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ABSTRACT Background Aims Patients/Methods Results Conclusions Periorbital hyperpigmentation is a prevalent skin condition that represents a large quantity of cases seen in cosmetic dermatology. Patients tend to be left with pigmentation after Q‐switched ruby laser treatment, especially the perioribital area.The study is conducted to compare the effect of PRP injection combined with laser therapy versus laser alone for periorbital hyperpigmentation treatment.In this single‐center, case–control study, 30 patients with periorbital hyperpigmentation were allocated to receive PRP injection injection after Q‐switched ruby laser or Q‐switched ruby laser only, followed by a 12‐week and 24‐week follow‐up visit. Visual analogue scale, Sadick tear trough rating scale, and patients' self‐evaluation were used to evaluate the therapeutic effect.The combined group achieved a better improvement in long‐term effect and had effect on facial rejuvenation. Patient satisfaction was higher in the combined group. Erythema and mild pain were the most common adverse reactions of both groups.Combining with PRP injection can improve the therapeutic effect of Q‐switched ruby laser in treating periorbital hyperpigmentation and lessen the risk of post‐inflammatory hyperpigmentation, indicating a new option for POH treatment. [ABSTRACT FROM AUTHOR]

Focused ultrasound (FUS) is emerging as one of the most promising, non-invasive treatment techniques. The advancement of transducer technology has paved the way for dermatological applications. A comprehensive review is presented for healthcare practitioners and researchers, summarizing the effect of various operational parameters on the injury zone produced by ultrasound beams for various dermatological applications, which include skin tightening, fat reduction, hyperpigmentation and cancer treatment. In this article, we aim to highlight the efficient operational parameters of FUS to enhance pain relief during surgery and its affordability for skin treatment. Finally, a prospective future technique for efficient FUS is discussed. [ABSTRACT FROM AUTHOR]

Abstract Skin of color (SOC) is characterized by increased tendency for tanning and decreased likelihood of sunburns due to the attenuation of sunlight by epidermal melanin. Although this contributes to the decreased incidence of skin cancer among SOC populations, individuals with SOC remain susceptible to various health consequences associated with sun exposure, including non-melanoma skin cancer, photoaging, pigmentary disorders, and photodermatoses — many of which not only present differently, but also disproportionately affect SOC. Prior epidemiological studies have found lower prevalence of sun protection behaviors among individuals with SOC, particularly in sunscreen use, signifying an unmet area for improvement in the prevention of sun-induced dermatologic conditions in these populations. The objective of this narrative review was to summarize the biology and health consequences of sun exposure in SOC, as well as cognitive and behavioral factors that affect the practice of photoprotection behaviors in SOC populations. We also review prior interventions that have been used to enhance photoprotection knowledge and behaviors among individuals with SOC, either in racially and ethnically diverse communities or within specific SOC populations.

Idiopathic eruptive macular pigmentation (IEMP) is a rare disorder of pigmentation presenting with asymptomatic hyperpigmentation mainly in children and adolescents over face, neck, trunk, and extremities. Epidermal basal-cell pigmentation is observed on histopathology. It usually resolves spontaneously over months to years. Lichen planus pigmentosus and erythema dyschromicum perstans should be differentiated from IEMP. We report four cases of IEMP fulfilling the criteria proposed by Sanz de Galdeano et al. in 1996. [ABSTRACT FROM AUTHOR]

Skin of color (SOC) is characterized by increased tendency for tanning and decreased likelihood of sunburns due to the attenuation of sunlight by epidermal melanin. Although this contributes to the decreased incidence of skin cancer among SOC populations, individuals with SOC remain susceptible to various health consequences associated with sun exposure, including non-melanoma skin cancer, photoaging, pigmentary disorders, and photodermatoses — many of which not only present differently, but also disproportionately affect SOC. Prior epidemiological studies have found lower prevalence of sun protection behaviors among individuals with SOC, particularly in sunscreen use, signifying an unmet area for improvement in the prevention of sun-induced dermatologic conditions in these populations. The objective of this narrative review was to summarize the biology and health consequences of sun exposure in SOC, as well as cognitive and behavioral factors that affect the practice of photoprotection behaviors in SOC populations. We also review prior interventions that have been used to enhance photoprotection knowledge and behaviors among individuals with SOC, either in racially and ethnically diverse communities or within specific SOC populations. [ABSTRACT FROM AUTHOR]

