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Porriño-Bustamante ML, Montero-Vílchez T, Pinedo-Moraleda FJ, Fernández-Flores Á, Fernández-Pugnaire MA, Arias-Santiago S. Frontal Fibrosing Alopecia and Sunscreen Use: A Cross-sectional Study of Actinic Damage. Acta Derm Venereol 2022; 102:adv00757. [PMID: 35604235 PMCID: PMC9609976 DOI: 10.2340/actadv.v102.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Patients with frontal fibrosing alopecia report higher rates of sunscreen use than control subjects. However, it is not known whether the higher use of sunscreens is a cause or a consequence of the alopecia. A greater use of sunscreens should be associated with a lower incidence of signs of actinic damage. The aim of this study is to assess the presence of actinic damage in patients with frontal fibrosing alopecia. A cross-sectional study was carried out on 101 patients with frontal fibrosing alopecia and 40 control subjects. The presence of actinic damage, in the form of solar lentigines, actinic keratoses, and basal and squamous cell carcinomas, was recorded in both groups, together with sunscreen use. Trichoscopy and skin biopsy were performed on patients. Actinic damage was present more frequently in patients with frontal fibrosing alopecia (69.3%) than in control subjects (50%) (p = 0.031). Patients used sunscreens more frequently than did control subjects (83.2% vs 62.5%, p = 0.008). However, the prevalence of trichoscopic inflammatory signs, peripheral alopecia, and inflammatory infiltrate and sebaceous gland involvement in skin biopsy, were similar in patients who used sunscreens and those who did not use them. In conclusion, patients with frontal fibrosing alopecia had greater actinic damage than did control subjects, and this is hypothesized as a reason for the higher use of sunscreens among patients. Thus, use of sunscreens may not be the trigger for frontal fibrosing alopecia that dermatologists have proposed.
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Affiliation(s)
| | - Trinidad Montero-Vílchez
- Dermatology Department, University Hospital Virgen de las Nieves, Avenida de Madrid, 15, ES-18012, Granada, Spain.
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Hara Y, Yamashita T, Ninomiya M, Kubo Y, Katagiri C, Saeki S, Iizuka H. Vascular morphology in facial solar lentigo assessed by optical coherence tomography angiography. J Dermatol Sci 2021; 102:193-195. [PMID: 33836925 DOI: 10.1016/j.jdermsci.2021.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/19/2021] [Accepted: 04/01/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Yusuke Hara
- Shiseido Co., Ltd., Shiseido Global Innovation Center, Yokohama, Japan.
| | | | - Masato Ninomiya
- Shiseido Co., Ltd., Shiseido Global Innovation Center, Yokohama, Japan
| | | | - Chika Katagiri
- Shiseido Co., Ltd., Shiseido Global Innovation Center, Yokohama, Japan
| | - Souichi Saeki
- Meijo University, Mechanical & Physical Engineering, Nagoya, Japan
| | - Hajime Iizuka
- Research Institute of Psoriasis, Kojinkai Association of Medical Corporation, Sapporo, Japan
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Josse G, Le Digabel J, Questel E. Protection against summer solar lentigo over-pigmentation with a SPF30 daily cream. Skin Res Technol 2018; 24:485-489. [PMID: 29446160 DOI: 10.1111/srt.12458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND/PURPOSE The aim of this study was to measure lentigines' pigmentation over a long period of time and evaluate if summer over-pigmentation can be avoided by the use a SPF30 day skin cream. METHODS Seventeen healthy female volunteers aged 50 and over and presenting lentigines participated in the study from spring to summer. Throughout the study, all subjects applied a SPF30 daily skin cream to only one hand. Color measurements of the target lesions were performed with a chromameter and with a color-calibrated camera. Target lesions were also imaged with in vivo reflectance confocal microscopy (RCM). A specific procedure for re-registering the images was developed to ensure that the same papillae were measured over time. RESULTS Both color measurement methods, chromametry and color-calibrated camera, showed that lentigines treated over time with the SPF30 day skin cream were significantly lighter than the non-treated lentigines. The RCM images showed a decrease in the papillary contrast for the treated lentigines. CONCLUSION This study shows that this over-pigmentation can be avoided using a SPF30 day skin cream. Moreover, we have demonstrated that very fine re-registration of the RCM images is possible and ensures a more robust analysis.
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Affiliation(s)
- G Josse
- Pierre Fabre Dermo-Cosmétique, Centre de Recherche sur la Peau, Toulouse, France
| | - J Le Digabel
- Pierre Fabre Dermo-Cosmétique, Centre de Recherche sur la Peau, Toulouse, France
| | - E Questel
- Pierre Fabre Dermo-Cosmétique, Centre de Recherche sur la Peau, Toulouse, France
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Moazzami B, Razavi N, Babaei M, Haghparast M, Bayani MA. The association between Solar Lentigines and Type-2 Diabetes. CASPIAN JOURNAL OF INTERNAL MEDICINE 2017; 8:317-320. [PMID: 29201325 PMCID: PMC5686313 DOI: 10.22088/cjim.8.4.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background Limited information exists between the associations of diabetes mellitus (DM) and solar lentigo (SL); a benign, common skin lesion characterized by hyperpigmented macules. Methods This study was conducted on 90 patients diagnosed with DM and their age and sex matched controls who were referred to the Departments of Endocrinology at Babol University of Medical Science in Northern of Iran from January 2013 to December 2015. All demographic data including age, gender, occupation, family history of DM, estimated average sun exposure and presence of skin lesions were collected and analyzed. Results Presence of SL was significantly higher among patients with DM compared to controls (61.9% vs 33.6%, P<0.001). After adjusting for age, sex and sun exposure rate, results indicated that DM was independently associated with the presence of SL (p=0.002). Stratifying patients based on gender, indicated that DM was significantly associated with SL in females (p=0.03), but not in male patients (p=0.06). Conclusion The findings of the present study indicate that DM is an independent risk factor for the occurrence of SL lesions. These findings could represent a novel association between DM as a chronic oxidation state and SL as an early sign of aging.
