Bilateral naevus of Ota: a rare manifestation in a Caucasian

The naevus of Ota (naevus fusculocoeruleus ophthalmomaxillaris) was first described by the Japanese dermatologist M. T. Ota in 1939. It has a reported incidence of 0.2% to 1% in the Japanese population. It usually occurs in the skin innervated by the first or second branch of the trigeminal nerve. The naevus comprises dermal melanocytes and is congenital or acquired during adolescence. Commonly associated lesions include scleral melanocytosis and other ocular manifestations as well as lesions of the tympanic membrane, oral and intranasal mucosa and leptomeninges. Diseases associated with Ota's naevus in rare cases are open-angle glaucomas and melanoma. The naevus of Ota in Europeans is a rare manifestation. We report the very rare case of a bilateral naevus of Ota associated with enoral melanocytosis in a white European person.     

Parkinsonism associated with Addison's disease.

We describe a 35-year-old woman who developed parkinsonism in association with Addison's disease. The parkinsonism disappeared following treatment for Addison's disease without the use of antiparkinsonian drugs. This association stands unique although the pathophysiology remains unclear.     

Minocycline Hydrochloride Hyperpigmentation Complicating Treatment of Pyoderma Gangrenosum

Minocycline-associated hyperpigmentation is an uncommon side effect We report the case of a patient with pyoderma gangrenosum successfully treated with oral minocycline but complicated by marked hyperpigmentation in his pyoderma gangrenosum and acne scars. One of the clinical forms of minocycline hyperpigmentation includes dark-blue or black macules in depressed acne scars or other sites of skin inflammation; this pattern seems to be independent of the total cumulative dose and the skin process.     

Skin hyperpigmentation treatment using herbs: A review of clinical evidences

Hyperpigmentation of skin is caused by several factors. UV exposure, in addition to oxidative stress, elevates inflammatory mediators stimulating melanogenesis. Herbal-derived compounds for improving skin lightness are gaining interest as they are perceived to be milder, safer, and healthier than fully synthetic products. This review briefly addresses the causes of skin hyperpigmentation and extensively summarizes the status of herbs currently used in skin-lightening cosmetics. The properties of active compounds and their dose rate information are summarized where available, along with human or animal relevant models for activity testing. This review will be of value to cosmetic formulators and dermatologists who are searching for naturally derived ingredients for improving skin lightness, in line with consumer preference and expectations.     

Retreatment using a dual mode of low-fluence Q-switched and long-pulse Nd:YAG laser in patients with melasma aggravation after previous therapy

Background: Aggravated melasma after treatment is vulnerable to stimulation, can easily deteriorate, and may be distressing without proper management. Objective: To retrospectively assess the effectiveness and safety of combination therapy using low-fluence Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser (QSNY) and long-pulse Nd:YAG laser (LPNY) (dual toning) in patients with rebound melasma. Materials and methods: A total of 30 patients with aggravated melasma after previous therapy who were treated with dual toning were enrolled. A total of 10 sessions were conducted at 1-week intervals, followed by maintenance treatment. The results were evaluated using the modified Melasma Area and Severity Index (mMASI) and the physician's global assessment (PGA) before and 2 months after completing the 10 treatment sessions. Results: The baseline mMASI was 10.48 ± 3.64, which significantly decreased to 3.22 ± 1.45 2 months after completing the 10 treatment sessions (p < 0.001). Twenty-four patients (80%) had PGA grade 4 (76–100% improvement) and 6 patients (20%) had PGA grade 3 (51–75% improvement). Conclusion: Dual toning may be a safe and effective salvage treatment for patients with aggravated melasma after previous treatment. LPNY may stabilize melasma activity to prevent rebound hyperpigmentation via dermal remodeling.     