Idiopathic eruptive macular pigmentation (IEMP) is a rare disorder of pigmentation presenting with asymptomatic hyperpigmentation mainly in children and adolescents over face, neck, trunk, and extremities. Epidermal basal-cell pigmentation is observed on histopathology. It usually resolves spontaneously over months to years. Lichen planus pigmentosus and erythema dyschromicum perstans should be differentiated from IEMP. We report four cases of IEMP fulfilling the criteria proposed by Sanz de Galdeano et al. in 1996.

Introduction: Melasma may occur in thyroid diseases, and its manifestations may be the first presenting sign or even precede the diagnosis by many years. Melasma is difficult to treat. An initial screening of thyroid dysfunction will help in better management of both thyroid disorders and melasma. Aim: To detect the proportion of thyroid dysfunction in patients with melasma and describe the clinical profile of such patients. Materials and Methods: This was a cross-sectional, observational study carried out in the Department of Dermatology, Venereology and Leprosy, of a tertiary care teaching hospital of Karnataka, India from September 2020 to February 2022. Patient above or equal to 18 years of age with newly diagnosed melasma alone and no history of thyroid dysfunction were included in the study. A detailed history, using a preformed questionnaire, was taken. Wood’s lamp examination, to know the depth of pigmentation, along with thyroid dysfunction test, and antiThyroid Peroxidase (TPO) antibody was evaluated. Descriptive statistics data were analysed using a Statistical Package for the Social Sciences (SPSS) software version 20.0. Results: There were 100 patients with a mean age of 35.9 years, with a predominance of female (86%) and the majority (48%) of population were housewives. The distribution of lesion was either dermal (55%) or epidermal (44%). There were 65 patients with positive antiTPO; with men (85.7%) being significantly more than women (61.6%). The distribution of pigmentations was higher for the dermal pattern (55%), among females (46) and males (9), while only one mixed pattern was seen in males. Conclusion: Male melasma patients had higher positivity of antiTPO positivity than females, with significant antiTPO positivity. These patients showed more dermal pigmentations on Wood’s lamp examination.

A 6‐year‐old female with a history of Aicardi–Goutières syndrome (AGS) presented to dermatology clinic with hypopigmented and hyperpigmented macules and patches consistent with dyschromatosis symmetrica hereditaria (DSH). Previous genetic workup demonstrated a de novo, heterozygous mutation in the adenosine deaminase acting on RNA 1 (ADAR) gene. While the co‐occurrence of AGS and DSH has previously been described in mutations of the ADAR gene, our case highlights the potential association between these disorders that may aid in earlier future diagnosis of AGS. [ABSTRACT FROM AUTHOR]

Dowling-Degos Disease is a rare, pigmentary disorder with variable presentations. The most common among them are hyperpigmented macules and reticulate pigmentary anomaly of flexures. Many other phenotypic variations of Dowling-Degos disease have been reported in literature. We present here a case of Dowling-Degos disease with comedo-like lesions and pits without typical flexural hyperpigmented macules.

Lichen planus pigmentosus (LPP) is a condition characterized by persistent and asymptomatic brownish-black-to-blue or purple-gray pigmentation, predominantly in the face and sun-exposed areas, commonly in dark-skinned individuals. Several clinical variants of LPP have been reported. However, the ichthyosiform type of LPP has not been reported. We present a 19-year-old male patient who presented with a 7-year history of asymptomatic grayish macules; patches with fine scales on the face, trunk, and upper extremities; and grayish plaques with thick "ichthyosiform" scales on the lower extremities. The diagnosis of LPP was proven by histopathological findings on both the macular and ichthyosiform plaques. Cluster differentiation (CD) 68 stain highlights the same density of pigment-laden macrophages in both the gray macule and the ichthyosiform plaque. The cause of LPP is unknown. Transcription factor anomalies may play a role in increased keratinization of lichen planus lesions. It can be assumed that the mechanism of the altered distribution of keratinization may occur on the ichthyosiform lesions in this patient. The terminology "ichthyosiform lichen planus pigmentosus" is hereby proposed to be added to the clinical variants of LPP., (©Audi Sugiharto, Julius Gatmaitan, Johannes Dayrit. Originally published in JMIR Dermatology (http://derma.jmir.org), 19.04.2024.)