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Affiliation(s)
- Bobak Moazzami
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran.,Department of Rheumatology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Niloofar Razavi
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Mansour Babaei
- Department of Rheumatology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Motahareh Haghparast
- Department of Internal Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Ali Bayani
- Department of Internal Medicine, Babol University of Medical Sciences, Babol, Iran
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Oh CT, Kwon TR, Choi EJ, Kim SR, Seok J, Mun SK, Yoo KH, Choi YS, Choi SY, Kim BJ. Inhibitory effect of 660-nm LED on melanin synthesis inin vitroandin vivo. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2016; 33:49-57. [DOI: 10.1111/phpp.12276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/21/2016] [Indexed: 01/04/2023]
Affiliation(s)
- Chang Taek Oh
- Department of Dermatology; Chung-Ang University College of Medicine; Seoul Korea
- Department of Medicine; Graduate School; Chung-Ang University; Seoul Korea
| | - Tae-Rin Kwon
- Department of Dermatology; Chung-Ang University College of Medicine; Seoul Korea
| | - Eun Ja Choi
- Department of Dermatology; Chung-Ang University College of Medicine; Seoul Korea
| | - Soon Re Kim
- Department of Dermatology; Chung-Ang University College of Medicine; Seoul Korea
| | - Joon Seok
- Department of Dermatology; Chung-Ang University College of Medicine; Seoul Korea
| | - Seog Kyun Mun
- Department of Otorhinolaryngology; Chung-Ang University College of Medicine; Seoul Korea
| | - Kwang Ho Yoo
- Department of Dermatology; College of Medicine; Catholic Kwandong University; International St. Mary's Hospital; Incheon Korea
| | - Yeon Shik Choi
- Medical IT Convergence Research Center; Korea Electronics Technology Institute; Gyeonggi-do Korea
| | - Sun Young Choi
- Department of Dermatology; Chung-Ang University College of Medicine; Seoul Korea
| | - Beom Joon Kim
- Department of Dermatology; Chung-Ang University College of Medicine; Seoul Korea
- Department of Medicine; Graduate School; Chung-Ang University; Seoul Korea
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Nouveau S, Agrawal D, Kohli M, Bernerd F, Misra N, Nayak CS. Skin Hyperpigmentation in Indian Population: Insights and Best Practice. Indian J Dermatol 2016; 61:487-95. [PMID: 27688436 PMCID: PMC5029232 DOI: 10.4103/0019-5154.190103] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Skin pigmentation is one of the most strikingly variable phenotypes in humans, therefore making cutaneous pigmentation disorders frequent symptoms manifesting in a multitude of forms. The most common among them include lentigines, postinflammatory hyperpigmentation, dark eye circles, and melasma. Variability of skin tones throughout the world is well-documented, some skin tones being reported as more susceptible to pigmentation disorders than others, especially in Asia and India. Furthermore, exposure to ultraviolet radiation is known to trigger or exacerbate pigmentation disorders. Preventive strategies for photoprotection and treatment modalities including topical and other medical approaches have been adopted by dermatologists to mitigate these disorders. This review article outlines the current knowledge on pigmentation disorders including pathophysiology, molecular profiling, and therapeutic options with a special focus on the Indian population.
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Affiliation(s)
- Stephanie Nouveau
- Department of Advanced Research, L'Oreal Research and Innovation, France
| | - Divya Agrawal
- Department of Advanced Research, L'Oreal India Pvt. Limited, Mumbai, Maharashtra, India
| | - Malavika Kohli
- Department of Dermatology, Jaslok Hospital and Breach Candy Hospital Trust, Mumbai, Maharashtra, India
| | - Francoise Bernerd
- Department of Advanced Research, L'Oreal Research and Innovation, France
| | - Namita Misra
- Department of Advanced Research, L'Oreal India Pvt. Limited, Mumbai, Maharashtra, India
| | - Chitra Shivanand Nayak
- Department of Dermatology, Leprology and Venereology, Topiwala National Medical College and B. Y. L. Nair Charitable Hospital, Mumbai, Maharashtra, India
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Tian BWCA. Novel Low Fluence Combination Laser Treatment of Solar Lentigines in Type III Asian Skin. J Cutan Aesthet Surg 2016; 8:230-2. [PMID: 26865789 PMCID: PMC4728906 DOI: 10.4103/0974-2077.172199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective: To demonstrate a novel low fluence combination laser technique [Erbium-doped yttrium aluminum garnet (Erb:YAG) and neodymium-doped yttrium aluminum garnet (Nd:YAG)] to effectively treat solar lentigines in type III Asian skin in a single session. Design: A prospective study. Setting: A Singapore-based clinic. Participants: Five patients (all females) were enrolled into the study. The ages ranged 35-60 years; all patients had Fitzpatrick skin type III. Measurements: Photographs were taken at baseline and at 1-month follow-up. These were reviewed by two independent physicians who were blinded to the study. Changes in pigment severity were assessed by a 5-point scale (1: Aggravation of pigment, 2: No change, 3: 25-50% improvement, 4: 51-75% improvement, and 5: 76-100% improvement). Results: All patients received a single treatment session. At 1-month follow-up, a reduction in pigment was observed in all patients. Both physicians’ reports were independently agreeable. All patients scored 5, having >90% improvement in pigment severity. No hypopigmentation, postinflammatory hyperpigmentation (PIH), or recurrence was seen. Conclusion: Low fluence combination laser is effective and safe for clearance of solar lentigines in type III Asian skin.
