Acne in ethnic skin

Acne is the most common disorder observed in ethnic skin. Clinical presentation is different than in white skin. Postinflammatory hyperpigmentation is a common sequelae of acne in darker skin. The management of acne in ethnic skin is based largely on the prevention and treatment of hyperpigmentation.     

Dermoscopy of pigmented skin lesions

Dermoscopy is an in vivo method for the early diagnosis of malignant melanoma and the differential diagnosis of pigmented lesions of the skin. It has been shown to increase diagnostic accuracy over clinical visual inspection in the hands of experienced physicians. This article is a review of the principles of dermoscopy as well as recent technological developments.     

Dermoscopy of pigmented skin lesions

This paper describes the basic concepts of dermoscopy, the various dermoscopic equipments and the standard criteria for diagnosing pigmented skin lesions. In assessing dermoscopic images, both global and local features can be recognized. These features will be systematically described and illustrated in Part I of this article. First, we will focus on 8 morphologically rather distinctive global features that allow a quick, preliminary categorization of a given pigmented skin lesion. Second, we will describe various local features representing the letters of the dermoscopic alphabet. The local features permit a more detailed assessment of pigmented skin lesions.     

Acne scarring treatment using skin needling

Background. Acne is a common condition seen in up to 80% of people between 11 and 30 years of age and in up to 5% of older adults. In some patients, it can result in permanent scars that are surprisingly difficult to treat. A relatively new treatment, termed skin needling (needle dermabrasion), seems to be appropriate for the treatment of rolling scars in acne. Aim. To confirm the usefulness of skin needling in acne scarring treatment. Methods. The present study was conducted from September 2007 to March 2008 at the Department of Systemic Pathology, University of Naples Federico II and the UOC Dermatology Unit, University of Rome La Sapienza. In total, 32 patients (20 female, 12 male patients; age range 17–45) with acne rolling scars were enrolled. Each patient was treated with a specific tool in two sessions. Using digital cameras, photos of all patients were taken to evaluate scar depth and, in five patients, silicone rubber was used to make a microrelief impression of the scars. The photographic data were analysed by using the sign test statistic (α < 0.05) and the data from the cutaneous casts were analysed by fast Fourier transformation (FFT). Results. Analysis of the patient photographs, supported by the sign test and of the degree of irregularity of the surface microrelief, supported by FFT, showed that, after only two sessions, the severity grade of rolling scars in all patients was greatly reduced and there was an overall aesthetic improvement. No patient showed any visible signs of the procedure or hyperpigmentation. Conclusion. The present study confirms that skin needling has an immediate effect in improving acne rolling scars and has advantages over other procedures.     

Papillary pigmented dystrophy of the skin

A clinical case with a rare dermatosis of children, papillary pigmented dystrophy of the skin, is reported. Clinical and morphological picture of the disease is fairly typical and is not difficult to diagnose; however since the condition is very rare, it is often misdiagnosed. This dermatosis runs a benign course in children, but the patients should be followed up on an outpatient basis.     

Dispelling myths concerning pigmented skin lesions

The history of medicine is replete with examples of debunked myths, and in daily clinical dermatological practice, we must still counter many misconceptions regarding pigmented lesions, both with patients and other medical practitioners. Debunking myths and attempting to explain the reasons for these erroneous beliefs are the purposes of this review. The literature review has been partially guided by the results obtained from an online questionnaire conducted on an Italian website ( www.vediamocichiara.it ) from February 15, 2015 to March 15, 2015. The remaining discussed were selected on the basis of the existing literature and our personal experience. In order to explore these misconceptions, the following are the seven most salient questions that require investigation: (i) Is it dangerous to excise moles?; (ii) Is it dangerous to traumatize moles?; (iii) Are plantar moles worrisome?; (iv) Is it necessary to selectively apply sunscreen to moles?; (v) Is it inadvisable to partially biopsy a melanoma?; (vi) Do moles turn into melanoma?; and (vii) Is it necessary to perform sentinel lymph node biopsy for thin melanomas and for atypical Spitz naevi? Myths are ubiquitous, being prevalent in dermatological practice, with many of them concerning pigmented skin lesions. By encouraging critical analysis by patients and medical practitioners, the birth and perpetuation of myths can potentially be minimized, for the ultimate benefit of patients. This requires a scientific approach to be rigorously applied to dermatology, with critical questioning of unsubstantiated hypotheses including those emanating from the mass media as well as from respected sources.     

Surface microscopy of pigmented skin tumours

In vivo cutaneous surface microscopy, epiluminescence microscopy, dermatoscopy and dermoscopy are terms that all describe the same process of examination of cutaneous lesions with an incident light magnification system with oil at the skin-microscope interface. Increased investigation in surface microscopy has occurred in the last decade, primarily because of the introduction of inexpensive hand-held instruments. Research has focused particularly on morphological definitions, diagnostic models and image analysis systems. In this paper, these issues are discussed, and the relevant controversies highlighted.     