Diffuse hyperpigmentation with guttate hypopigmentation (DHGH) is a new acquired pigmentary disorder. Only a few cases have previously been reported in the Chinese population, in Chinese. To summarise the clinical, dermoscopic, and histopathological findings of DHGH in the English literature, to improve the recognition and management of this condition. This was a retrospective study to summarise the clinical, dermoscopic, and pathological findings of nine cases of DHGH. All nine patients with DHGH were female. The age at onset varied from 6 to 24 years (median 17 years). Patients were generally in good health without systemic disease. The lesions were often generalised to the trunk and extremities without any discomfort. Typical lesions were characterised by multiple uniform hypopigmented spots, 2-5 mm in diameter, irregularly distributed over diffuse hyperpigmentation. Dermoscopy revealed multiple blurred patchy areas of brownish pigmentation, sparse linear and dotted vessels, and perifollicular pigmentation on a white to bright white background, surrounded by brown hyperpigmentation. Histopathological findings included mild abnormal pigment of the epidermis, focal vacuolar degeneration of the basal cells, mild pigment incontinence and perivascular lymphocytic infiltration in the dermis. DHGH is a new entity with distinctive clinical manifestations that differ from those of other known pigmentary disorders. So far, DHGH has only been reported in the Chinese population. It may not be uncommon and has not received much attention due to the few reports. The aetiology and pathogenesis of DHGH are still unknown and require further investigation.

Background: A recent report suggested potential of high‐intensity focused ultrasound in improving UVB‐induced hyperpigmentation in patients with Fitzpatrick skin type IV, but reports regarding its efficacy in other hyperpigmented conditions including melasma are lacking. Objectives: To investigate efficacy and safety of high‐intensity focused ultrasound for the treatment of melasma in Asians. Methods: Each side of the face of 25 melasma patients was randomized to receive 3‐monthly sessions of high‐intensity focused ultrasound treatment or serve as control. Lightness index, Melasma Area and Severity Index of malar area (MASIm) by blinded dermatologists, self‐evaluated improvement and satisfaction scales by patients, and side effects were assessed every 4 weeks for 20 weeks. Results: Twenty‐one patients with Fitzpatrick skin type III and IV completed the study. There was a greater reduction of relative lightness index and MASIm after treatment in high‐intensity focused ultrasound‐treated side. However, there were no statistically significant differences between both sides. More than 50% improvement on treatment side was rated in 11 patients (52.4%). Side effects were minimal. None had worsening of melasma. Conclusions: High‐intensity focused ultrasound may be an adjuvant for treatment of melasma. Further studies with larger sample size and proper parameter settings are recommended to determine its efficacy. [ABSTRACT FROM AUTHOR]

Recent progress in the field of laser and aesthetic medicine is discussed in this review to provide actual evidence for clinical practices. To date, several advances have been reported in this field. Among them, the most outstanding advancements include the application of short interval, multiple-session 1064-nm Q-switched laser for the treatment of caf佴-au-lait macules; treatment of facial hypopigmented scars by the laser hole technique; perioral microgroove correction with Erbium-YAG laser resurfacing; and so on. Laser treatment and other technologies are worth repeating and confirming by peers. [ABSTRACT FROM AUTHOR]

Dowling-Degos Disease is a rare, pigmentary disorder with variable presentations. The most common among them are hyperpigmented macules and reticulate pigmentary anomaly of flexures. Many other phenotypic variations of Dowling-Degos disease have been reported in literature. We present here a case of Dowling-Degos disease with comedo-like lesions and pits without typical flexural hyperpigmented macules. [ABSTRACT FROM AUTHOR]