The Use of Cellulose Nanocrystals for Potential Application in Topical Delivery of Hydroquinone

Nanotechnology‐based drug delivery systems can enhance drug permeation through the skin and improve the drug stability. The biodegradability and biocompatibility of cellulose nanocrystals have made these nanoparticles good candidates to use in biomedical applications. The hyperpigmentation is a common skin disorder that could be caused by number of reasons such as sun exposure and pregnancy. Hydroquinone could inhibit the production of melanin and eliminate the discolorations of skin. This study is aimed at introducing cellulose nanocrystals as suitable carriers for drug delivery to skin. Prepared cellulose nanocrystals were characterized by dynamic light scattering and atomic force microscopy. The size of cellulose nanocrystals determined using dynamic light scattering was 301 ± 10 nm. Hydroquinone–cellulose nanocrystal complex was prepared by incubating of hydroquinone solution in cellulose nanocrystals suspension. The size of hydroquinone–cellulose nanocrystal complex determined using dynamic light scattering was 310 ± 10 nm. The hydroquinone content of the hydroquinone–cellulose complex was determined using UV/vis spectroscopy. Hydroquinone was bound to cellulose nanocrystals representing 79.3 ± 2% maximum binding efficiency when 1.1 mg hydroquinone was added to 1 mL of cellulose nanocrystals suspension (2 mg cellulose nanocrystal). The hydroquinone–cellulose nanocrystal complex showed an approximately sustained release profile of hydroquinone. Approximately, 80% of bound hydroquinone released in 4 h.     

强脉冲光联合左旋维生素C导入治疗痤疮后色素沉着疗效观察

目的:观察强脉冲光联合左旋维生素C导入治疗面部痤疮后遗留色素沉着的疗效。方法:将112例患者随机分为联合治疗组36例,强脉冲光组37例,左旋维生素C导入组39例,三组患者均治疗4个月。结果:联合治疗组有效率86.1%,强脉冲光组有效率59.4%,左旋维生素C导入组有效率53.8%。联合组疗效与其他两组疗效比较,差异分别有统计学意义(P0.05)。结论:强脉冲光联合左旋维生素C导入治疗面部痤疮后遗留色素沉着,疗效明确,不良反应发生率低,痛苦小,安全、有效,值得临床推广应用。     

Management of periorbital hyperpigmentation: An overview of nature‐based agents and alternative approaches

Periorbital hyperpigmentation (POH) is a common dermatological condition that presents as dark periorbital area beneath the lower eyelids, and it is commonly found in females belonging to the age group of 16 to 45 years. The data presented in this review include studies conducted on patients with a clinical/histological diagnosis of POH or melasma. Many diverse topical depigmenting agents comprising an array of naturally obtained actives such as arabinoxylans, α‐arbutin, asiaticoside, azelaic acid, beta‐carotene, boswellic acid, caffeine, chrysin, curcumin, cyanidin‐3‐glucoside, d ‐glucoronic acid, dihydrochalcone, dipalmitoyl‐hydroxyprolene, fucoxanthin, genistein, glabridin, b‐glucogallin, hyaluronic acid, lactic acid, lycopene, niacinamide, pycnogenol, retinol, salidroside, and xymenynic acid demonstrated significant benefits in the management of POH. An exhaustive literature search revealed that other techniques such as blepharoplasty, carboxytherapy, calcium hydroxylapatite fillers, tear trough implant, Q‐switched ruby laser, medicated tattoo, fat transfer, micro‐needling, chemical peels, nitrogen plasma skin regeneration, intense pulsed light, and radiofrequency have been evaluated and reported to be beneficial in the treatment of POH. The use of topical depigmenting agents is the most widely reported method in the clinical management of POH. Of these, α‐arbutin, caffeine, cyanidin‐3‐glucoside, and dihydrochalcone are reported to exhibit significant benefits. Combination products containing a blend of actives are reported to be better than single active containing products. This review aims to provide a comprehensive perspective on the role of several topical actives in the modulation of melanin and tyrosinase biosynthesis pathway involved in the complex pathophysiology of POH. It also presents the advantages of combination products and other alternative therapies used in the management of POH.