangkijngamvong N, Kerr S, Prueksapanich P, Sithisarankul P, Kumtornrut C, Asawanonda P, Sutheparuk S, Panchaprateep R. Chronic occupational exposure to lead leads to significant mucocutaneous changes in lead factory workers. J Eur Acad Dermatol Venereol 2019; 33:1993-2000. [DOI: 10.1111/jdv.15678] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 05/02/2019] [Indexed: 01/06/2023]
Affiliation(s)
- P. Rerknimitr
- Skin and Allergy Research Unit Division of Dermatology Department of Medicine Faculty of Medicine Chulalongkorn University Bangkok Thailand
| | - K. Kantikosum
- Skin and Allergy Research Unit Division of Dermatology Department of Medicine Faculty of Medicine Chulalongkorn University Bangkok Thailand
| | - N. Chottawornsak
- Skin and Allergy Research Unit Division of Dermatology Department of Medicine Faculty of Medicine Chulalongkorn University Bangkok Thailand
| | - N. Tangkijngamvong
- Skin and Allergy Research Unit Division of Dermatology Department of Medicine Faculty of Medicine Chulalongkorn University Bangkok Thailand
| | - S.J. Kerr
- Center for Excellence in Biostatistics Faculty of Medicine Chulalongkorn University Bangkok Thailand
| | - P. Prueksapanich
- Division of Gastroenterology Department of Medicine Faculty of Medicine Chulalongkorn University Bangkok Thailand
| | - P. Sithisarankul
- Department of Preventive and Social Medicine Faculty of Medicine Chulalongkorn University Bangkok Thailand
| | - C. Kumtornrut
- Skin and Allergy Research Unit Division of Dermatology Department of Medicine Faculty of Medicine Chulalongkorn University Bangkok Thailand
| | - P. Asawanonda
- Skin and Allergy Research Unit Division of Dermatology Department of Medicine Faculty of Medicine Chulalongkorn University Bangkok Thailand
| | - S. Sutheparuk
- Division of Toxicology Department of Medicine Faculty of Medicine Chulalongkorn University Bangkok Thailand
| | - R. Panchaprateep
- Skin and Allergy Research Unit Division of Dermatology Department of Medicine Faculty of Medicine Chulalongkorn University Bangkok Thailand
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15
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Clarysse K, Grosber M, Ring J, Gutermuth J, Kivlahan C. Skin lesions, differential diagnosis and practical approach to potential survivors of torture. J Eur Acad Dermatol Venereol 2019; 33:1232-1240. [PMID: 30659672 DOI: 10.1111/jdv.15439] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 12/03/2018] [Indexed: 11/29/2022]
Abstract
As the international refugee crisis has reached new proportions (BMJ, 355, 2016 and i5412), survivors of torture increasingly present in treating physicians with an array of acute or chronic skin lesions. Physicians should be aware of common presentations and likely differential diagnoses in order to avoid mislabelling or under-recognizing torture. Survivors of torture also frequently suffer from psychological sequelae, such as post-traumatic stress disorder, and appropriate referrals are essential in order to improve recovery trajectory. Skin sequelae are the most common physical findings of torture. Not all skin lesions seen in tortured survivors are due to perpetrator inflicted injuries, and many dermatological conditions can mimic lesions typical of torture, as can scars as a result of folk remedies or cultural practices specific to geographical regions. Medical documentation of torture includes injury and lesion description. While forensic dermatology and other forensic specialties use an injury description taxonomy, and the standard dermatologic taxonomy uses an anatomic description, they are complementary sciences for lesions inflicted by torture. This results in an opportunity for learning across disciplines in order to improve evidence documentation for survivors of torture. This article describes features of common skin lesions consistent with torture, including their clinical appearances, differential diagnoses, patterns of injury and appropriate clinical descriptions.
