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Van Gysel D, De Maeseneer H, Locy H, Forsyth R, Janmohamed SR. A 10-year-old girl with gray-brown patches in the axillary and inguinal folds. Pediatr Dermatol 2024; 41:915-917. [PMID: 38621740 DOI: 10.1111/pde.15626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/30/2024] [Indexed: 04/17/2024]
Affiliation(s)
- Dirk Van Gysel
- Department of Pediatrics, O.L. Vrouw Hospital Aalst, Aalst, Belgium
- Department of Dermatology, Interdisciplinary Unit of Pediatric Dermatology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | | | - Hanne Locy
- Department of Pathology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Ramses Forsyth
- Department of Pathology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Sherief R Janmohamed
- Department of Dermatology, Interdisciplinary Unit of Pediatric Dermatology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
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Garg S, Vashisht KR, Garg D, Oberoi B, Sharma G. Advancements in Laser Therapies for Dermal Hyperpigmentation in Skin of Color: A Comprehensive Literature Review and Experience of Sequential Laser Treatments in a Cohort of 122 Indian Patients. J Clin Med 2024; 13:2116. [PMID: 38610881 PMCID: PMC11012689 DOI: 10.3390/jcm13072116] [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: 01/15/2024] [Revised: 02/08/2024] [Accepted: 02/19/2024] [Indexed: 04/14/2024] Open
Abstract
The heightened awareness of ethnic dermatology aligns with the growing prevalence of skin of color communities globally, where hyperpigmentation disorders pose a common dermatological challenge. Effectively addressing dermal pigmentation is challenging due to its resistance to conventional therapies and its association with impaired quality of life. This underscores the need for effective treatments and a thorough grasp of laser advancements. A relevant literature search spanning the last 7 years across the PubMed database reveals core studies, challenges, and the evolution of laser technologies tailored for various forms of congenital and acquired dermal hyperpigmentation in skin of color. This comprehensive review explores the mechanisms, applications, and recommendations for pigmentary laser technologies, highlighting the key role of Q-switched lasers in their established millisecond/ nanosecond forms and emerging picosecond lasers, fractional non-ablative and ablative lasers, Intense Pulsed Light, etc. The summary of evidence includes studies on dermal melanocytosis (nevus of Ota and Hori's nevus), tattoos, acquired dermal macular hyperpigmentation, etc., and also entities with mixed epidermal-dermal components, such as melasma and post-inflammatory hyperpigmentation. The review offers valuable insights for clinicians to make informed decisions based on diagnosis, skin type, and the latest technologies to optimize results and minimize complications, especially in darker Fitzpatrick skin types. In their five-year study with 122 Indian patients, the authors applied specific laser combinations for diverse dermal melanoses, including tattoos, dermal/mixed melasma, acquired dermal macular hyperpigmentation, and dermal nevi. Substantial pigmentation reduction, subjectively assessed by both physicians and patients, was observed across all groups. A one-way ANOVA indicated a significant difference in mean improvement scores across various pigmentary conditions (F = 3.39, p = 0.02), with melasma patients exhibiting a significantly higher improvement score than tattoos (p = 0.03). The results affirmed the safety and efficacy of sequential laser therapy for dermal pigmentation in skin of color, advocating for flexibility in approach while maintaining the rationale behind the laser sequences. Despite advancements, challenges persist, and gaps in the current literature are identified. In conclusion, this summary highlights the ongoing pursuit of optimal protocols in dermatological laser treatments for dermal melanoses, offering valuable insights for future research and clinical practice.