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Murase D, Hachiya A, Kikuchi-Onoe M, Fullenkamp R, Ohuchi A, Kitahara T, Moriwaki S, Hase T, Takema Y. Cooperation of endothelin-1 signaling with melanosomes plays a role in developing and/or maintaining human skin hyperpigmentation. Biol Open 2015; 4:1213-21. [PMID: 26340945 PMCID: PMC4610214 DOI: 10.1242/bio.011973] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 07/30/2015] [Indexed: 12/11/2022] Open
Abstract
Skin hyperpigmentation is characterized by increased melanin synthesis and deposition that can cause significant psychosocial and psychological distress. Although several cytokine-receptor signaling cascades contribute to the formation of ultraviolet B-induced cutaneous hyperpigmentation, their possible involvement in other types of skin hyperpigmentation has never been clearly addressed. Since our continuous studies using skin specimens from more than 30 subjects with ethnic skin diversity emphasized a consistent augmentation in the expression of endothelin-1 (ET-1) and its receptor (Endothelin B receptor, ET-B) in hyperpigmented lesions, including senile lentigos (SLs), the precise function of ET-1 signaling was investigated in the present study. In line with previous studies, ET-1 significantly induced melanogenesis followed by increases in melanosome transport in melanocytes and in its transfer to keratinocytes while inhibition of ET-B function substantially depressed melanogenic ability in tissue-cultured SLs. Additionally, in agreement with a previous report that the formation of autophagosomes rather than melanosomes is stimulated according to starvation or defective melanosome production, ET-1 was found to remarkably augment the expression of components necessary for early melanosome formation, indicating its counteraction against autophagy-targeting melanosome degradation in melanocytes. Despite the lack of substantial impact of ET-1 on keratinocyte melanogenic functions, the expression of ET-1 was enhanced following melanosome uptake by keratinocytes. Taken together, our data suggest that ET-1 plays a substantial role in the development and/or maintenance of skin hyperpigmentation in reciprocal cooperation with increased melanosome incorporation.
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Affiliation(s)
- Daiki Murase
- Biological Science Laboratories, Kao Corporation, Haga, Tochigi 321-3497, Japan Biological Science Americas Laboratory, Kao Corporation, Cincinnati, OH 45214, USA
| | - Akira Hachiya
- Biological Science Laboratories, Kao Corporation, Haga, Tochigi 321-3497, Japan
| | - Mamiko Kikuchi-Onoe
- Biological Science Laboratories, Kao Corporation, Haga, Tochigi 321-3497, Japan
| | - Rachel Fullenkamp
- Biological Science Americas Laboratory, Kao Corporation, Cincinnati, OH 45214, USA
| | - Atsushi Ohuchi
- Biological Science Laboratories, Kao Corporation, Haga, Tochigi 321-3497, Japan
| | - Takashi Kitahara
- Biological Science Laboratories, Kao Corporation, Haga, Tochigi 321-3497, Japan
| | - Shigeru Moriwaki
- Biological Science Laboratories, Kao Corporation, Haga, Tochigi 321-3497, Japan
| | - Tadashi Hase
- Biological Science Laboratories, Kao Corporation, Haga, Tochigi 321-3497, Japan
| | - Yoshinori Takema
- Research and Development Global, Kao Corporation, Sumida-ku, Tokyo 131-8501, Japan
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Dobos G, Trojahn C, Lichterfeld A, D′Alessandro B, Patwardhan SV, Canfield D, Blume-Peytavi U, Kottner J. Quantifying dyspigmentation in facial skin ageing: an explorative study. Int J Cosmet Sci 2015; 37:542-9. [DOI: 10.1111/ics.12233] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Accepted: 03/25/2015] [Indexed: 12/30/2022]
Affiliation(s)
- G. Dobos
- Clinical Research Center for Hair and Skin Science; Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - C. Trojahn
- Clinical Research Center for Hair and Skin Science; Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - A. Lichterfeld
- Clinical Research Center for Hair and Skin Science; Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - B. D′Alessandro
- Canfield Scientific; 253 Passaic Avenue Fairfield NJ 07004 U.S.A
| | - S. V. Patwardhan
- Canfield Scientific; 253 Passaic Avenue Fairfield NJ 07004 U.S.A
| | - D. Canfield
- Canfield Scientific; 253 Passaic Avenue Fairfield NJ 07004 U.S.A
| | - U. Blume-Peytavi
- Clinical Research Center for Hair and Skin Science; Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - J. Kottner
- Clinical Research Center for Hair and Skin Science; Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
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Duval C, Cohen C, Chagnoleau C, Flouret V, Bourreau E, Bernerd F. Key regulatory role of dermal fibroblasts in pigmentation as demonstrated using a reconstructed skin model: impact of photo-aging. PLoS One 2014; 9:e114182. [PMID: 25490395 PMCID: PMC4260844 DOI: 10.1371/journal.pone.0114182] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 10/17/2014] [Indexed: 12/30/2022] Open
Abstract
To study cutaneous pigmentation in a physiological context, we have previously developed a functional pigmented reconstructed skin model composed of a melanocyte-containing epidermis grown on a dermal equivalent comprising living fibroblasts. The present studies, using the same model, aimed to demonstrate that dermal fibroblasts influence skin pigmentation up to the macroscopic level. The proof of principle was performed with pigmented skins differing only in the fibroblast component. First, the in vitro system was reconstructed with or without fibroblasts in order to test the global influence of the presence of this cell type. We then assessed the impact of the origin of the fibroblast strain on the degree of pigmentation using fetal versus adult fibroblasts. In both experiments, impressive variation in skin pigmentation at the macroscopic level was observed and confirmed by quantitative parameters related to skin color, melanin content and melanocyte numbers. These data confirmed the responsiveness of the model and demonstrated that dermal fibroblasts do indeed impact the degree of skin pigmentation. We then hypothesized that a physiological state associated with pigmentary alterations such as photo-aging could be linked to dermal fibroblasts modifications that accumulate over time. Pigmentation of skin reconstructed using young unexposed fibroblasts (n = 3) was compared to that of tissues containing natural photo-aged fibroblasts (n = 3) which express a senescent phenotype. A stimulation of pigmentation in the presence of the natural photo-aged fibroblasts was revealed by a significant increase in the skin color (decrease in Luminance) and an increase in both epidermal melanin content and melanogenic gene expression, thus confirming our hypothesis. Altogether, these data demonstrate that the level of pigmentation of the skin model is influenced by dermal fibroblasts and that natural photo-aged fibroblasts can contribute to the hyperpigmentation that is associated with photo-aging.