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Affiliation(s)
- K Clarysse
- Department of Dermatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - M Grosber
- Department of Dermatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - J Ring
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - J Gutermuth
- Department of Dermatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - C Kivlahan
- University of California San Francisco Health System, San Francisco, CA, USA
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Alharbi MA. Q‐switched double‐frequency Nd:YAG (532 nm) laser is an effective treatment for racial lip pigmentation. J Cosmet Dermatol 2019; 18:1672-1674. [DOI: 10.1111/jocd.12946] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 11/06/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Mana Abdullah Alharbi
- Department of Dermatology Imam Muhammad ibn Saud Islamic University (IMSIU) Riyadh Saudi Arabia
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Abstract
Drug-induced pigmentation accounts for up to 20% of all cases of acquired pigmentation. A thorough review of medical history and previous and ongoing medications as well as a complete skin examination can guide diagnosis. Implicated agents include alkylating/cytotoxic agents, analgesics, antiarrhythmics, anticoagulants, antiepileptics, antimalarials, antimicrobials, antiretrovirals, metals, prostaglandin analogs, and psychotropic agents, among others. Confirming true drug associations can be challenging, especially in the setting of delayed onset of pigmentation and coexisting polypharmacy.
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Affiliation(s)
- Amanda F Nahhas
- Department of Dermatology, Beaumont-Farmington Hills, Farmington Hills, MI, USA
- Department of Dermatology, Henry Ford Hospital, 3031 W. Grand Blvd., Suite 800, Detroit, MI, 48202, USA
| | - Taylor L Braunberger
- Department of Dermatology, Henry Ford Hospital, 3031 W. Grand Blvd., Suite 800, Detroit, MI, 48202, USA
| | - Iltefat H Hamzavi
- Department of Dermatology, Henry Ford Hospital, 3031 W. Grand Blvd., Suite 800, Detroit, MI, 48202, USA.
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Mucocutaneous Hyperpigmentation in a Patient With a History of Both Minocycline and Silver Ingestion. Am J Dermatopathol 2018; 39:916-919. [PMID: 28475520 DOI: 10.1097/dad.0000000000000920] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Minocycline is a derivative of tetracycline. It has been widely used in dermatology for the treatment of acne and rosacea. One of its adverse effects is pigmentation of various body tissues. Clinically, 3 main distinct types of hyperpigmentation by minocycline have been distinguished: type I, with blue-gray to black pigment on the face in areas of scarring or inflammation; type II, with blue-gray pigment on normal skin of the legs, forearms and on the shins; and type III, with a diffuse muddy-brown discoloration in areas of sun exposure. In the current report, we present the case of a 50-year old man with a history of severe acne treated with minocycline in the past, who currently complained about discoloration of his face. He had also taken colloidal silver supplements for "good health" about 16 years ago. Physical examination revealed gray-blue discoloration on the face, sclera, hard palate and back. Histologic examination showed intracellular pigment deposits in macrophages of the superficial dermis in a perivascular and an interstitial distribution. The pigment stained with Fontana-Masson and von Kossa, whereas it was Perls' iron negative. This case does not fit well into any of the previously described patterns of minocycline-related hyperpigmentation.