Background and Objective: Little is known about the anti-pigmentation effects of whitening agents on solar lentigines. Epidermal growth factor (EGF) has been used as a booster for wound healing in the skin, and it has been suggested to have anti-pigmentation effects. This study aimed to evaluate the effect and safety of EGF-containing ointment for treating solar lentigines with a Q-switched (QS) 532 nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser (Bluecore company, Seoul, Republic of Korea). Materials and Methods: Subjects who underwent QS 532 nm Nd:YAG laser treatment of solar lentigines were randomly assigned to treatment with an EGF ointment or petrolatum. After the laser procedure, the subjects were administered the test ointment twice a day for 4 weeks. The physician’s assessment of the degree of pigment clearance and patient’s satisfaction were assessed after 4 and 8 weeks. Additionally, the melanin index (MI), erythema index (EI), transepidermal water loss (TEWL), and post-inflammatory hyperpigmentation (PIH) were evaluated. This trial was registered with ClinicalTrials.gov (NCT04704245). Results: The blinded physician’s assessment using 5-grade percentage improvement scale and patient’s satisfaction were significantly higher in the study group than in the control group at the 4th and 8th weeks. The MI was significantly higher in the control group than in the study group at the 4th and 8th weeks. The EI and TEWL did not differ significantly between the two groups at either time point. The incidence of PIH was higher in the control group (37.5%) than in the EGF group (7.14%) at the 8th week. Conclusions: The application of EGF-containing ointment on facial solar lentigines with a QS 532 nm Nd:YAG laser showed efficient and safe therapeutic effects, with less PIH. Thus, EGF-containing ointment could be suggested as the promising adjuvant treatment strategy with a QS laser for solar lentigines.

Purpose: To evaluate the association between age-related macular degeneration (ARMD) and sensory neural hearing impairment (SHI). Methods: In this case-control study, hearing status of 46 consecutive patients with ARMD were compared with 46 age-matched cases without clinical ARMD as a control group. In all patients, retinal involvements were confirmed by clinical examination, fluorescein angiography (FA) and optical coherence tomography (OCT). All participants were examined with an otoscope and underwent audiological tests including pure tone audiometry (PTA), speech reception threshold (SRT), speech discrimination score (SDS), tympanometry, reflex tests and auditory brainstem response (ABR). Results: A significant (P = 0.009) association was present between ARMD, especially with exudative and choroidal neovascularization (CNV) components, and age-related hearing impairment primarily involving high frequencies. Patients had higher SRT and lower SDS against anticipated presbycusis than control subjects. Similar results were detected in exudative, CNV and scar patterns supporting an association between late ARMD with SRT and SDS abnormalities. ABR showed significantly prolonged wave I and IV latency times in ARMD (P = 0.034 and 0.022, respectively). Average latency periods for wave I in geographic atrophy (GA) and CNV, and that for wave IV in drusen patterns of ARMD were significantly higher than controls (P = 0.030, 0.007 and 0.050, respectively). Conclusion: The association between ARMD and age-related SHI may be attributed to common anatomical components such as melanin in these two sensory organs.

Solar lentigines are common pigmentary lesions. Q-switched lasers are effective treatment options but postinflammatory hyperpigmentation (PIH) is common in darker skin. The objective of the study is to compare the efficacy and safety in solar lentigines of Asian skin treated by Q-switched potassium titanyl phosphate (KTP) 532-nm nanosecond laser vs. KTP 532-nm picosecond laser for the treatment of solar lentigines in Asians. Thirty patients with at least 2 solar lentigines on the upper extremities were enrolled. A total of 30 paired lentiginous lesions were randomly treated with a single treatment of either Q-switched KTP 532-nm nanosecond laser vs. KTP 532-nm picosecond laser. In terms of efficacy, mean luminance score was evaluated at baseline, at 6th, and 12th week. Degree of pigment clearance was assessed by a blinded physician and the patients. Satisfaction score was rated by patients using visual analogue scale. Adverse events were also recorded. Twenty-eight patients completed the study. Both lasers showed significant improvement in mean luminance score from baseline (p < 0.05). Likewise, there was no significant difference in pigment clearance between two lasers either assessed by physician or patients. However, patients' satisfaction score was significantly higher with the picosecond laser (p = 0.014). Adverse events and pain were not different between groups. Q-switched KTP 532-nm nanosecond laser and KTP 532-nm picosecond laser are safe and effective for treating solar lentigines in Asians. Based on cost-effectiveness, Q-switched KTP 532-nm nanosecond laser remains the main treatment while KTP 532-nm picosecond laser can be considered as a treatment option. [ABSTRACT FROM AUTHOR]

