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Surgical Treatment
Published in Vineet Relhan, Vijay Kumar Garg, Sneha Ghunawat, Khushbu Mahajan, Comprehensive Textbook on Vitiligo, 2020
Venkataram Mysore, Madhulika Mhatre, Revanta Saha
Vitiligo is a pigmentary disorder of the skin associated with considerable social stigma. Patients seek treatment for improving aesthetic appeal. Treatment aims at stabilization of pigmentation and repigmentation of involved areas. This leads to improvement in the cosmetic appearance and skin tolerance to sunburns [1]. There are a great number of treatments available for vitiligo. Surgery for vitiligo forms one of the cornerstones of treatment. The principle of surgery for vitiligo is to obtain cosmetically acceptable repigmentation of vitiliginous lesions. Patients with vitiligo suffer psychologically and are often desperate to seek relief due to the stigma attached to the disease. Hence, proper evaluation of not only the clinical but also the psychological aspects is required. Counseling of the patients with respect to the disease, treatments, and outcomes is vital in order for patients to have realistic expectations.
Actions of Dopamine on the Skin and the Skeleton
Published in Nira Ben-Jonathan, Dopamine, 2020
Disorders of pigmentation are diagnosed as skin that is discolored, blotchy, darker, or lighter than normal. These changes occur when the body either produces too little (hypopigmentation) or too much (hyperpigmentation) melanin. The disorders can be localized in restricted sites or can diffusely spread throughout the body. Some pigmentation disorders such as liver spots, are common, whereas others, such as albinism, are rare. In some disorders, the cause of dyspigmentation is readily identified as sun exposure, drug reactions, or inflammation. In other cases, the etiology is not as clear. Evidently, most disorders can be diagnosed by appearance.
Metals
Published in Frank A. Barile, Barile’s Clinical Toxicology, 2019
Anirudh J. Chintalapati, Frank A. Barile
Animal studies have shown that Se supplementation can counteract elevated blood Ag levels. Se complexes with Ag to form insoluble silver selenide, which renders the metal soluble and amenable to excretion. In patients with progressive skin pigmentation, the use of sunscreen and other topical protectants helps reduce further pigmentation of the underlying skin.
Skin pigmentation improvement with resveratrol microemulsion gel using polyoxyethylene hydrogenated castor oil
Published in Drug Development and Industrial Pharmacy, 2023
Lu Cao, Xiaoyan Li, Jing Zhao, Qing Du, Jiening Dun
Changes in skin pigmentation are often recognized as indicators of skin exposure to damaging agents, such as those caused by air and other pollution or radiation from electronic and electrical equipment [1]. Some previous studies suggested that the increase in skin pigment is related to the increase of epidermal cytochrome caused by pigment incontinence, the increase of melanin and melanocyte levels in the basal cell layer, and the increase of melanin particles and melanophages in the superficial layer of the dermis [2]. Melanin, which is produced in epidermal melanocytes, is a light-absorbing polymer produced by oxidation catalyzed by tyrosinase. Its production process is influenced by various signaling pathways. In addition, melanin is important in protecting skin from ultraviolet (UV) radiation damage [3]. However, abnormal melanin production can lead to many skin diseases, such as melasma and freckles, caused by melanoma and pigmentation disorders [4,5]. Thus, it is of great clinical value to study and develop drugs that can inhibit the formation of melanin in treating abnormal pigmentation.
A prospective, split-face study comparing 1,064-nm picosecond Nd:YAG laser toning with 1,064-nm Q-switched Nd:YAG laser toning in the treatment of melasma
Published in Journal of Dermatological Treatment, 2022
Jun Ki Hong, Sun Hye Shin, Su Jung Park, Seong Jun Seo, Kui Young Park
Melasma is an acquired skin melanosis and one of the most common facial pigmentation disorders. Three types of melasma exist based on the location of the pigmentation: epidermal, dermal, and mixed. Genetic background, chronic exposure to ultraviolet (UV) radiation, and hormonal factors have been proposed as the main causes of melasma, as they stimulate the abnormal activation of melanogenesis (1,2). A complex pathogenesis with multiple factors makes the treatment of melasma more challenging. Topical agents, such as hydroquinone, retinoic acid, alpha-arbutin, and glycolic acid, have been widely used to exert anti-melanogenic effects (3). However, the outcomes are marginal; local irritation, unwanted hyperpigmentation, and high relapse rates are common. Laser- and light-based devices have been considered as adjuvant treatment options for patients with moderate-to-severe melasma in combination with other modalities, including photoprotection, topical bleaching agents, chemical peels, and systemic therapies; however, they only result in partial improvement, and high rates of recurrence and complications have been reported. In particular, non-ablative fractional laser shows a high likelihood of postinflammatory hyperpigmentation in Asian patients (Fitzpatrick skin type III–IV) (3–5).
Striae gravidarum and different modalities of therapy: a review and update
Published in Journal of Dermatological Treatment, 2022
Yangyiyi Yu, Haijing Wu, Heng Yin, Qianjin Lu
Compared with other lasers, an excimer laser is particularly effective in increasing the pigmentation of SA scars (54). Improved pigmentation with obvious esthetic significance with repetitive sessions was found following the use of an excimer laser (34). Notably, 31% of patients showed increased pigmentation in the normal surrounding skin. Furthermore, the authors hypothesized that the improvements in pigmentation were likely to be transient, though this study did not perform patient follow-up. In a further comparative study, the histologic and ultrastructural changes were analyzed after UVB light or excimer laser treatment. They found an increase in melanin and hypertrophy of melanocytes without any improvement in dermal atrophic scarring (35). Increased pigmentation was shown weakly in a study conducted by Ostovari et al., with pigment diffusion to the surrounding normal skin as a major adverse reaction (36). Moreover, all these changes were not long-lasting, so multiple maintenance treatments are needed (34–36,55).