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Debnath K, Chatterjee A. Clinical and histological evaluation on application of platelet concentrates on depigmented gingival epithelium. J Indian Soc Periodontol 2018; 22:150-157. [PMID: 29769770 PMCID: PMC5939023 DOI: 10.4103/jisp.jisp_342_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background The platelet concentrate is a windfall in the field of regenerative therapy in periodontology. It accelerates wound healing by excellent neovascularization and promoting fast cicatricle tissue remodeling. Aim This study aims to evaluate clinically and histologically accelerated effect of platelet-rich fibrin (PRF) membrane and PRF matrix (PRFM) following depigmentation procedure. Materials and Methods Eleven individuals were divided into three groups after depigmentation procedure. PRF membrane and PRFM gel were prepared as per standard protocol. Group A and B received PRF membrane and PRFM gel followed by periodontal dressing, respectively, and the only periodontal dressing was placed in Group C. The individuals were evaluated for visual analog scale (VAS) and healing index (HI) on 3rd and 5th day. Epithelization test and histologic analysis from punch biopsy were done on the 5th day. At 3rd month, reevaluation was performed. Results The intergroup statistical analysis in respect to VAS, HI, epithelization test, and histologic analysis showed a statistically significant results with P < 0.001 in Groups A and B compared to Group C. Clinical evaluation of epithelization test and histologic analysis revealed better-wound healing and moderate to no inflammatory cell infiltrate in Groups A and B, respectively, as compared to Group C, which appeared more erythematous with dense inflammatory cells. Conclusion Thus, the application of PRF membrane and PRFM gel has shown a successful approach to protect the raw wound area of depigmented sites with better patient comfort and faster healing.
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Affiliation(s)
- Koel Debnath
- Department of Periodontology, The Oxford Dental College, Bengaluru, Karnataka, India
| | - Anirban Chatterjee
- Department of Periodontology, The Oxford Dental College, Bengaluru, Karnataka, India
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Abstract
Pigmented deposits can occur in the skin due to many and varied causes. Some of them are systemic conditions accompanied by involvement of internal organs. Others have serious prognostic implications, and early diagnosis can help in the correct and adequate management of the diseases. In addition, some of them are quite innocuous and the correct diagnosis avoids unnecessary treatments. In this article, we review the morphologic features of some of the most common and some of the less usual pigmented deposits in skin other than tattoos.
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Abstract
PURPOSE To present a case of minocycline-induced blue scleral pigmentation and discuss the pathophysiology and differential diagnoses. The uses, mechanisms, and other adverse effects of minocycline will also be highlighted. CASE REPORT An elderly Caucasian male patient presented for routine ocular examination complaining of blue discoloration to the whites of his eyes. He was found to have bilateral blue scleral pigmentation and blue discoloration to various other dermal areas of his body. The blue pigmentation was also visible in the posterior segment within a scleral crescent around his right optic nerve. This pigmentation was determined to be caused by long-term use of oral minocycline. CONCLUSIONS Long-term minocycline use may induce scleral, dermal, and organ hyperpigmentation, typically blue or black in coloration. The pigmentation may reverse with discontinuation of the medication, but can also be permanent. The exact mechanism of pigment deposition remains uncertain, but several theories have been proposed. While the cosmetic appearance may be dramatic, this side effect is not known to cause any systemic or ocular morbidity.
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Rodriguez V, Romaguera RL, Heidecker B. Silver-Containing Wound Cream Leading to Argyria-Always Ask About Alternative Health Products. Am J Med 2017; 130:e145-e146. [PMID: 28159181 DOI: 10.1016/j.amjmed.2016.11.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 11/16/2016] [Accepted: 11/17/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Vanessa Rodriguez
- Department of Geriatrics and Palliative Care, Mount Sinai Hospital, New York, NY
| | - Rita L Romaguera
- Department of Pathology, Bruce W. Carter Miami Veteran Affairs Hospital, Fla
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Giménez-García R. Hyperpigmentation Induced by Combination Therapy With Telmisartan-Hydrochlorothiazide. J Clin Hypertens (Greenwich) 2015; 18:361-2. [PMID: 26360127 DOI: 10.1111/jch.12665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Rosa Giménez-García
- Department of Dermatology, Río Hortega University Hospital, Valladolid, Spain
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Namdeoraoji Bahadure R, Singh P, Jain E, Khurana H, Badole G. Management of pigmented gingiva in child patient: a new era to the pediatric dentistry. Int J Clin Pediatr Dent 2014; 6:197-200. [PMID: 25206222 PMCID: PMC4086607 DOI: 10.5005/jp-journals-10005-1218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 08/30/2013] [Indexed: 11/23/2022] Open
Abstract
Gingival health in the form of size, shape, consistency and appearance are essential components responsible for an attractive smile as well as may cause unpleasant appearance. Melanin pigmentation often occurs in the gingiva as a result of an abnormal deposition of melanin which can compromise the confidence level from the age of childhood. The present article describes and discusses the two cases of gingival melanin pigmentation in 12 and 13 years of female patient and their early surgical intervention with successful follow-up of 9 and 6 months. Patients were instructed to prevent sun exposure, intake of hot foods or beverages like cold drinks, tea, coffee and brushing immediately after surgery. How to cite this article: Bahadure RN, Singh P, Jain E, Khurana H, Badole G. Management of Pigmented Gingiva in Child Patient: A New Era to the Pediatric Dentistry. Int J Clin Pediatr Dent 2013;6(3):197-200.
