Revista de Dermatologia e Doenças Dermatológicas

https://www.omicsonline.org/pigmentary-disorders-open-access-abstract.php

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Idiopathic guttate hypomelanosis (IGH) is a very common, acquired, and frequently ignored condition characterized by an appearance of multiple, well-circumscribed, asymptomatic, polygonal, white macules symmetrically distributed on the extensor forearms and shins. Once present, skin lesions do not increase in size with time and do not coalesce. IGH occurs in all races and skin types, especially in elderly patients over the age of 70 years. IGH appears to result from an impaired synthesis of melanin, decreased size and poor melanization of melanosomes and inadequate transfer of melanosomes from melanocytes to surrounding keratinocytes. The diagnosis of IGH is usually made clinically. Despite straightforward clinical appearance of IGH in majority of cases, several additional diagnostic procedures may be needed for confirmation of diagnosis in some less clear cases.

Reports of halo nevus in medium-sized CMN are limited in the literature and its association with vitiligo is not very common. We present three healthy children with medium-sized CMN. There was no family history of vitiligo, other autoimmune disorders or melanoma. After years of follow up, the patients developed an achromic regular halo around the congenital nevus and one of them showed others halo nevi. Following these changes, achromic macules appeared and vitiligo was diagnosed. At follow-up, we observed reduction in size of the CMN and no thought-provoking malignant changes. Conclusion: We support that in halo medium sized CMN, like in other congenital nevi with unusual features, continuous observation should be recommended. Furthermore, parents should be informed about the long period of time required for complete resolution and the low possibility of malignant change in the nevus. Pediatricians should be familiar with this no life-threatening association.

Vitiligo is an acquired pigment disorder. It occurs worldwide, with a prevalence of 0.5% to 2%. Vitiligo had profound impact on patients’ quality of life. In China, vitiligo is quite common. Some epidemiological studies have been conducted and reported prevalence of vitiligo was 0.1% to 0.56%. The most common clinical type was non segmental vitiligo. The pathogenesis of vitiligo is still not fully understood and there is a plethora of different treatments. In China, various treatments for vitiligo are available including topical treatment, UV irradiation and surgical treatment. Chinese Working Group for Vitiligo has made a guideline for treatment of vitiligo which helps Chinese dermatologists to use proper treatment and achieve good effects.

Hypochromia secondary to the use of CO2 fractional laser, although common, is seldom reported in the medical literature, as well as how to proceed in such cases. We report a patient who was submitted to the procedure for treatment of diffuse atrophic striae in the lower limbs. She noted new lesions more evident than the original, as soon as the post-procedure crusts came off. She was treated with a progressive improvement after 3 months with oral therapy of Brosimum gaudichaudii Trécul, topical psoralen, and a not frequent sun exposure (UVA).

Hyperpigmentation occurs when there is an increase in melanin content in the skin. It can be localised i.e. limited to a certain area or it can be diffuse i.e. occurring all over the body. Localised form of hyperpigmentation can happen as a result of injury or inflammation from conditions such as Acne, contact dermatitis, lupus etc known as post inflammatory hyperpigmentation or Melasma. Diffuse generally results from a systemic disease, drug or neoplasm. Localised hyperpigmentation like PIH and melasma can lead to a lot of psychological distress with skin type IV and above being particularly susceptible. It is not only important to find the cause of pigmentation in order to arrest further progression but it is also important to treat the pigmented lesions. Further prevention should advocate the use of daily sun protection with sunscreen agents and other sun avoidance measures.

Vitiligo is a depigmentation disorder of the skin with profound physical and psychological effects. Several techniques have been developed over the years to treat this disorder, including combinations of topical treatments, oral medications, light therapies, and laser treatments. The current mainstay for treatment is narrow-band ultra-violet B (NB-UVB), topical calcineurin inhibitors, and topical corticosteroids. Still, many patients today continue to suffer from the effects of this disorder. This paper aims to present new, promising treatments for vitiligo that has been presented in the literature of late.

Background and Objective: The aim of this study was to compare the effectiveness of two non-ablative techniques for facial rejuvenation in Latin-American skin types.

Materials and Methods: 36 consecutive patients with moderate-to-advanced photoaging were treated with IPL or a combination of IPL/Nd YAG laser. Clinical improvements were assessed at baseline and 30 days after two treatments. The results were compared with a non- parametric statistical test. Side effects were reported.

Results: 18 patients received treatment with IPL and 18 patients with combination IPL/NdYAG laser. Significant differences between baseline and 30 days post- treatments were observed for all features. Outcomes achieved with IPL/NdYAG were significantly higher. Side effects were limited to mild transitory erythema.

Conclusions: Non-ablative techniques with IPL or combination IPL/NdYAG laser long pulse for facial rejuvenation are safe and effective treatments in Latin- American skin types with almost no side effects. Outcomes achieved with IPL/NdYAG laser were higher than using IPL alone in this study.