Introduction: Post-inflammatory hyperpigmentation (PIH) after solar lentigo removal using a Q-switched (QS) 532-nm Nd:YAG laser is a cause for concern. This study aimed to evaluate the efficacy and safety of intradermal injections of tranexamic acid (TA) at reducing the risk of PIH after QS 532-nm Nd:YAG laser treatment of solar lentigines. Methods: Twenty-five patients with 50 solar lentigines on forearms underwent QS 532-nm Nd:YAG laser treatment. Then, TA (50 mg/mL) was injected randomly into one lesion and 0.9% normal saline was injected intradermally into another lesion. Two blinded dermatologists and a Mexameter® evaluated photographs at baseline, and at weeks 2, 4, 8, and 12. Results: At the end of the study, the mean melanin index (MI) had decreased significantly in both groups. The TA group showed a significant reduction in the mean MI compared with that in the control group at week 4 (p = 0.025). The overall PIH rates were 16% and 28% in the TA and control groups, respectively. The side effects of TA were minimal and they were resolved within 1 h. Conclusion: Single dose of intradermal TA (50 mg/mL) injected can reduce the risk of developing PIH 4 weeks after 532-nm QS Nd:YAG laser treatment of solar lentigines. [ABSTRACT FROM AUTHOR]

Background/Objectives: Controversy persists as to whether lichen planus pigmentosus and ashy dermatosis are separate clinical entities. This study was conducted to examine the clinicopathological features and treatment outcome of the two conditions. Methods: A retrospective medical chart review of all patients who were diagnosed with lichen planus pigmentosus or ashy dermatosis was conducted. The information collected included the participants' age at onset, site of onset, duration of disease, presence of precipitating factors, distribution of disease, pigmentation and presence of symptoms. In patients from whom a biopsy was taken the histopathological reports were included. Results: Altogether 26 patients with ashy dermatosis and 29 with lichen planus pigmentosus were included in the study. Compared with ashy dermatosis, lichen planus pigmentosus had a more localised distribution with a preponderance for facial involvement, compared with the truncal preponderance in ashy dermatosis. Ashy dermatosis tended to have a more stable clinical course than lichen planus pigmentosus, which was more likely to wax and wane. The utility of histopathology in differentiating between the two conditions is low. Conclusion: Ashy dermatosis and lichen planus pigmentosus, as defined in this study, appear to be two separate clinical entities with distinguishable clinical features and natural histories. [ABSTRACT FROM AUTHOR]

Background: Vitiligo is one of the commonest pigmentary disorders characterized by destruction of melanocytes. Aim: To evaluate the efficacy of topical bimatoprost ophthalmic solution in stable facial vitiligo. Material and methods: Eight cases of stable facial vitiligo were treated with bimatoprost 0.03% ophthalmic solution once daily for 12 weeks. Photographic records were taken at 2 weeks follow-up along with dermoscopic (Polarized, 109) evaluation. Results: Four cases had excellent repigmentation, two cases had partial repigmentation and two cases had poor response. Conclusion: Bimatoprost seems to be promising in treating stable vitiligo but largescale studies are required. [ABSTRACT FROM AUTHOR]

A variety of topical depigmenting agents have been used clinically, with varying degrees of success. To date, the most effective topical treatment is a triple-combination agent containing hydroquinone (HQ), tretinoin, and fluocinolone acetonide. However, its use is associated with relatively high frequencies of adverse reactions, and therefore there is a necessity to produce effective topical depigmenting agents with fewer adverse effects. Several processes can be targeted for the treatment of hyperpigmentation; specifically, regulation of melanogenesis by inhibiting tyrosinase activity, a key enzyme in melanin synthesis, represents a major therapeutic target. Another option is regulation of melanosomes by manipulation of their formation or transfer. In addition, depigmenting agents can act through antioxidant or anti-inflammatory activities. We compared the tyrosinase inhibitory activity and cytotoxicity of HQ with those of other cosmetic ingredients. The results showed that although HQ was a strong tyrosinase inhibitor, it was cytotoxic at high concentrations. By contrast, 4-n-butylresorcinol effectively controlled tyrosinase activity without showing toxicity at high concentrations. These findings indicated that 4-n-butylresorcinol had the potential to act as an effective depigmenting agent, while producing less irritation than the currently available agents.