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Piriou Y, Sirvent A, Natalizio A, Girard-ory F. Skin-lightening and anti-ageing effect of a food supplement containing Pinus pinaster extract. ACTA ACUST UNITED AC 2014. [DOI: 10.1007/s13749-014-0036-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Questel E, Durbise E, Bardy AL, Schmitt AM, Josse G. Follow-up of solar lentigo depigmentation with a retinaldehyde-based cream by clinical evaluation and calibrated colour imaging. Skin Res Technol 2014; 21:241-6. [PMID: 25078981 DOI: 10.1111/srt.12182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE To assess an objective method evaluating the effects of a retinaldehyde-based cream (RA-cream) on solar lentigines; 29 women randomly applied RA-cream on lentigines of one hand and a control cream on the other, once daily for 3 months. METHODS A specific method enabling a reliable visualisation of the lesions was proposed, using high-magnification colour-calibrated camera imaging. Assessment was performed using clinical evaluation by Physician Global Assessment score and image analysis. Luminance determination on the numeric images was performed either on the basis of 5 independent expert's consensus borders or probability map analysis via an algorithm automatically detecting the pigmented area. RESULTS Both image analysis methods showed a similar lightening of ΔL* = 2 after a 3-month treatment by RA-cream, in agreement with single-blind clinical evaluation. CONCLUSION High-magnification colour-calibrated camera imaging combined with probability map analysis is a fast and precise method to follow lentigo depigmentation.
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Affiliation(s)
- E Questel
- Skin Research Center, Pierre Fabre Laboratories, Toulouse Cedex 3, France
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Jun HJ, Kim SM, Choi WJ, Cho SH, Lee JD, Kim HS. A split-face, evaluator-blind randomized study on the early effects of Q-switched Nd:YAG laser versus Er:YAG micropeel in light solar lentigines in Asians. J COSMET LASER THER 2014; 16:83-8. [PMID: 24409833 DOI: 10.3109/14764172.2013.877749] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Asians are prone to develop epidermal pigmentary lesions as a result of photoaging. Solar lentigines, especially those which are light in color, show somewhat limited response to pigment lasers and intense pulsed light sources. OBJECTIVES We sought to compare the early effects as well as side effects of Q-switched Nd:YAG and Er:YAG micropeel in treating light solar lentigines in Asians. PATIENT AND METHODS This was a split-face, evaluator-blind, randomized controlled study. A single session of treatment was performed on Asian patients with light facial lentigines. Q-switched Nd:YAG laser was allocated to one half of the face, and Er:YAG micropeel to the other half. The response to therapy was evaluated by two independent dermatologists with standardized photographs taken 2 weeks and 1 month after the laser treatment. Patients' satisfaction and preference in treatment were also assessed. RESULTS Fifteen patients completed the study and were analyzed. A reduction in pigment was observed with both lasers during the study period. The degree of pigment reduction in the Q-switched Nd:YAG treated side of the face was significantly higher than that of the Er:YAG micropeel treated side at 2-week follow-up (p < 0.001). The degree of pigment reduction between the Q-switched Nd:YAG-treated side and the Er:YAG micropeel-treated side was similar at 1-month follow-up (p = 0.110). CONCLUSION While there is no perfect therapy for light solar lentigines, a single session of Q-switched Nd:YAG laser and Er:YAG micropeel was shown to reduce pigmentation. The immediate effects (2-week follow-up) were better with the Q-switched Nd:YAG laser but there was no great difference between the two laser types at 1-month follow-up due to the greater degree of post-inflammatory hyperpigmentation following Q-switched Nd:YAG. Both laser types could be applied either singly in turns, or in combination for maximal efficacy in future.
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Affiliation(s)
- Hee Jin Jun
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea , Incheon , Republic of Korea
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Jun HJ, Cho SH, Lee JD, Kim HS. A split-face, evaluator-blind randomized study on the early effects of Q-switched Nd:YAG laser plus Er:YAG micropeel (combined therapy) versus Q-switched Nd:YAG alone in light solar lentigines in Asians. Lasers Med Sci 2013; 29:1153-8. [DOI: 10.1007/s10103-013-1489-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 11/03/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Hee Jin Jun
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Dongsuro, Bupyeong-gu, 150-713, Incheon, South Korea
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Watanabe T, Tahira M, Morino S, Horie T, Adachi K, Tsutsumi R, Yamada N, Yoshida Y, Yamamoto O. Novel morphological study of solar lentigines by immunohistochemical and electron microscopic evaluation. J Dermatol 2013; 40:528-32. [DOI: 10.1111/1346-8138.12165] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 02/26/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Tessin Watanabe
- Division of Dermatology; Department of Medicine of Sensory and Motor Organs; Tottori University; Yonago; Japan
| | - Makoto Tahira
- Division of Dermatology; Department of Medicine of Sensory and Motor Organs; Tottori University; Yonago; Japan
| | - Shinichi Morino
- Laboratory of Electron Microscopy; Faculty of Medicine; Tottori University; Yonago; Japan
| | - Takashi Horie
- Laboratory of Electron Microscopy; Faculty of Medicine; Tottori University; Yonago; Japan
| | - Koji Adachi
- Division of Dermatology; Department of Medicine of Sensory and Motor Organs; Tottori University; Yonago; Japan
| | - Reiko Tsutsumi
- Division of Dermatology; Department of Medicine of Sensory and Motor Organs; Tottori University; Yonago; Japan
| | - Nanako Yamada
- Division of Dermatology; Department of Medicine of Sensory and Motor Organs; Tottori University; Yonago; Japan
| | - Yuich Yoshida
- Division of Dermatology; Department of Medicine of Sensory and Motor Organs; Tottori University; Yonago; Japan
| | - Osamu Yamamoto
- Division of Dermatology; Department of Medicine of Sensory and Motor Organs; Tottori University; Yonago; Japan
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Ho SGY, Chan NPY, Yeung CK, Shek SY, Kono T, Chan HHL. A retrospective analysis of the management of freckles and lentigines using four different pigment lasers on Asian skin. J COSMET LASER THER 2012; 14:74-80. [PMID: 22372516 DOI: 10.3109/14764172.2012.670707] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The risk of post-inflammatory hyperpigmentation (PIH) is increased during freckles and lentigines treatment in Asians. OBJECTIVE To determine the effectiveness and safety of using 595-nm long pulsed dye laser (LPDL), 755-nm LP Alexandrite laser, 532-nm QS Nd:YAG laser and 532-nm LP potassium-titanyl-phosphate (KTP) laser for the treatment of freckles or lentigines in Asian patients. METHODS This is a retrospective study of 40 Chinese patients, who were divided into four groups based on treatment modality using four different pigment lasers. Each patient attended between 1 and 4 treatments (mean of 1.8), at 4-6 weeks intervals, depending on clinical response. Lesional clearance and PIH were assessed by two independent clinicians. RESULTS Statistically significant improvement of global and focal facial pigmentation was found after treatment with LPDL, QS Nd:YAG and LP KTP lasers. No significant improvement was found after LP Alexandrite laser. PIH risk was 20% after LP Alexandrite treatment, 10% with QS Nd:YAG, and absent after LPDL and LP KTP treatment. CONCLUSION A long pulse laser and small spot size appear to reduce the risks of lentigines treatment in darker skin types.