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Affiliation(s)
- Rakesh Namdeoraoji Bahadure
- Lecturer, Department of Pedodontics and Preventive Dentistry, Sharad Pawar Dental College, Wardha, Maharashtra, India, e-mail:
| | - Parul Singh
- Lecturer, Department of Pedodontics and Preventive Dentistry, FODS Chhatrapati Shahuji Maharaj Medical University, Lucknow, Uttar Pradesh, India
| | - Eesha Jain
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry, FODS, Chhatrapati Shahuji Maharaj Medical University, Lucknow, Uttar Pradesh, India
| | - Heena Khurana
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry, FODS, Chhatrapati Shahuji Maharaj Medical University, Lucknow, Uttar Pradesh, India
| | - Gautam Badole
- Lecturer, Department of Conservative Dentistry, VSPM Dental College, Nagpur, Maharashtra, India
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Abstract
: The cutaneous deposition disorders are a group of unrelated conditions characterized by the accumulation of either endogenous or exogenous substances within the skin. These cutaneous deposits are substances that are not normal constituents of the skin and are laid down usually in the dermis, but also in the subcutis, in a variety of different circumstances. There are 5 broad categories of cutaneous deposits. The first group includes calcium salts, bone, and cartilage. The second category includes the hyaline deposits that may be seen in the dermis in several metabolic disorders, such as amyloidosis, gout, porphyria, and lipoid proteinosis. The third category includes various pigments, heavy metals, and complex drug pigments. The fourth category, cutaneous implants, includes substances that are inserted into the skin for cosmetic purposes. The fifth category includes miscellaneous substances, such as oxalate crystals and fiberglass. In this article, the authors review the clinicopathologic characteristics of cutaneous deposition diseases, classify the different types of cutaneous deposits, and identify all the histopathologic features that may assist in diagnosing the origin of a cutaneous deposit.
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Affiliation(s)
- Kyle T. Amber
- Department of Dermatology and Cutaneous Surgery; University of Miami; Miller School of Medicine; Miami FL USA
| | - Caroline Y. Winslow
- Department of Dermatology and Cutaneous Surgery; University of Miami; Miller School of Medicine; Miami FL USA
| | - Andrew Styperek
- Department of Dermatology and Cutaneous Surgery; University of Miami; Miller School of Medicine; Miami FL USA
| | - Peter H. Schwartz
- Department of Dermatology and Cutaneous Surgery; University of Miami; Miller School of Medicine; Miami FL USA
| | - Michael I. Shiman
- Department of Dermatology and Cutaneous Surgery; University of Miami; Miller School of Medicine; Miami FL USA
| | - George Elgart
- Department of Dermatology and Cutaneous Surgery; University of Miami; Miller School of Medicine; Miami FL USA
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Budair FM. Non drug related cutaneous hyperpigmentation in a patient with malaria. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2014. [DOI: 10.1016/j.jssdds.2013.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Hydroxychloroquine-associated hyperpigmentation mimicking elder abuse. Dermatol Ther (Heidelb) 2013; 3:203-10. [PMID: 24318415 PMCID: PMC3889308 DOI: 10.1007/s13555-013-0032-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Indexed: 12/04/2022] Open
Abstract