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Affiliation(s)
| | - Kanya Rani Vashisht
- Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India
| | - Diksha Garg
- Aura Skin Institute, Chandigarh 160009, India
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Solanki V, Dongre A, Nayak C. A clinico-epidemiological study of different dermoscopic patterns in hyperpigmented facial lesions in a tertiary care centre. J Cutan Aesthet Surg 2024; 17:112-123. [PMID: 38800811 PMCID: PMC11126221 DOI: 10.4103/jcas.jcas_48_23] [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: 05/29/2024] Open
Abstract
Introduction Facial pigmentation is a common presentation of patients attending dermatology out patient department (OPD) and is of great concern to patients. Facial pigmentation may be multifactorial and is only rarely diagnosed accurately by a detailed history and clinical examination. Pigmentary disorders cause psychological distress and negatively impact the quality of life of an individual. Aims and Objectives (1) To study different dermoscopic patterns in facial melanosis. (2) To estimate the frequency of different dermoscopic patterns. Materials and Methods Patients with facial hyperpigmentation attending the dermatology OPD were recruited after taking their written consent. A detailed history was taken to collect demographic data. Clinical examination and dermoscopy were done in all patients. Biopsy was done as and when required. Descriptive statistics has been used to describe the quantitative data. Qualitative data were presented as frequency and percentage for clinical and dermoscopic patterns. Results The study included 100 patients with 15 different facial melanoses. The most common age group affected was 21-40 years in 53 (53%) cases. The female-to-male ratio was 1.63:1. Melasma was reported as the most common cause of facial melanosis constituting 49 (49%) of the total cases. Out of the total melasma cases, epidermal melasma constituted 22 (45%) cases, dermal melasma constituted four (4%) cases and mixed melasma constituted 23 (47%) cases. Other cases included were lichen planus pigmentosus (14; 14%), facial acanthosis nigricans (14; 14%), periorbital hyperpigmentation (7; 7%), post-inflammatory hyperpigmentation (4; 4%), exogenous ochronosis (2; 2%), lentigines (2; 2%), frictional melanosis (2;2%), and one case each of Becker's nevus, nevus of Ota, olanzapine-induced hyperpigmentation, Riehl's melanosis, macular amyloidosis, and tanning. Conclusions Melasma was reported as the most common cause of facial melanosis. The most common dermoscopic feature was accentuated pseudopigment network. The study is beneficial in understanding the different clinical and dermoscopic patterns of facial melanosis, thus helping the physician to effectively manage the conditions and reduce the need of biopsy. Limitations (1) A small sample size. (2) Histopathological correlation was not done in all cases.
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Affiliation(s)
- Vikas Solanki
- Department of Dermatology, B. Y. L. Nair Charitable Hospital & Topiwala National Medical College, Mumbai, Maharashtra, India
| | - Atul Dongre
- Department of Dermatology, B. Y. L. Nair Charitable Hospital & Topiwala National Medical College, Mumbai, Maharashtra, India
| | - Chitra Nayak
- Department of Dermatology, B. Y. L. Nair Charitable Hospital & Topiwala National Medical College, Mumbai, Maharashtra, India
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Shah S, Baskaran N, Vinay K, Bishnoi A, Parsad D, Kumaran MS. Acquired dermal macular hyperpigmentation: an overview of the recent updates. Int J Dermatol 2023; 62:1447-1457. [PMID: 37767951 DOI: 10.1111/ijd.16859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
Acquired dermal macular hyperpigmentation (ADMH), previously known as macular pigmentation of uncertain etiology (MPUE), is an umbrella concept that unifies the distinct but overlapping acquired dermal pigmentary disorders like lichen planus pigmentosus, ashy dermatosis, erythema dyschromicum perstans, Riehl's melanosis and pigmented contact dermatitis. All of these disorders usually lack a clinically apparent inflammatory phase, are characterised by dermal pigmentation clinically and histologically, and have a variable protracted disease course. Recently, a proposal has been made to classify these disorders into those with and without contact sensitisation. Dermoscopy is essentially similar across the spectrum of these disorders, and is useful for diagnosis and therapeutic response monitoring. Scoring system has been validated for the same. The treatment of ADMH remains challenging, with multiple topicals, oral therapies including mycophenolate mofetil, and lasers tried. Need of the hour is randomised controlled trials to enhance the therapeutic armamentarium.
