[Lentigines in different multiple organ defects syndromes]. / Wystepowanie plam soczewicowatych w róznych zespolach wielonarzadowych.

The aim of our study is to introduce a larger number of doctors to the subject of lentigines. They may be a first syndrome coexistent with very rare multiple organ defects as syndrome Peutz-Jeghers, LEOPARD, LAMB and Carney syndrome.

Efficacy and adverse effects of Q-switched ruby laser on solar lentigines: a prospective study of 91 patients with Fitzpatrick skin type II, III, and IV.

BACKGROUND: Laser-induced postinflammatory hyperpigmentation could be a limiting factor for selecting patients appropriate for the use of ruby laser in the treatment of lentigenes, especially in dark-skinned individuals. OBJECTIVE: To evaluate the efficacy and adverse effects of Q-switched ruby laser light (694 nm) on solar lentigines in patients with Fitzpatrick skin type II, III, and IV. METHODS AND MATERIALS: Controlled comparison study in a university-based laser clinic center. Ninety-one solar lentigines in patients with skin type II, III, and IV were enrolled. All patients were followed for 6 months for frequency of side effects. Before-and-after photographs and images from all follow-up sessions were taken and then assessed by a blinded dermatologist for the evaluation of side effects. RESULTS: Complete clearance was achieved in all patients. Postinflammatory dyspigmentation occurred in 7.8% patients with Fitzpatrick skin type II, 9.8% patients with type III, and 16.6 patients with type IV (p=.67); all improved over a 6-month follow-up period. CONCLUSION: Q-switched ruby laser treatment is a safe procedure for the treatment of solar lentigines even in dark-skinned individuals. Considering routine factors in addition to melanin content alone is required for minimizing side effects, especially postinflammatory hyperpigmentation in darker skin.

Solar lentigines are strongly related to sun exposure in contrast to ephelides.

Solar lentigines and ephelides are different types of pigmented skin lesions predominantly present on sun-exposed skin. Both lesions are risk indicators for melanoma and non-melanoma skin cancer. Solar lentigines are considered as a sign of photodamage although well-conducted epidemiological studies are lacking on this subject. Ephelides are associated with fair skin type and red hair. The aim of the present study was to investigate the relation of sun-exposure estimates with solar lentigines and ephelides. In the Leiden Skin cancer Study 577 patients with malignant melanoma and/or non-melanoma skin cancer and 385 individuals without a history of skin cancer were studied. The presence of solar lentigines and ephelides in the face and on the back was assessed. Data on skin type, hair color, sun-exposure variables and cutaneous signs of photodamage were collected, by questionnaire and physical examination. Data were analyzed by chi-square or Student t-tests and with multivariable regression. Exposure odds ratios with 95% confidence intervals (95% CI) were calculated to estimate the relative risk for the presence of solar lentigines and ephelides dependent on signs of photodamage. The association with age was strongly positive for solar lentigines whereas it was strongly negative for ephelides (P-values for trend <0.0001). After adjustment for age, sex and skin type, solar lentigines on the back were positively associated with cumulative (P = 0.01) and intermittent (P = 0.0002) sun exposure. After adjustment, solar lentigines on the back were also associated with a history of sunburns before the age of 20 yr (P = 0.0003) and the number of sunburns in childhood (P = 0.002). Solar lentigines in the face were significantly associated with cutaneous signs of photodamage, i.e. elastosis (odds ratio 2.4, 95% CI 1.7-3.3) and actinic keratosis (odds ratio 1.8, 95% CI 1.3-2.4) whereas ephelides were not. Ephelides in the face and on the back showed an inverse association with chronic sun exposure but after adjustment theses associations disappeared. Sunburns before the age of 20 appeared to be positively associated with ephelides on the back (P = 0.04). In contrast to lentigines, ephelides were much more associated with constitutional host factors such as fair skin and/or red hair (both P < 0.0001). This study indicates that both chronic and acute sun exposure are important in the pathogenesis of solar lentigines.

Ephelides are more related to pigmentary constitutional host factors than solar lentigines.

Ephelides and solar lentigines are benign pigmented spots, which are currently associated with an increased risk of skin cancer. These two pigmented spots are known to be discriminated by their clinical, histological, and electron microscopic characteristics, even though occasional misclassification can occur because of their similarity. It has also been questioned whether these spots are not one and the same. In this study, we have attempted to differentiate between these two pigmented spots with the use of a standardized protocol for clinical examinations on 272 healthy volunteers, paying particular consideration to their pigmentary and constitutional host factors. We found that solar lentigines 1) are more prevalent than ephelides, 2) increase in prevalence and number with higher age, and 3) are most prevalent on the trunk and occur more frequently in males than in females. A trend is also observed whereby ephelides 1) loose their prevalence with age, 2) become equally distributed on the face, arms, and trunk, and 3) occur more frequently in females. An intimate association of ephelides, but not solar lentigines, has been found with hair color and skin type. All of these findings are in agreement with most of those reported in the literature, supporting the view that ephelides and solar lentigines are different types of pigmented lesions.

Etiological differences between subtypes of cutaneous malignant melanoma: Western Canada Melanoma Study.

From newly incident cases in Western Canada, 415 patients with superficial spreading melanoma (SSM), 128 with nodular melanoma (NM), and 56 with lentigo maligna melanoma (LMM) were interviewed, with age- and sex-matched controls chosen from the general population. The associations of these 3 subtypes with pigmentation, skin reaction to sun, different types of sun exposure, sunburn, and suntan were assessed. Compared to the other types, LMM occurred in older patients, and 75% of lesions occurred on the head and neck: It was less strongly related to pigmentation factors, intermittent sun exposure, and skin reaction to sun. The associations of SSM and NM with pigmentation, chronic sun exposure, skin reaction, and suntan were very similar: Both were associated with intermittent sun exposure, but SSM was more strongly related to vacation exposures than was NM. These results were compared with those from a similar Australian study. While LMM appears different in its etiology from SSM and NM, there is no strong evidence of major etiological differences between SSM and NM.

Genetic approaches to the nosology of deafness.

Profound deafness of childhood is a heterogeneous entity. Perhaps 50% of cases owe their handicap to mendelian segregation of single genes. Various types of genetic methods, combined with clinical and statistical analyses, are described by means of which an initial approach can be made to the problem of the estimation of the number of different gene loci involved and of the prevalence of the various abnormal alleles, as well as of the definition of their modes of action.