Background Hydroxychloroquine may result in cutaneous dyschromia. Older individuals who are the victims of elder abuse can present with bruising and resolving ecchymoses. Purpose The features of hydroxychloroquine-associated hyperpigmentation are described, the mucosal and skin manifestations of elder abuse are reviewed, and the mucocutaneous mimickers of elder abuse are summarized. Case Report An elderly woman being treated with hydroxychloroquine for systemic lupus erythematosus developed drug-associated black and blue pigmentation of her skin. The dyschromia was misinterpreted by her clinician as elder abuse and Adult Protective Services was notified. The family was eventually cleared of suspected elder abuse. A skin biopsy of the patient’s dyschromia confirmed the diagnosis of hydroxychloroquine-associated hyperpigmentation. Conclusion Hyperpigmentation of skin, mucosa, and nails can be observed in patients treated with antimalarials, including hydroxychloroquine. Elder abuse is a significant and underreported problem in seniors. Cutaneous findings can aid in the discovery of physical abuse, sexual abuse, and self-neglect in elderly individuals. However, medication-associated effects, systemic conditions, and accidental external injuries can mimic elder abuse. Therefore, a complete medical history and appropriate laboratory evaluation, including skin biopsy, should be conducted when the diagnosis of elder abuse is suspected.
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Shinohara MM, Nguyen J, Gardner J, Rosenbach M, Elenitsas R. The histopathologic spectrum of decorative tattoo complications. J Cutan Pathol 2012; 39:1110-8. [DOI: 10.1111/cup.12023] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 02/12/2012] [Accepted: 05/18/2012] [Indexed: 12/19/2022]
Affiliation(s)
- Michi M. Shinohara
- Department of Medicine, Division of Dermatology; University of Washington; Seattle; WA; USA
| | - Jennifer Nguyen
- Department of Dermatology; University of Pennsylvania; Philadelphia; PA; USA
| | - Jennifer Gardner
- Department of Dermatology; University of Pennsylvania; Philadelphia; PA; USA
| | - Misha Rosenbach
- Department of Dermatology; University of Pennsylvania; Philadelphia; PA; USA
| | - Rosalie Elenitsas
- Department of Dermatology; University of Pennsylvania; Philadelphia; PA; USA
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Abstract
Imatinib mesylate (STI-571, Gleevec(®)), a tyrosine kinase inhibitor, is a first-line medication for treating chronic myeloid leukemia (CML). Clinical studies revealed very good hematological responses without significant side effects. However, imatinib may lead to mucosal pigmentation. Three patients, two males aged 64 and 53 and one female aged 29 presented with a painless, diffuse, grey-blue pigmentation of the mucosa of the hard palate. Both male patients had a history of CML and had been on imatinib for 4 and 10 years, respectively. The female patient had been on imatinib for 4 years for pelvic fibromatosis. Histopathologically, deposition of fine, dark-brown, spherical granules was noted within the connective tissue. There was no inflammation or hemorrhage, and no melanosis or melanocytic hyperplasia in the epithelium. The granules stained positively for both Fontana-Masson and Prussian blue stains. Imatinib-induced pigmentation is similar to that caused by other medications such as minocycline and anti-malarial medications, namely the deposition of a drug metabolite containing melanin and iron.