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Affiliation(s)
- Shikha Shah
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Narayanan Baskaran
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Muthu S Kumaran
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Kim MS, Chung BY, Chang SE, Oh SH, Ryu HJ, Kim DH, Lee JH, Ko JY, Kim JE, Lee JH, Lee GY, Jeon J, Choi H, Roh MR, Bae JM, Na JI, Jung HJ, Bang CH, Kim HS, Lee SH, Shin MK, Lee SH, Park KY, Park CJ, Choi M, Yoon TJ, Suh KS, Park YL, Ryoo YW, Kim MH, Kim YC. Pigmented contact dermatitis and hair dyes: A retrospective case-control multicentre study in Korea. J Eur Acad Dermatol Venereol 2023; 37:2543-2549. [PMID: 37528459 DOI: 10.1111/jdv.19395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 06/26/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Pigmented contact dermatitis (PCD), a rare variant of non-eczematous contact dermatitis, is clinically characterized by sudden-onset brown or grey pigmentation on the face and neck. It is hypothesized to be caused by repeated contact with low levels of allergens. OBJECTIVES This study evaluated the risk of using hair dyes in patients with PCD in Korea. METHODS A total of 1033 PCD patients and 1366 controls from 31 university hospitals were retrospectively recruited. We collected and analysed the data from the patient group, diagnosed through typical clinical findings of PCD and the control group, which comprised age/sex-matched patients who visited the participating hospitals with pre-existing skin diseases other than current allergic disease or PCD. RESULTS Melasma and photosensitivity were significantly more common in the control group, and a history of contact dermatitis was more common in the PCD group. There were significantly more Fitzpatrick skin type V participants in the PCD group than in the control group. There was no significant difference in sunscreen use between the groups. Using dermatologic medical history, Fitzpatrick skin type and sunscreen use as covariates, we showed that hair dye use carried a higher PCD risk (odds ratio [OR] before adjustment: 2.06, confidence interval [CI]: 1.60-2.65; OR after adjustment: 2.74, CI: 1.88-4.00). Moreover, henna users had a higher risk of PCD (OR before adjustment: 5.51, CI: 4.07-7.47; OR after adjustment: 7.02, CI: 4.59-10.74), indicating a significant increase in the risk of PCD with henna dye use. Contact dermatitis history was more prevalent in henna users than in those using other hair dyes in the PCD group (17.23% vs. 11.55%). CONCLUSION Hair dye use is a risk factor for PCD. The risk significantly increased when henna hair dye was used by those with a history of contact dermatitis.
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Affiliation(s)
- Myoung Shin Kim
- Department of Dermatology, Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, South Korea
| | - Bo Young Chung
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sang Ho Oh
- Department of Dermatology, Severance Hospital and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Hwa Jung Ryu
- Department of Dermatology, College of Medicine, Korea University, Ansan Hospital, Ansan, South Korea
| | - Dong Hyun Kim
- Department of Dermatology, Bundang Medical Center, School of Medicine, CHA University, Seongnam, South Korea
| | - June Hyunkyung Lee
- Department of Dermatology, Eulji Medical Center, College of Medicine, Eulji University, Seoul, South Korea
| | - Joo Yeon Ko
- Department of Dermatology, Hanyang University College of Medicine and Hanyang University Seoul Hospital, Seoul, South Korea
| | - Jeong Eun Kim
- Department of Dermatology, Hanyang University College of Medicine and Hanyang University Seoul Hospital, Seoul, South Korea
| | - Jong Hee Lee
- Department of Dermatology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Ga Young Lee
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jiehyun Jeon
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Hoon Choi
- Department of Dermatology, Chosun University Hospital, Gwangju, South Korea
| | - Mi Ryung Roh
- Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Jung Min Bae
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jung-Im Na
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Hye Jung Jung
- Department of Dermatology, National Medical Center, Seoul, South Korea
| | - Chul Hwan Bang
- Department of Dermatology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Hei Sung Kim
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, South Korea
| | - Seung Ho Lee
- Department of Dermatology, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang, South Korea
| | - Min Kyung Shin
- Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Si-Hyung Lee
- Department of Dermatology, Seoul National University Hospital, Seoul, South Korea
| | - Kui Young Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Chul-Jong Park
- Department of Dermatology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, South Korea
| | - Mira Choi
- Department of Dermatology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea
| | - Tae-Jin Yoon
- Department of Dermatology, School of Medicine, Gyeongsang National University & Hospital, Jinju, South Korea
| | - Kee Suck Suh
- Department of Dermatology, Kosin University College of Medicine, Busan, South Korea
| | - Young Lip Park
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Young Wook Ryoo
- Department of Dermatology, School of Medicine, Keimyung University, Daegu, South Korea
| | - Myung Hwa Kim
- Department of Dermatology, College of Medicine, Dankook University, Cheonan, South Korea
| | - You Chan Kim
- Department of Dermatology, Ajou University School of Medicine, Suwon, South Korea
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Ding Y, Xu Z, Xiang LF, Zhang C. Unveiling the mystery of Riehl's melanosis: An update from pathogenesis, diagnosis to treatment. Pigment Cell Melanoma Res 2023; 36:455-467. [PMID: 37401632 DOI: 10.1111/pcmr.13108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 06/07/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023]
Abstract
Riehl's melanosis is a hyperpigmentation disorder that has a significant psychological and social impact on individuals. In the past 10 years, new categories have been developed, raising questions about how to classify Riehl's melanosis. The mechanism of this disease remains unclear, although the type IV hypersensitivity response caused by allergic sensitization, as well as genetic, ultraviolet radiation, and autoimmune factors, is to blame. Clinical manifestation, dermoscopy, reflectance confocal microscopy, patch/photopatch testing, histopathology, and a novel multimodality skin imaging system have been used for the diagnosis. A variety of therapies including topical skin-lightening agents, oral tranexamic acid, glycyrrhizin compound, chemical peels, and lasers and light therapies (intense pulsed light, 1064-nm Q-Switched Nd: YAG laser, 755-nm PicoWay laser, nonablative 1927-nm fractional thulium fiber laser, new pulsed-type microneedling radiofrequency), with improved effectiveness. The latest findings on possible biomarkers and their relationship to other autoimmune diseases were also summarized.