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Affiliation(s)
- S G Y Ho
- Division of Dermatology, Department of Medicine, The University of Hong Kong, Hong Kong SAR, China
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18
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Tschandl P, Rosendahl C, Kittler H. Accuracy of the first step of the dermatoscopic 2-step algorithm for pigmented skin lesions. Dermatol Pract Concept 2012; 2:203a08. [PMID: 23785610 PMCID: PMC3663352 DOI: 10.5826/dpc.0203a08] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 05/31/2012] [Indexed: 12/03/2022] Open
Abstract
Objectives: To evaluate the frequency of misclassifications of equivocal pigmented lesions according to the first step of the dermatoscopic 2-step algorithm. Patients and Methods: 707 consecutive cases from 553 patients of central Europe and Australia were included in the study. Dermatoscopic images were evaluated in a blinded fashion for the presence of features described in the 2-step algorithm to determine their melanocytic or non-melanocytic origin. Mucosal, genital and non-pigmented lesions were excluded. Results: The sensitivity of the first step was 97.1% for patients from Australia and 96.8% for patients from central Europe. The specificity was 33.6% for Australian patients and 67.9% for European patients. The most common reasons for misclassification were the presence of a pigmented network in a non-melanocytic lesion (n=68, 25.2%) and the absence of dermatoscopic features of melanocytic and non-melanocytic lesions in 69 (25.6%) non-melanocytic lesions. Conclusion: The first step of the dermatoscopic 2-step algorithm, if applied consistently, has high sensitivity but low specificity. Many non-melanocytic lesions, especially solar lentigines and seborrheic keratoses, are wrongly classified as melanocytic. The worse performance of the first step algorithm in Australian patients is probably due to a higher rate of solar lentigines in patients with severely sun-damaged skin.
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Affiliation(s)
- Philipp Tschandl
- Department of Dermatology, Division of General Dermatology, Medical University of Vienna, Austria
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Furumura M, Sato N, Kusaba N, Takagaki K, Nakayama J. Oral administration of French maritime pine bark extract (Flavangenol(®)) improves clinical symptoms in photoaged facial skin. Clin Interv Aging 2012; 7:275-86. [PMID: 22956863 PMCID: PMC3426262 DOI: 10.2147/cia.s33165] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND French maritime pine bark extract (PBE) has gained popularity as a dietary supplement in the treatment of various diseases due to its polyphenol-rich ingredients. Oligometric proanthocyanidins (OPCs), a class of bioflavonoid complexes, are enriched in French maritime PBE and have antioxidant and anti-inflammatory activity. Previous studies have suggested that French maritime PBE helps reduce ultraviolet radiation damage to the skin and may protect human facial skin from symptoms of photoaging. To evaluate the clinical efficacy of French maritime PBE in the improvement of photodamaged facial skin, we conducted a randomized trial of oral supplementation with PBE. METHODS One hundred and twelve women with mild to moderate photoaging of the skin were randomized to either a 12-week open trial regimen of 100 mg PBE supplementation once daily or to a parallel-group trial regimen of 40 mg PBE supplementation once daily. RESULTS A significant decrease in clinical grading of skin photoaging scores was observed in both time courses of 100 mg daily and 40 mg daily PBE supplementation regimens. A significant reduction in the pigmentation of age spots was also demonstrated utilizing skin color measurements. CONCLUSION Clinically significant improvement in photodamaged skin could be achieved with PBE. Our findings confirm the efficacy and safety of PBE.
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Affiliation(s)
- Minao Furumura
- Department of Dermatology, Fukuoka University School of Medicine, Fukuoka, Japan.
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Tsatsou F, Trakatelli M, Patsatsi A, Kalokasidis K, Sotiriadis D. Extrinsic aging: UV-mediated skin carcinogenesis. DERMATO-ENDOCRINOLOGY 2012; 4:285-97. [PMID: 23467430 PMCID: PMC3583890 DOI: 10.4161/derm.22519] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Age-associated skin lesions linked to UV radiation (UVR) include actinic keratosis, non-melanoma skin cancer-such as basal cell carcinoma and squamous cell carcinoma-lentigo senilis and lentigo maligna. Their incidence is increasing worldwide, mainly due to exaggerated UV exposure and to an aging population. Early diagnosis and therapy of pre-malignant cutaneous lesions is crucial for the secondary prophylaxis of invasive and highly aggressive skin cancers. Combined efforts to increase public awareness, patient education about self-examination, prophylactic modalities, such as consistent and sufficient UV protection, and rigorous follow-up of high-risk groups are of highest importance.