Skin hyperpigmentation is a frequently encountered problem, particularly in darker skin types. Unfortunately, standard treatments for this condition have shown disappointing results. High-intensity focused ultrasound (HIFU) is commonly indicated for skin laxity, but recently was used to treat UV-induced hyperpigmentation in animal models. This study is aimed to evaluate the efficacy and safety of high-intensity focused ultrasound for UVB-induced hyperpigmentation in human subjects. A randomized, evaluator-blinded pilot study was conducted on 20 subjects. Each subject was induced three hyperpigmentary spots by local broadband UVB. After 2 weeks, each spot was randomly allocated to control, low-energy, and high-energy HIFU. Subjects were instructed to follow up weekly for a duration of 1 month. Lightness index measurements, mean improvement scores, subjects' satisfaction, pain scores, and side effects were evaluated. All 20 subjects completed the study. Fourteen subjects had Fitzpatrick (FPT) skin type III and six subjects had FPT skin type IV. Twelve subjects showed greater improvement at control sites while eight subjects showed greater improvement at HIFU-treated sites. In FPT skin type III, HIFU appeared to be inferior to control in both lightness index and mean improvement scores, but in FPT skin type IV, HIFU had greater lightness index improvement and higher improvement scores than control. Side effects were more frequent in high-energy-treated areas. Focused ultrasound may be offered in some patients with hyperpigmentary conditions. More research is needed to determine proper energy settings for optimal outcome. [ABSTRACT FROM AUTHOR]

Objective: The 730 nm picosecond titanium sapphire laser is a novel laser that shows promising results in treating freckles. This study aimed to further investigate the efficacy and safety of the 730 nm picosecond titanium sapphire laser for treating freckles in Asian patients compared with those of the 755 nm picosecond alexandrite laser., Methods: Each face of 86 participants was split into two parts and randomly assigned either one session of 730 or 755 nm picosecond-laser treatment each. Efficacy and safety were determined based on blinded visual evaluations and self-reports at each follow-up visit., Results: The treatment outcomes of the 730 nm picosecond laser for the treatment of freckles were comparable to those of the 755 nm picosecond laser, with 68.99 ± 7.42% and 69.27 ± 7.75% clearance, respectively (p > 0.05). Participants achieved similar Global Aesthetic Improvement Scale scores (4.04 ± 0.31 vs. 4.02 ± 0.30, respectively [p > 0.05]). Additionally, the 730 nm picosecond laser was perceived to be less painful than the 755 nm picosecond laser (4.69 ± 1.63 vs. 5.65 ± 1.80 nm, p < 0.0001)., Conclusion: The 730 nm picosecond laser is safe and effective for the treatment of freckles in Asian patients. Besides, the 730 nm picosecond laser is less painful than the 755 nm picosecond laser., (© 2023 Wiley Periodicals LLC.)

Piebaldism is a rare autosomal dominant disorder of melanocyte development characterized by a congenital white forelock and multiple symmetrical stable hypopigmented or depigmented macules. We report a family with piebaldism affecting three successive generations and also review the literature.

Facial vitiligo is associated with considerable psychological impact. The management is challenging and requires multidisciplinary treatment. Adding fractional carbon dioxide (CO2) to the conventional treatment has been reported as an effective modality. This study aimed to evaluate the efficacy of combined fractional CO2 laser, targeted ultraviolet B (UVB) phototherapy, and topical steroid on facial vitiligo. A prospective, randomized, split face study was conducted on 14 patients with symmetrical non-segmental facial vitiligo. Ten sessions of fractional CO2 laser was performed on the lesions on one side of face with 2-week interval. Immediately after laser, the lesions on both side of face were treated with 10 sessions of 2-week interval targeted UVB phototherapy and twice daily application of topical 0.05 % clobetasol propionate cream. The patients were followed up for 12 weeks after the last treatment. Clinical improvement was graded by blinded dermatologists and patients using a quartile grading scale. Twelve out of 14 patients completed the study. The degree of improvement was not different between both sides in nine patients. One patient showed more improvement on the combined laser side, and two patients showed inferior results on the combined laser side. Two patients with lesser improvement on the laser-treated side had positive Koebner phenomenon on the non-facial area. The combined treatment with laser, targeted UVB, and topical steroids are not superior to targeted UVB and topical steroids in facial vitiligo. Furthermore, laser may retard the response to the standard treatment in patients with Koebner phenomenon on non-treated areas. [ABSTRACT FROM AUTHOR]