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Kathariya R, Pradeep AR. Split mouth de-epithelization techniques for gingival depigmentation: A case series and review of literature. J Indian Soc Periodontol 2011; 15:161-8. [PMID: 21976842 PMCID: PMC3183669 DOI: 10.4103/0972-124x.84387] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2010] [Accepted: 04/17/2011] [Indexed: 11/05/2022] Open
Abstract
Gingival melanin pigmentation occurs in all races of mankind. Although clinical melanin pigmentation does neither present itself as a medical problem nor a disease entity, it is a major esthetic concern for many people, especially Asians. Esthetic gingival depigmentation procedures can be performed in such patients with excellent results. This case series presents a split mouth de-epithelization procedure using popular surgical techniques such as scalpel, bur abrasion or electrosurgery. These techniques were successfully used to treat gingival hyperpigmentation. Although we found that electrosurgery increased the efficacy of our work, giving a cleaner and neater work field, it required a lot of precision. In contrast, scalpel de-epithelization was easy and technique-friendly, giving excellent results and patient satisfaction. However, the cases are being followed-up to study the factors affecting the rate and length of time required for repigmentation and to study the repigmentation patterns. This case series also reviews the advantages and disadvantages of various techniques available for depigmentation, and reiterates that the scalpel technique still serves as a gold standard for depigmentation.
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Affiliation(s)
- Rahul Kathariya
- Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India
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Forensics in dermatology: Part II. J Am Acad Dermatol 2011; 64:811-24; quiz 825-6. [DOI: 10.1016/j.jaad.2010.06.066] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2009] [Revised: 04/08/2010] [Accepted: 06/04/2010] [Indexed: 11/23/2022]
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Müller S. Melanin-associated pigmented lesions of the oral mucosa: presentation, differential diagnosis, and treatment. Dermatol Ther 2010; 23:220-9. [PMID: 20597941 DOI: 10.1111/j.1529-8019.2010.01319.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Intraoral pigmentation is quite common and has numerous etiologies, ranging from exogenous to physiological to neoplastic. Many pigmented lesions of the oral cavity are associated with melanin pigment. The differential diagnosis of mucosal pigmented lesions includes hematomas, varices, and petechiae which may appear to be pigmented. Unlike cutaneous melanomas, oral melanomas are diagnosed late and have a poor prognosis regardless of depth of invasion. As such, the clinical presentation and treatment of intraoral melanoma will be discussed. Developing a differential diagnosis is imperative for a clinician faced with these lesions in order to appropriately treat the patient. This article will focus on the most common oral melanocytic lesions, along with mimics.
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Affiliation(s)
- Susan Müller
- Department of Pathology, Emory University, Atlanta, GA 30322, USA.
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El Safoury OS, El Fatah DSA, Ibrahim M. Treatment of periocular hyperpigmentation due to lead of kohl (surma) by penicillamine: a single group non-randomized clinical trial. Indian J Dermatol 2010; 54:361-3. [PMID: 20101339 PMCID: PMC2807714 DOI: 10.4103/0019-5154.57614] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Periocular hyperpigmentation is a condition in which skin of eyelids become darker in color than the normal surrounding skin. Lead and other heavy metals produce increased pigmentation because of deposition of metal particles in the dermis and increased epidermal melanin production. Aims: This study was conducted to evaluate the dual effect of chelation therapy in treating periocular hyperpigmentation and lead toxicity. Methods: The study population consisted of nine females complaining from dark coloration of their eyelids. The nine females were continuously using kohl as eyeliner. Lead levels in conjunctiva and serum before and after D-penicillamine (D-PCN) oral administration were estimated in relation to vertical, horizontal length, and degree of hyperpigmentation score. Results: Highly significant P values (0.000) were obtained as regard to the conjunctival lead levels, serum lead levels, horizontal length, and degree of darkness score before and after D-PCN therapy. A less significant P value (0.040) was recorded as regard to the vertical length. Conclusion: Regardless other causes, this study spots the light on a new concept for periocular hyperpigmentation from lead toxicity in adult females using kohl and suggests D-PCN in a low divided dose (750 mg/day) for its treatment.
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Affiliation(s)
- Omar Soliman El Safoury
- Department of Dermatology, Research Biostatistics Unit, Management Team, EBM Unit, MEDC, Cairo University, Egypt.