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Affiliation(s)
- Fragkiski Tsatsou
- Second Department of Dermatology and Venereology; Papageorgiou Hospital; Aristotle University School of Medicine; Thessaloniki, Greece
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21
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Wendt J, Schanab O, Binder M, Pehamberger H, Okamoto I. Site-dependent actinic skin damage as risk factor for melanoma in a central European population. Pigment Cell Melanoma Res 2012; 25:234-42. [PMID: 22145962 DOI: 10.1111/j.1755-148x.2011.00946.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Sun exposure is causal for melanoma but is subject to bias of recall so that it is difficult to dissect the role of particular patterns of sun exposure. In this hospital-based case-control study (n = 1991), we aimed to analyze pigmentation traits and signs of actinic damage at different anatomic locations as markers of melanoma risk in central European patients. Although all signs of actinic damage (freckling, wrinkling and solar lentigos) were significantly associated with melanoma risk in multivariate logistic regression models adjusting for age and sex, the strongest associations were observed for the dorsal parts of the body: adjusted odds ratios [OR] were 4.22 for wrinkling on the neck, 3.43 for solar lentigos and 3.37 for freckling on the back (all P < 0.001), respectively. These associations were independent of age, sex and pigmentation traits. Our results indicate that signs of actinic damage are predictors of melanoma risk, particularly on the back.
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Affiliation(s)
- Judith Wendt
- Division of General Dermatology, Department of Dermatology, Medical University of Vienna, Vienna, Austria
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22
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Wang CC, Chen CK. Effect of spot size and fluence on Q-switched alexandrite laser treatment for pigmentation in Asians: a randomized, double-blinded, split-face comparative trial. J DERMATOL TREAT 2011; 23:333-8. [DOI: 10.3109/09546634.2011.560929] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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23
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Chu M, Kollias N. Documentation of normal stratum corneum scaling in an average population: features of differences among age, ethnicity and body site. Br J Dermatol 2011; 164:497-507. [PMID: 21054338 DOI: 10.1111/j.1365-2133.2010.10120.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Scaling skin involves an imbalance between cell proliferation and desquamation, resulting in partially detached corneocytes at the stratum corneum (SC) surface that become visible as they scatter light. OBJECTIVES The purpose of this study was to document scaling skin with no associated pathology, to estimate the range of normal corneocyte detachment in the average population, and to determine if age, pigmentation and/or body sites of different exposures contribute to differences observed in the SC. METHODS Healthy African-American and Caucasian female subjects (n = 151) from a typical central New Jersey population, aged between 14 and 75 years, were evaluated on the dorsal forearm and upper inner arm. Dermatoscopy and adhesive tape were used to evaluate the appearance and adhesion of surface corneocytes. Transepidermal water loss and conductivity were measured to assess water-handling properties of the SC. Measurements were conducted during the winter. RESULTS Corneocyte detachment observed with dermatoscopy became more prevalent with age and was more severe on the dorsal forearm and in Caucasian subjects. The distribution of the amount of corneocyte removal with adhesive tape increased with age. The range of values was larger in the dorsal forearm than the upper inner arm and was greater in Caucasian subjects than African-American subjects. Minimal changes were observed for water-handling properties. CONCLUSIONS The architecture of the outer SC appears different between ages, body sites of different exposures, and individuals of different pigmentation groups, but minimal differences in water-handling properties are observed.
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Affiliation(s)
- M Chu
- Johnson & Johnson Consumer and Personal Products Worldwide, Skillman, NJ 08558, USA.
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24
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Lin CB, Hu Y, Rossetti D, Chen N, David C, Slominski A, Seiberg M. Immuno-histochemical evaluation of solar lentigines: The association of KGF/KGFR and other factors with lesion development. J Dermatol Sci 2010; 59:91-7. [DOI: 10.1016/j.jdermsci.2010.06.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Revised: 06/06/2010] [Accepted: 06/14/2010] [Indexed: 02/07/2023]
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25
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Barone E, Calabrese V, Mancuso C. Ferulic acid and its therapeutic potential as a hormetin for age-related diseases. Biogerontology 2008; 10:97-108. [PMID: 18651237 DOI: 10.1007/s10522-008-9160-8] [Citation(s) in RCA: 199] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2008] [Accepted: 07/09/2008] [Indexed: 01/24/2023]
Affiliation(s)
- Eugenio Barone
- Institute of Pharmacology, Catholic University School of Medicine, Largo Francesco. Vito 1, 00168, Rome, Italy
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26
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Ishikawa M, Kawase I, Ishii F. Combination of amino acids reduces pigmentation in B16F0 melanoma cells. Biol Pharm Bull 2007; 30:677-81. [PMID: 17409501 DOI: 10.1248/bpb.30.677] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Amino acids, the building blocks of proteins, play significant roles in numerous physiological events in mammals. As the effects of amino acids on melanogenesis have yet to be demonstrated, the present study was conducted to identify whether amino acids, in particular alanine, glycine, isoleucine and leucine, influence melanogenesis in B16F0 melanoma cells. Glycine and L-isoleucine, but not D-isoleucine, reduced melanogenesis in a concentration-dependent manner without any morphological changes in B16F0 melanoma cells. L-Alanine and L-leucine, but not D-alanine and D-leucine, also reduced melanogenesis without any morphological changes in B16F0 melanoma cells. However these amino acids did not show a concentration-dependency. Combination of L-alanine and the other amino acids, particularly 4 amino acids combination, had an additive effect on the inhibition of melanogenesis compared with single treatment of L-alanine. None of the amino acids affected the activity of tyrosinase, a key enzyme in melanogenesis. These results suggest that L-alanine, glycine, L-isoleucine and L-leucine, but not the D-form amino acids, have a hypopigmenting effect in B16F0 melanoma cells, and that these effects are not due to the inhibition of tyrosinase activity. Combination of these 4 amino acids had the additive effect on hypopigmentation that was as similar as that of kojic acid.