In vivo epiluminescence microscopy of pigmented skin lesions. I. Pattern analysis of pigmented skin lesions

The importance of recognizing early melanoma is generally accepted. Because not all pigmented skin lesions can be diagnosed correctly by their clinical appearance, additional criteria are required for the clinical diagnosis of such lesions. In vivo epiluminescence microscopy provides for a more detailed inspection of the surface of pigmented skin lesions, and, by using the oil immersion technic, which renders the epidermis translucent, opens a new dimension of skin morphology by including the dermoepidermal junction into the macroscopic evaluation of a lesion. In an epiluminescence microscopy study of more than 3000 pigmented skin lesions we have defined morphologic criteria that are not readily apparent to the naked eye but that are detected easily by epiluminescence microscopy and represent relatively reliable markers of benign and malignant pigmented skin lesions. These features include specific patterns, colors, and intensities of pigmentation, as well as the configuration, regularity, and other characteristics of both the margin and the surface of pigmented skin lesions. Pattern analysis of these features permits a distinction between different types of pigmented skin lesions and, in particular, between benign and malignant growth patterns. Epiluminescence microscopy is thus a valuable addition to the diagnostic armamentarium of pigmented skin lesions at a clinical level.     

窄波UVB诱导正常皮肤色素斑的研究

目的 观测窄波UVB诱导正常人腹部皮肤色素沉着斑的颜色变化指标。方法 采用窄波UVB治疗仪，以1.5倍的最小红斑量照射30例志愿者的腹部皮肤，形成人工色素沉着斑。在照射前、照射后1，2，4，6，8周，分别用 CM-2600d分光光度计测量局部皮肤的L*、a*、b*、△L、△a、△b、 △E值，以SIAscopy仪检测色素斑处血红蛋白、胶原蛋白、黑素总量，并捕获相应图像。同时，用数码相机拍摄志愿者腹部照片。结果 照射后局部皮肤呈淡灰色，4 h后出现局部潮红，1周后色素沉着最明显，2例受试者照射部位出现细小脱屑，所有受试者均无水疱发生。CM-2600d分光光度计测量照射部皮肤，结果显示，照射后1周，L*下降到最低，a*值升至最高，b*变化不明显。1周后L*值开始升高，而a*值下降，直到照射后8周，各自接近照射前水平。SIAscopy仪检测提示，照射后1周，皮肤血红蛋白增加最明显，以后迅速下降，低于照射前水平。而总黑素含量和胶原蛋白照射后持续缓慢增加，第6周达最高。结论 窄波UVB可诱导正常皮肤色素斑形成，通过观察皮肤色素的变化规律，客观地评估美白产品的功效。     

Acne vulgaris: more than skin deep

Acne vulgaris is a common skin disorder affecting at least 85 percent of adolescents and young adults. This disorder is often dismissed by the medical community and general population as a superficial affliction associated with growing up, however scientific evidence has illustrated that the effects of this condition are far more than skin deep. This brief review of relevant scientific literature discusses the potential effect of acne beyond its dermatological manifestations. These include effects on psychiatric health, psychological well-being, and quality of life.     

Laypersons' perceptual discrimination of pigmented skin lesions

BACKGROUND: Most cutaneous malignant melanomas of the skin are visible and should, at least in theory, be possible to detect with the naked eye. OBJECTIVE: This study was conducted to learn more about laypersons' ability to discriminate between benign pigmented lesions and malignant ones. METHODS: Four groups of laypersons (n = 120) were asked to evaluate pictures of different types of pigmented skin lesions, before and after they received information about the ABCD (asymmetry, border irregularity, color variegation, and diameter greater than 6 mm) criteria, with respect to the necessity of action. RESULTS: The respondents made adequate assessments of melanomas but overestimated the danger of benign pigmented skin lesions. Information about the ABCD criteria enhanced their ability to make adequate assessments. CONCLUSION: People seem to make adequate decisions concerning how to act if they have a melanoma. On the other hand, common moles and dysplastic nevi were harder to discriminate. Providing information to the public about the features of melanomas, in accordance with the ABCD criteria, might help laypersons in their perceptual discrimination of skin lesions.     

Principles of dermatoscopy of pigmented skin lesions

There has been a dramatic increase in the incidence of malignant melanoma in most parts of the world. Because the tumor thickness is the most important prognostic factor for the prognosis of the malignant melanoma, the early detection of thin melanomas is essential. Dermatoscopy allows the physician to discriminate between melanocytic and nonmelanocytic lesions with high diagnostic accuracy and to detect initial malignant melanomas. We review the principles of dermatoscopy and the differential diagnosis of pigmented skin lesions. Before using the ABCD rule of dermatoscopy to classify melanocytic lesions into benign, suspicious, or malignant, the distinction between melanocytic and nonmelanocytic lesions is necessary. An essential prerequisite for the usefulness of this technique is adequate training.