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Kwon HB, Lee JH, Lee SH, Lee AY, Choi JS, Ahn YS. A case of argyria following colloidal silver ingestion. Ann Dermatol 2009; 21:308-10. [PMID: 20523812 DOI: 10.5021/ad.2009.21.3.308] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Accepted: 02/20/2009] [Indexed: 11/08/2022] Open
Abstract
Argyria is a rare cutaneous discoloration caused by the intake of silver or various compounds containing silver. We report a case of argyria in a 73-year-old male following ingestion of colloidal silver as an alternative medicine over 5 years. He had a diffuse, slate gray discoloration of his face and hands. A biopsy specimen from the face revealed brown-black extracellular granules in the upper dermis and between collagen bundles. We also found silver particles in the mucous of the colon. The ingestion of colloidal silver appears to be increasing among patients using alternative health practices. We report this case to bring people's attention to the problems associated with the ingestion of colloidal silver.
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Affiliation(s)
- Hyok Bu Kwon
- Department of Dermatology, Dongguk University International Hospital, College of Medicine, Dongguk University, Goyang, Korea
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Layton AM, Cunliffe WJ. Minocycline induced pigmentation in the treatment of acne—a review and personal observations. J DERMATOL TREAT 2009. [DOI: 10.3109/09546638909086679] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
BACKGROUND Dermatofibromas are common benign tumors in women, and breast cancer is the most common malignancy in women. The aim of this study is to determine if there is any relationship between the two conditions. MATERIALS AND METHODS Five patients with dermatofibromas and 10 control patients (two groups) had their skin biopsies measured for arsenic by inductively coupled mass spectrometry. Fifty randomly selected patients with breast cancer and 50 control patients were examined for the presence of dermatofibromas. RESULTS The dermatofibromas were found to have an arsenic concentration of 0.171 micrograms/gram, compared with 0.06 and 0.07 micrograms/gram of the two control groups. Forty-three out of 50 patients with breast cancer had dermatofibromas and 32/50 patients with breast cancer had multiple dermatofibromas, compared to 10/50 control patients with dermatofibromas and only 1/50 with multiple dermatofibromas. CONCLUSIONS Arsenic is important in the development of dermatofibromas and dermatofibromas represent a reservoir and important sign of chronic arsenic exposure. Dermatofibromas represent an important sign for women at risk for breast cancer, and arsenic may represent the cause of the majority of cases of breast cancer.
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Affiliation(s)
- Paul I Dantzig
- Department of Dermatology, Columbia University School of Medicine, New York 10022, USA.
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Hostynek JJ, Maibach HI. Skin Penetration by Metal Compounds with Special Reference to Copper. Toxicol Mech Methods 2008; 16:245-65. [DOI: 10.1080/15376520500194718] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Puri PK, Lountzis NI, Tyler W, Ferringer T. Hydroxychloroquine-induced hyperpigmentation: the staining pattern. J Cutan Pathol 2008; 35:1134-7. [PMID: 18727667 DOI: 10.1111/j.1600-0560.2008.01004.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report two cases of hydroxychloroquine-induced hyperpigmentation presenting in a 50-year-old Caucasian female (case 1) and a 78-year-old female (case 2), both receiving 400 mg per day. Case 1 had an arthritis predominant undifferentiated connective tissue disease, which was treated with hydroxychloroquine for 4-5 years. She presented with a mottled, reticulated macular gray pigmentation involving the upper back and shoulders. Case 2 had a history of systemic lupus erythematosus and rheumatoid arthritis, treated with hydroxychloroquine for 1.5 years. She presented to the hospital for treatment of constrictive cardiomyopathy and was noted to have a blue macular pigmentation involving the right temple. The biopsies from both patients showed superficial dermal, yellow-brown, non-refractile and coarsely granular pigment deposition. A Fontana-Masson stain highlighted some of these granules, while the Perl's iron stain was negative. Rare, previous reports of hyperpigmentation indicate the presence of both melanin and hemosiderin in patients being treated with antimalarial medication. To our knowledge, this staining pattern for hydroxychloroquine has not been previously reported in the literature and supports that hydroxychloroquine, in addition to chloroquine, binds to melanin.