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Affiliation(s)
- Masago Ishikawa
- Drug Evaluation Department, Life Science Institute, SSP CO., LTD, Japan
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27
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Unver N, Freyschmidt-Paul P, Hörster S, Wenck H, Stäb F, Blatt T, Elsässer HP. Alterations in the epidermal-dermal melanin axis and factor XIIIa melanophages in senile lentigo and ageing skin. Br J Dermatol 2006; 155:119-28. [PMID: 16792763 DOI: 10.1111/j.1365-2133.2006.07210.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Senile lentigo (SL) is a pigmentation disorder that occurs predominantly on the dorsa of the hands, the forearms and the face; its incidence increases with age. Histological hallmarks of SL lesions are hyperpigmentation of the epidermis and elongation of the epidermal rete ridges. Various factors such as alpha-melanocyte-stimulating hormone, endothelin-1 or stem cell factor are involved in the onset and maintenance of the increased pigmentation. Alterations of the dermal compartment have not yet been analysed in detail in SL. OBJECTIVES To study the occurrence and distribution of melanin in the dermis from SL and aged skin, biopsies from 12 subjects were morphologically analysed by light and electron microscopy in comparison with unaffected skin. METHODS Punch biopsies of SL and adjacent skin from 12 male or female volunteers aged 52-81 years were prepared for light and electron microscopy and samples were analysed by morphological, morphometric, histochemical and immunohistochemical methods. RESULTS The epidermis from SL revealed morphological features such as hyperpigmentation of basal keratinocytes and the formation of elongated rete ridges. S100+ melanocytes in the stratum basale were not markedly increased, indicating that the hyperpigmentation is predominantly due to changes in melanin synthesis, distribution or turnover. Quantification of epidermal cells expressing the proliferation marker Ki67 did not show an increase of this parameter in SL, indicating that at least in the established lesion cell proliferation is not enhanced. We further focused on the dermal compartment and observed granulated cells which were more abundant in SL. Electron microscopic and histochemical analysis revealed that the granulation of these cells is based on melanosomes, mostly present in large melanosomal complexes. Immunohistochemistry using antibodies to CD68 and factor XIIIa (FXIIIa) showed these melanophages to be predominantly FXIIIa+ dermal dendrocytes, which were about six times more abundant than CD68+ macrophages. CONCLUSIONS In SL an increased number of melanophages was found compared with unaffected skin from the same subject. These melanophages were identified as FXIIIa+ dermal dendrocytes. Possible functional consequences of the massive melanin uptake by dermal dendrocytes are discussed.
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Affiliation(s)
- N Unver
- Institut für Zytobiologie und Zytopathologie, Philipps University of Marburg, Marburg, Germany
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28
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Abstract
Cutaneous melanoma is responsible for the majority of skin cancer deaths. Early and accurate detection are the most important means to improve patient survival. This article reviews the common clinical presentations of head and neck cutaneous melanoma, and discusses lesions that might be clinically mistaken for melanoma.
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Wang CC, Sue YM, Yang CH, Chen CK. A comparison of Q-switched alexandrite laser and intense pulsed light for the treatment of freckles and lentigines in Asian persons: A randomized, physician-blinded, split-face comparative trial. J Am Acad Dermatol 2006; 54:804-10. [PMID: 16635661 DOI: 10.1016/j.jaad.2006.01.012] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2005] [Revised: 12/26/2005] [Accepted: 01/06/2006] [Indexed: 11/29/2022]
Abstract
BACKGROUND Q-switched (QS) pigmented lasers and intense pulsed light (IPL) successfully treat pigment disorders. OBJECTIVE We sought to compare efficacy and side effects of QS alexandrite laser (QSAL) and IPL for freckle and lentigo treatment in Asians. METHODS In all, 15 patients with freckles and 17 patients with lentigines were treated randomly with one session QSAL in one cheek and two sessions IPL in the other cheek at 4-week intervals. Efficacy was determined using a new pigmentation area and severity index score. RESULTS All patients experienced improvement (P < .0001). Postinflammatory hyperpigmentation developed in one patient with freckles and 8 patients with lentigines after QSAL. No postinflammatory hyperpigmentation occurred after IPL. Freckles achieved greater improvement after QSAL than IPL (P = .04). In lentigines, the results after IPL were better than QSAL among those with postinflammatory hyperpigmentation after QSAL. LIMITATIONS Limitations include a small case number and short follow-up period. CONCLUSION QSAL was superior to IPL for freckle treatment. IPL should be used for lentigines in Asian persons.
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Affiliation(s)
- Chia-Chen Wang
- Department of Dermatology, Cardinal Tien Hospital, Taipei, Taiwan.
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30
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Tobiishi M, Haratake A, Kaminaga H, Nakahara M, Komiya A, Koishikawa H, Uchiwa H, Kawa Y, Mizoguchi M. Changes in responses of UVB irradiated skin of brownish guinea pigs with aging. ACTA ACUST UNITED AC 2005; 18:278-84. [PMID: 16029421 DOI: 10.1111/j.1600-0749.2005.00246.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
It is known that skin often shows irregular pigmentation during aging, which is frequently associated with hyperpigmentation. Many studies have utilized brownish A1 guinea pigs to investigate the pathogenesis of ultraviolet B (UVB)-induced skin pigmentation, however, responses associated with aging following UVB irradiation have not been elucidated. To characterize those responses, dorsal skin of A1 guinea pigs from 14-weeks to 5-yr old were investigated. The minimal erythema dose was found to increase with aging. Further, in pigmentation induced by UVB radiation, skin brightness (DeltaL*-value) decreased equally in both the 14-week old (young) group and in the 3-yr old (old) group of guinea pigs. The DeltaL*-value recovered in the young group from 21 d after UVB irradiation, whereas no such recovery was seen in the old group. In addition, the amount of melanin and the number of melanocytes returned near pre-irradiation levels in the young group, while they remained high in the old group. Our results therefore demonstrate for the first time that skin responses following UVB irradiation change with aging in A1 guinea pigs.
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Affiliation(s)
- Megumi Tobiishi
- Basic Research Laboratory, Kanebo Cosmetics Inc., Odawara, Kanagawa, Japan.