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Affiliation(s)
- Yuecen Ding
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhongyi Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Leihong Flora Xiang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chengfeng Zhang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
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Mehta H, Subburaj K, Dogra S, Bishnoi A, Vinay K, Chatterjee D, Parsad D, Kumaran MS. Acquired dermal macular hyperpigmentation secondary to bangles - an unusual encounter. Indian J Dermatol Venereol Leprol 2023; 0:1-3. [PMID: 37609739 DOI: 10.25259/ijdvl_908_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 06/09/2023] [Indexed: 08/24/2023]
Affiliation(s)
- Hitaishi Mehta
- Department of Dermatology Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kiruthika Subburaj
- Department of Dermatology Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Dogra
- Department of Dermatology Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuradha Bishnoi
- Department of Dermatology Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Debajyoti Chatterjee
- Department of Dermatology Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - M Sendhil Kumaran
- Department of Dermatology Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Muacevic A, Adler JR, Attas MA, Miyajan KF, Al Hawsawi K. Follicular Variant of Acquired Dermal Macular Hyperpigmentation: A Case Report. Cureus 2023; 15:e34133. [PMID: 36843742 PMCID: PMC9948115 DOI: 10.7759/cureus.34133] [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] [Accepted: 01/24/2023] [Indexed: 01/25/2023] Open
Abstract
Acquired dermal macular hyperpigmentation (ADMH) is a term used to describe a group of diseases that are characterized by idiopathic macular dermal hypermelanosis. These skin conditions include erythema dyschromicum perstans, lichen planus pigmentosus, and pigmented contact dermatitis, also known as Riehl's melanosis. This case report involves a 55-year-old woman who was generally healthy but who had been experiencing asymptomatic, slowly progressive skin lesions for the previous four years. A thorough inspection of her skin revealed many non-scaly, pin-point follicular brown macules, which in some spots had coalesced into patches across her neck, chest, upper extremities, and back. Darier disease and Dowling-Degos disease were included in the differential diagnosis. The biopsies of the skin revealed follicular plugging. The dermis had pigment incontinence with melanophages and slight perivascular and perifollicular mononuclear cell infiltrates. The patient was diagnosed with a follicular form of ADMH. Patient's skin condition caused her concern. She was reassured and prescribed topical steroids 0.1% betamethasone valerate ointment application twice a day for two days per week (weekends) and 0.1% tacrolimus ointment application twice a day for five days per week for three months. She showed some improvement and was put under periodic follow-ups.
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Xu L, Huang Q, Wu T, Mu Y. Research Advances in the Treatment of Riehl's Melanosis. Clin Cosmet Investig Dermatol 2023; 16:1181-1189. [PMID: 37168093 PMCID: PMC10166104 DOI: 10.2147/ccid.s403090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/21/2023] [Indexed: 05/13/2023]
Abstract
Riehl's melanosis (RM) is a contact photodermatitis, with fast progressive gray-brown skin pigmentation as the main manifestation, which can seriously affect the psychology and physiology of patients. Currently, although the etiological factors of Riehl's melanosis is still be unknown, the existing literature proves clearly the cause of it is related to the contacting with suspected allergens. For decades, there has been no standard method for the treatment of RM, but with both conventional drug therapy and laser therapy having been attempted. Topical application of bleaching agents is mainly used as an auxiliary treatment modality. The laser treatment modality remains a hot spot, among which Q-switched Nd:YAG laser is well received for RM. Positive outcomes have been achieved by the combined treatment modalities attempted in recent years also achieve positive outcomes. The purpose of this paper is to review and summarize recent advances in the treatment of the disease.