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Affiliation(s)
- Puja K Puri
- Department of Dermatology/Dermatopathology, Geisinger Medical Center, Danville, PA 17822, USA.
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FLEMING C, HUNT M, SALISBURY E, McCARTHY S, BARNETSON RS. Minocycline-induced hyperpigmentation in leprosy. Br J Dermatol 2008. [DOI: 10.1046/j.1365-2133.1996.97810.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Brenner M, Hearing VJ. Modifying skin pigmentation - approaches through intrinsic biochemistry and exogenous agents. ACTA ACUST UNITED AC 2008; 5:e189-e199. [PMID: 19578486 DOI: 10.1016/j.ddmec.2008.02.001] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Rates of skin cancer continue to increase despite the improved use of traditional sunscreens to minimize damage from ultraviolet radiation. The public perception of tanned skin as being healthy and desirable, combined with the rising demand for treatments to repair irregular skin pigmentation and the desire to increase or decrease constitutive skin pigmentation, arouses great interest pharmaceutically as well as cosmeceutically. This review discusses the intrinsic biochemistry of pigmentation, details mechanisms that lead to increased or decreased skin pigmentation, and summarizes established and potential hyper- and hypo-pigmenting agents and their modes of action.
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Affiliation(s)
- Michaela Brenner
- Laboratory of Cell Biology, National Cancer Institute, National Institutes of Health, Bethesda MD 20892, USA
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Abstract
Facial and neck pigmentations are significant cosmetic problems. They are common in middle-aged women, related to endogenous (hormones) and exogenous factors (cosmetics, perfumes, sun exposure), and often represent paramount causes of emotional distress. Although melasma is the most common cause of facial pigmentation, there are many other forms including drug-induced and postinflammatory hyperpigmentation. We review pathogenesis, clinical and histopathological data, effect on quality of life, and treatment options in facial hyperpigmentation disorders.
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Affiliation(s)
- D Rigopoulos
- Department of Dermatology, A. Sygros Hospital, University of Athens, Athens, Greece
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45
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SABROE R, ARCHER C, HARLOW D, BRADFIELD J, PEACHEY R. Minocycline-induced discolouration of the sclerae. Br J Dermatol 2008. [DOI: 10.1111/j.1365-2133.1996.tb01170.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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46
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Abstract
Mercury is a metal that is a liquid at room temperature. Mercury has a long and interesting history deriving from its use in medicine and industry, with the resultant toxicity produced. In high enough doses, all forms of mercury can produce toxicity. The most devastating tragedies related to mercury toxicity in recent history include Minamata Bay and Niagata, Japan in the 1950s, and Iraq in the 1970s. More recent mercury toxicity issues include the extreme toxicity of the dimethylmercury compound noted in 1998, the possible toxicity related to dental amalgams, and the disproved relationship between vaccines and autism related to the presence of the mercury-containing preservative, thimerosal.
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Affiliation(s)
- Jack C Clifton
- Great Lakes Center for Children's Environmental Health, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.
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47
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Geist DE, Phillips TJ. Development of chrysiasis after Q-switched ruby laser treatment of solar lentigines. J Am Acad Dermatol 2006; 55:S59-60. [PMID: 16843130 DOI: 10.1016/j.jaad.2005.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2005] [Revised: 10/30/2005] [Accepted: 12/04/2005] [Indexed: 10/24/2022]
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48
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49
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Affiliation(s)
- Nicole L Lacz
- Dermatology, New Jersey Medical School, Newark, NJ, USA
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50
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Affiliation(s)
- Elizabeth Arnold Spenceri
- Laser and Dermatologic Surgery Center, 14377 Woodlake Drive, Suite 111, Town and Country, MO 63017, USA
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