Periocular hyperpigmentation: a review of etiology and current treatment options

BACKGROUND

Periocular "dark circles" fall among the most difficult chief complaints to address. In most cases, we have little information regarding etiology and no gold-standard treatment option. The extent of the problem is reflected in the sheer number of products on the market advertised to either lighten or cover the pigmentation.

OBJECTIVE/METHODS

To present dermatologists with a complete review of the literature with regard to anatomy, definition, etiology, and treatment of periocular hyperpigmentation.

CONCLUSIONS

Our understanding of the causes and treatment of periocular hyperpigmentation continues to advance. Nevertheless, we are in need of additional controlled clinical trials and novel therapeutic options. Individual patients will likely benefit most from a combination of approaches. Although more randomized clinical studies are necessary, Pfaffia paniculata/Ptychopetalum olacoides B.⁄Lilium candidum L.-associated compound cream seems to be a promising option, with 90% improvement. For patients with increased melanin deposition, quality-switched ruby laser therapy could offer a better treatment option. In the hands of experienced professionals, a surgical option might be suitable, either by autologous fat transplantation or hyaluronic acid filler.

Allergic contact cheilitis and perioral dermatitis caused by propolis: case report

We report a case of propolis allergy in an 18-year-old female patient. Medical history revealed self-prescribed topical use of propolis spray as a medication for gingival swelling caused by orthodontic molar bands. After 24 hours, the patient developed lip edema and erythema of the perioral skin accompanied by burning pain in her lips. Discrete erosions were present in the corners of her lips. Erythema of the right infraorbital region was also observed. The patient was prescribed betamethasone propionate cream two times daily. Complete recovery was observed after 10 days. Propolis allergy was confirmed by a patch test. We believe that the use of propolis for the treatment of oral diseases should be avoided due to sparse evidence of its efficacy and numerous cases of allergic reactions.

[Diagnostic criteria, epidemiology and substantiation of clinicopathogenetic types of perioral dermatitis]

The perioral dermatitis is a multifactorial disease of a face skin meeting in population with frequency of 5% also represents inflammatory process with the various morphological characteristic of an eruption. A total of 511 patients are surveyed by a perioral dermatitis. For the first time clinico-pathogenetic types of development and a disease current (it is hormonal--immunologic, allergic, gastroenterology, metabolic) with characteristic distinctive changes of the hormonal status, a metabolism and immunity system are allocated. The complex of laboratory criteria of diagnostics of the specified types of the perioral dermatitis, giving representation about mechanisms of formation, clinical features of the dermatosis is developed, allowing differentiate to prove the approach to treatment.

[Oral and perioral endogenous pigmented lesions]

Pigmented lesions are commonly found in the mouth. Such lesions represent a variety of clinical entities, ranging from physiologic changes to manifestations of systemic illnesses and malignant neoplasms. Two groups of pigmented lesions of the oral mucosa are recognized: 1) endogenous lesions, including racial pigmentations, melanotic macules, melanocytic nevi, malignant melanoma and 2) exogenous lesions (e.g., blood-related pigmentations, metallic pigmentations). The etiology, differential diagnosis, clinical and histopathological features and management of endogenous pigmented lesions is discussed and the current literature is reviewed. In this article, pigmented lesions are described to allow practitioner to elaborate a positive diagnosis of endogenous pigmented lesions and to facilitate an early detection of these lesions particularly the malignant ones.

Perioral dermatitis

Perioral dermatitis is an inflammatory facial skin disorder that predominantly affects women. It is rarely diagnosed in children. The etiology of perioral dermatitis is unknown; however, uncritical use of topical corticosteroids often precedes skin lesions. There is a written diagnostic work-up, differential diagnosis and treatment.

Rashes in infants. Pitfalls and masquerades

BACKGROUND

Physiological and pathological skin eruptions are extremely common in neonates and are often presented to the general practitioner as either a primary or incidental problem at consultation.

OBJECTIVE

To discuss the presentation and treatment of common dermatological conditions presenting in the first six months of life.

DISCUSSION

Common conditions such as pityrosporum folliculitis, neonatal acne, cradle cap, eczema and food allergy are discussed. The rarer conditions of zinc deficiency and neonatal lupus are described because they may pose significant potential medical consequences.

Orofacial edema: a diagnostic and therapeutic challenge for the clinician

BACKGROUND AND CONCLUSION: A case of a 41-year-old patient with a 5-year history of chronic recurrent angioedema, refractory to conservative treatment is presented. The results of the case report suggest that in differential diagnosis of angioedema, in addition to usual causes, the allergist-immunologist needs to consider Melkersson-Rosenthal syndrome, which can present with a variety of symptom-combinations of the classic triad. The distinguishing characteristics of the Melkersson-Rosenthal syndrome are its refractoriness to the usual anti-inflammatory therapy and the need to consider corrective cosmetic surgery, which may benefit some patients.