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Affiliation(s)
- Liuli Xu
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People’s Republic of China
| | - Qing Huang
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People’s Republic of China
| | - Ting Wu
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People’s Republic of China
| | - Yunzhu Mu
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People’s Republic of China
- Correspondence: Yunzhu Mu, Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People’s Republic of China, Email
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Riehl’s Melanosis: A Multimodality, In Vivo, Real-Time Skin Imaging Study with Cellular Resolution Optical Coherence Tomography and Advanced Skin Diagnosis System in a Tertiary Medical Center. Bioengineering (Basel) 2022; 9:bioengineering9090419. [PMID: 36134965 PMCID: PMC9495881 DOI: 10.3390/bioengineering9090419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/13/2022] [Accepted: 08/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Riehl’s melanosis is a psychologically devastating hyperpigmentary disorder that typically occurs on the face and neck. The study of Riehl’s melanosis is limited due to its rarity, variable morphology, and lack of noninvasive diagnostic tools. Recent advances in skin imaging analysis and diagnostic systems improve diagnostic accuracy and enable the noninvasive, real-time evaluation of pigmentary disease. A comprehensive study of Riehl’s melanosis clinical morphology with multimodality and in vivo skin imaging systems has yet to be reported. Objectives: To investigate the clinical features and in vivo advanced skin imaging findings of Riehl’s melanosis. Methods: We retrospectively investigated the clinical characteristics, dermoscopic, and histopathological features of Riehl’s melanosis. We further utilized multimodality skin imaging analysis systems, including a cellular resolution optical coherence tomography (OCT) and new skin diagnosis system, to investigate the features of Riehl’s melanosis. In addition, we compared OCT findings with histopathological features and clinical assessment. Results: We evaluated 30 patients with Riehl’s melanosis at a tertiary medical center from 2010 to 2022. The average age was 47.7 ± 12.3 (mean ± SD) years, predominantly female patients (female: n = 23; male: n = 7). Cellular resolution OCT imaging from lesion skin shows increased melanocyte capping, disrupted basement membrane, telangiectatic blood vessels, and melanophages in the dermis. The advanced skin diagnosis system captured subclinical erythema of the skin, highlighting the inflammatory nature of the disease. The results correlated well with histopathological findings. Limitations: This is a single-center, cross-sectional study. Conclusions: We highlight the features of Riehl’s melanosis through a novel cellular resolution OCT and photographic skin diagnosis system. A multimodality skin diagnosis system can serve as a real-time, in vivo, noninvasive method for evaluating pigmentary disorders.
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Subburaj K, Vinay K, Bishnoi A, Kumaran MS, Parsad D. Pigmented contact dermatitis: A brief review. COSMODERMA 2022; 2:43. [DOI: 10.25259/csdm_45_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Hyperpigmentation is one of the common pigmentary complaints that brings the patient to dermatology services. Though there are multiple etiologies for hyperpigmentation, pigmented contact dermatitis (PCD) remains a common diagnosis. The cosmetics containing dyes, preservatives, fragrances, bactericidal, emulsifiers/surfactants, and vehicles are the potential sources, and paraphenylenediamine, benzyl salicylate, brilliant lake red R, thiomersal and gallate mix are some of the most commonly implicated allergens.
The clinical manifestation includes diffuse or patchy brown to blue-black pigmentation of the cheeks, the outer surface of ears, preauricular region, temporal area, nape of the neck, and upper back. Patch testing plays a pivotal role in the diagnosis of PCD and the testing series has to be selected according to the representative population. Given the chronicity of the disease, counseling patients against the use of cosmetics is challenging as the pigmentation tends to persist for longer durations inspite of stopping cosmetics. The pillars of treatment in PCD include recognition of the culprit allergen and preventing further exposure along with pharmacological therapy. This review provides a brief overview and an insight into the etiopathogenesis and management of PCD.
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Affiliation(s)
- Kiruthika Subburaj
- Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
| | - Davinder Parsad
- Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
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