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Bastiaens M, Hoefnagel J, Westendorp R, Vermeer BJ, Bouwes Bavinck JN. Solar lentigines are strongly related to sun exposure in contrast to ephelides. ACTA ACUST UNITED AC 2004; 17:225-9. [PMID: 15140067 DOI: 10.1111/j.1600-0749.2004.00131.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Solar lentigines and ephelides are different types of pigmented skin lesions predominantly present on sun-exposed skin. Both lesions are risk indicators for melanoma and non-melanoma skin cancer. Solar lentigines are considered as a sign of photodamage although well-conducted epidemiological studies are lacking on this subject. Ephelides are associated with fair skin type and red hair. The aim of the present study was to investigate the relation of sun-exposure estimates with solar lentigines and ephelides. In the Leiden Skin cancer Study 577 patients with malignant melanoma and/or non-melanoma skin cancer and 385 individuals without a history of skin cancer were studied. The presence of solar lentigines and ephelides in the face and on the back was assessed. Data on skin type, hair color, sun-exposure variables and cutaneous signs of photodamage were collected, by questionnaire and physical examination. Data were analyzed by chi-square or Student t-tests and with multivariable regression. Exposure odds ratios with 95% confidence intervals (95% CI) were calculated to estimate the relative risk for the presence of solar lentigines and ephelides dependent on signs of photodamage. The association with age was strongly positive for solar lentigines whereas it was strongly negative for ephelides (P-values for trend <0.0001). After adjustment for age, sex and skin type, solar lentigines on the back were positively associated with cumulative (P = 0.01) and intermittent (P = 0.0002) sun exposure. After adjustment, solar lentigines on the back were also associated with a history of sunburns before the age of 20 yr (P = 0.0003) and the number of sunburns in childhood (P = 0.002). Solar lentigines in the face were significantly associated with cutaneous signs of photodamage, i.e. elastosis (odds ratio 2.4, 95% CI 1.7-3.3) and actinic keratosis (odds ratio 1.8, 95% CI 1.3-2.4) whereas ephelides were not. Ephelides in the face and on the back showed an inverse association with chronic sun exposure but after adjustment theses associations disappeared. Sunburns before the age of 20 appeared to be positively associated with ephelides on the back (P = 0.04). In contrast to lentigines, ephelides were much more associated with constitutional host factors such as fair skin and/or red hair (both P < 0.0001). This study indicates that both chronic and acute sun exposure are important in the pathogenesis of solar lentigines.
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Affiliation(s)
- Maarten Bastiaens
- Department of Dermatology, Leiden University Medical Center, The Netherlands
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32
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Ammirati CT, Hruza GJ. Clinical presentations of cutaneous melanoma. Facial Plast Surg Clin North Am 2003; 11:9-22. [PMID: 15062283 DOI: 10.1016/s1064-7406(02)00051-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Christie Travelute Ammirati
- Department of Dermatology, PennState, Milton S. Hershey Medical Center, 500 University Drive, PO Box 850, Hershey, PA 17033, USA.
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Stern RS. Actinic degeneration and pigmentary change in association with psoralen and UVA treatment: a 20-year prospective study. J Am Acad Dermatol 2003; 48:61-7. [PMID: 12522372 DOI: 10.1067/mjd.2003.15] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Changes in the appearance of the skin including actinic degeneration and pigmentary changes have been noted in patients treated with psoralen and UVA (PUVA). OBJECTIVE Our purpose was to quantify risk factors for increased extent and progression of actinic degeneration and pigmentary changes in the skin of patients treated with PUVA. METHODS On the basis of standardized dermatologic examination conducted in 1977 and 1998 of patients enrolled in the PUVA Follow Up Study, we assessed the prevalence of and changes in the extent of actinic degeneration and pigmentary abnormalities on the hands and buttocks. RESULTS From 1977 to 1998, the prevalence of moderate or severe actinic degeneration increased from 15.6% to 60.5% on the hands and from 2.2% to 21.3% on the buttocks. During this same period, the prevalence of pigmentary changes of this degree increased from 15.6% to 58.6% on the hands and 12.6% to 24.7% on the buttocks. Extent of exposure to PUVA was the strongest predictor of an increased extent of clinical actinic degeneration or pigmentary change. CONCLUSION Long-term exposure to PUVA is associated with persistent increases in actinic degeneration and pigmentary abnormalities of the skin on both usually sun-exposed and sun-protected sites.
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Affiliation(s)
- Robert S Stern
- Beth Israel Deaconess Medical Center, Department of Dermatology, Boston, Massachusetts 02215, USA.
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Bastiaens MT, Westendorp RG, Vermeer BJ, Bavinck JN. Ephelides are more related to pigmentary constitutional host factors than solar lentigines. PIGMENT CELL RESEARCH 1999; 12:316-22. [PMID: 10541041 DOI: 10.1111/j.1600-0749.1999.tb00765.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Ephelides and solar lentigines are benign pigmented spots, which are currently associated with an increased risk of skin cancer. These two pigmented spots are known to be discriminated by their clinical, histological, and electron microscopic characteristics, even though occasional misclassification can occur because of their similarity. It has also been questioned whether these spots are not one and the same. In this study, we have attempted to differentiate between these two pigmented spots with the use of a standardized protocol for clinical examinations on 272 healthy volunteers, paying particular consideration to their pigmentary and constitutional host factors. We found that solar lentigines 1) are more prevalent than ephelides, 2) increase in prevalence and number with higher age, and 3) are most prevalent on the trunk and occur more frequently in males than in females. A trend is also observed whereby ephelides 1) loose their prevalence with age, 2) become equally distributed on the face, arms, and trunk, and 3) occur more frequently in females. An intimate association of ephelides, but not solar lentigines, has been found with hair color and skin type. All of these findings are in agreement with most of those reported in the literature, supporting the view that ephelides and solar lentigines are different types of pigmented lesions.
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Affiliation(s)
- M T Bastiaens
- Department of Dermatology and Clinical Epidemiology, Leiden University Medical Center, The Netherlands.
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