Background/Objectives: Cosmetic camouflage is known to improve quality of life in adults. Few data are available regarding cosmetic camouflage in children, and thus it is not often selected as a mode of treatment. We sought to determine whether cosmetic camouflage leads to improved quality of life of pediatric patients with visible dermatoses and their parent or primary caregiver. Methods: Patients aged 5 to 17 years with visible skin disease and their parent were assessed with the Children's Dermatology Life Quality Index (CDLQI) and the Family Dermatology Life Quality Index (FDLQI) before and after consultation regarding cosmetic camouflage. Results: Twenty-two children with skin conditions were included in the study. The mean CDLQI decreased from 6.82 (SD = 1.28) to 3.05 (SD = 0.65; P = .0014), while the mean FDLQI decreased from 7.68 (SD = 1. 15) to 4.68 (SD = 0.92; P = .0012). Conclusions: Our study highlighted improvement in quality of life in patients with skin disorders who were managed with cosmetic camouflage. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 14-year-old boy presented with multiple asymptomatic hypopigmentation on the trunk, neck, and upper limbs. His medical history indicated he did not have atopic dermatitis or any immunodeficiency. General physician mistakenly diagnosed him psoriasis. The histopathologic examination revealed hyperkeratosis, diagnosis of pityriasis versicolor was established, and the patient was given two doses of fluconazole and ketoconazole cream for treatment.

Competing Interests: DISCLOSURES.: The authors report no conflicts of interest relevant to the content of this article.

Background: The vitiligo of the penis and vulva is a difficult to treat region of the body where the existing surgical repigmentation methods usually do not give satisfactory results. Objective: This study was conducted to evaluate the efficacy of microskin grafting in stable genital vitiligo. Methods: Four male patients and 1 female patient were included in this study, and microskin grafting was performed in the stable vitiliginous areas of genitals under regional anaesthesia. Results: The microskin grafting technique has shown desired results at these sites with near total pigmentation and negligible donor area deformity. Conclusion: The microskin grafting for vitiligo is simple, reliable, and the most cost-effective technique of tissue grafting that has all the benefits of the latest cellular grafting techniques without its high cost and infrastructure. [ABSTRACT FROM AUTHOR]

Background: The management of dysplastic nevi is controversial. No studies have collected data regarding management of the lesion amongst Canadian dermatologists. Objective: To provide a comprehensive review of what the prevailing opinions are, regarding treatment and terminology of dysplastic nevi, amongst Canadian dermatologists. Methods: An online survey of 25 questions was e-mailed to 613 members of the Canadian Dermatology Association, in French and English. Results: A total of 179 responses were received. Varying numbers of participants completed each question. The majority of participants think that the term dysplastic nevus should not be abandoned, and they indicated that they never reexcise lesions with mild to moderate atypia even when the margins are positive. Conclusions: The majority of Canadian dermatologists retain the use of the term dysplastic nevus and do not reexcise lesions with mild to moderate atypia even when the margins are positive. [ABSTRACT FROM AUTHOR]

Background: Melanocyte-keratinocyte transplant procedure (MKTP) successfully repigments postburn leukodermic scars. Objective: To further investigate the efficacy and limitations of MKTP for treatment of mechanically and chemically induced leukodermic scars. Methods: Ten patients with mechanically or chemically induced, depigmented or hypopigmented scars were preoperatively evaluated with Wood's light examination, treated with MKTP, and followed for at least 6 months, with monitoring of repigmentation and colour matching. Results: Nine patients attended at least 6 months of follow-up. Six patients showed no fluorescence of scars under Wood's lamp. All patients whose lesions didn't fluoresce displayed less than 50% repigmentation, with 5 of 6 attaining 0% to 24%. Of the 3 patients displaying bright or some fluorescence, more than 95% repigmentation was achieved in 2 patients (skin phototypes V and VI), while less than 24% was attained for the third (skin phototype II). Conclusions: In this small case series, lack of fluorescence in leukodermic scars may be a useful negative prognostic indicator for MKTP, but additional trials are needed to verify that this is not due to melanocompetency. [ABSTRACT FROM AUTHOR]

Context: Onset of vitiligo during childhood is not uncommon but the data is limited on this subject. Aims: This study was planned to assess the magnitude of childhood onset vitiligo (COV) and adulthood onset vitiligo (AOV), and compare their clinical pattern. Settings and Design: A cross sectional hospital based clinical study. Materials and Methods: Consecutive patients with vitiligo attending the Dermatology OPD of RNT Medical College and MB Government Hospital, Udaipur, from April 2012 to September 2012 were the subjects of this study. A detailed history taking followed by general, systemic and cutaneous examination, and relevant investigations were carried out. The findings were recorded in a proforma for analysis and interpretation of data. Statistical analysis used: Statistical analysis of data was done using chi- square and Z test. Results: Of the 295 patients seen during the study period, 109 (36.95%) were patients with COV while 186 (63.05%) had AOV; the COV: AOV ratio being 1: 1.71. Amongst COV patients, females (65/109; 59.63%) outnumbered males (44/109; 40.37%). Maximum (51; 46.79%) patients of COV had onset of their disease on head and neck, out of which eyelid was the initial site of lesion in 29 (26.61%) patients. None of COV patients had universal and isolated mucosal vitiligo. Conclusions: Female predominance, affection of eyelids as initial site, and less frequent mucosal involvement in COV were the clinical features different from AOV. [ABSTRACT FROM AUTHOR]

Introduction Vitiligo is an acquired pigmentary disorder clinically manifested by circumscribed depigmented macules and often associated with leucotrichia. Not much is known about the biochemical abnormality occurring in vitiligo. Our study aims to determine whether serum homocysteine is raised in vitiligo patients and whether it can be used as a prognostic marker for vitiligo. Material and methods This study is a hospital-based, case-control, analytical study conducted on 70 patients of vitiligo patients. A total of 30 staff of the hospital served as control. Venous blood was withdrawn from the antecubital vein from all study participants using all aseptic precautions. Investigation of blood homocysteine levels was done in all the study participants. Scoring of vitiligo was done based on Vitiligo European Task Force (VETF) criteria which take into account body surface area, stage, and spread. Results Mean serum homocysteine level among vitiligo patients was 14.40± 5.80 micromoles/lit as compared to 10.33± 5.05 micromole/lit in control groups, and this difference was statistically significant (t-value = 3.19and p-value = 0.002). The correlation coefficient was statistically significant (correlation coefficient = 0.25 and p-value = 0.03) in between homocysteine level and stage of the disease. On multiple comparisons difference in serum homocysteine level of progressing category is significantly raised as compared to control, stable, and regressing categories. Conclusion The mean serum homocysteine level among all vitiligo patients was higher as compared to control groups. Moreover, the serum homocysteine level of active cases is significantly higher as compared to control, stable, and regressing categories. Also, serum homocysteine levels showed a positive correlation with the degree of depigmentation, i.e., stage of the disease., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Choudhary et al.)

A variety of topical depigmenting agents have been used clinically, with varying degrees of success. To date, the most effective topical treatment is a triple-combination agent containing hydroquinone (HQ), tretinoin, and fluocinolone acetonide. However, its use is associated with relatively high frequencies of adverse reactions, and therefore there is a necessity to produce effective topical depigmenting agents with fewer adverse effects. Several processes can be targeted for the treatment of hyperpigmentation; specifically, regulation of melanogenesis by inhibiting tyrosinase activity, a key enzyme in melanin synthesis, represents a major therapeutic target. Another option is regulation of melanosomes by manipulation of their formation or transfer. In addition, depigmenting agents can act through antioxidant or anti-inflammatory activities. We compared the tyrosinase inhibitory activity and cytotoxicity of HQ with those of other cosmetic ingredients. The results showed that although HQ was a strong tyrosinase inhibitor, it was cytotoxic at high concentrations. By contrast, 4- n -butylresorcinol effectively controlled tyrosinase activity without showing toxicity at high concentrations. These findings indicated that 4- n -butylresorcinol had the potential to act as an effective depigmenting agent, while producing less irritation than the currently available agents. [ABSTRACT FROM AUTHOR]