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3.
MMW Fortschr Med ; 162(5): 32, 2020 03.
Artigo em Alemão | MEDLINE | ID: mdl-32189268
4.
An Bras Dermatol ; 95(2): 217-220, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32173139

RESUMO

Melanonychia is the change in the coloration of the nail plate resulting from the deposition of melanin. Among its causes are melanocytic hyperplasia, melanocytic activation and nail melanoma. Subungual follicular inclusions are histological findings of unknown etiology, possibly related to trauma. We present three cases of melanonychia of different etiologies with subungual follicular inclusions, an association that has not been well described and with an indefinite pathogenesis.


Assuntos
Folículo Piloso/patologia , Melanose/patologia , Doenças da Unha/patologia , Adulto , Dermoscopia , Folículo Piloso/diagnóstico por imagem , Humanos , Masculino , Melanose/diagnóstico por imagem , Pessoa de Meia-Idade , Doenças da Unha/diagnóstico por imagem , Unhas/patologia , Ultrassonografia
6.
J Dermatolog Treat ; 31(1): 77-83, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30702958

RESUMO

Background: Treatment of melasma is challenging because its pathogenesis is unclear and it is prone to recurrence. We performed a meta-analysis to evaluate the efficacy and safety of laser and laser compound therapy for melasma.Methods: We searched the Cochrane, Embase, and Medline databases for all relevant studies published from inception to July 2018. All randomized controlled trials of melasma describing treatment with lasers or laser compound therapy were included.Results: A total of 346 patients were enrolled in nine RCT studies. Laser therapy and laser compound therapy had better PGA (MD: 1.96 (95% CI: 0.17, 3.75); I2 = 0%) and mMASI scores (MD: -1.57 (95% CI: -3.08, -0.05); I2 = 19%) than drug and laser therapy, respectively. Four studies were assessed to be of low risk of bias. Subgroup analysis was consistent with the results of the meta-analysis, reflecting the reliability of our results.Linking evidence to action: The results of this meta-analysis provide evidence that laser and laser compound therapy can improve the area and severity of melasma. Further high-quality clinical studies should be carried out in the future to confirm this conclusion. Abbreviations: MASI: Melasma Area and Severity Index; mMASI: modified Melasma Area and Severity Index; PGA: patient global assessment; MI: melasma index.


Assuntos
Terapia a Laser , Melanose/radioterapia , Bases de Dados Factuais , Humanos , Terapia a Laser/efeitos adversos , Terapia com Luz de Baixa Intensidade , Melanose/patologia , Recidiva , Índice de Gravidade de Doença
7.
BMJ Case Rep ; 12(10)2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31666252

RESUMO

A 1-day-old child was brought to the clinic for evaluation of enlarged right eye (OD). On examination, OD showed buphthalmos with diffuse scleral melanocytosis, fleshy blackish-brown extrascleral mass with corneal extension, and secondary glaucoma. Anterior segment evaluation revealed darkly pigmented iris and fundus evaluation OD revealed a darkly pigmented choroidal lesion. The left eye was within normal limits. A clinical diagnosis of choroidal melanocytoma with ocular melanocytosis was made. Enucleation OD followed by orbital implant was performed. Histopathology showed features of diffuse ocular melanocytosis involving limbus, iris, ciliary body, choroid, sclera, optic nerve head, optic nerve sheath, along with choroidal melanocytoma with extrascleral tumour extension. We presume that choroidal melanocytoma may have arisen from ocular melanocytosis.


Assuntos
Neoplasias da Coroide/congênito , Hidroftalmia/diagnóstico , Melanoma/patologia , Melanose/complicações , Neoplasias da Coroide/diagnóstico por imagem , Neoplasias da Coroide/patologia , Neoplasias da Coroide/cirurgia , Diagnóstico Diferencial , Enucleação Ocular/métodos , Neoplasias Oculares/diagnóstico por imagem , Neoplasias Oculares/patologia , Fundo de Olho , Humanos , Hidroftalmia/etiologia , Lactente , Masculino , Melanose/patologia , Doenças da Esclera/patologia , Resultado do Tratamento
8.
Dermatol Online J ; 25(10)2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31735001

RESUMO

Melasma is an acquired hyperpigmentation disorder most commonly affecting females with darker skin types. It is triggered by several factors including sun exposure, genetic influences, and female sex hormones. The pathology of melasma extends beyond melanocytes and recent literature points to interactions between keratinocytes, mast cells, gene regulation abnormalities, neovascularization, and disruption of basement membrane. This complex pathogenesis makes melasma difficult to target and likely to recur post treatment. A better understanding of the latest pathological findings is key to developing novel and successful treatment options. This review aims to provide a summary of the more novel pathological findings and latest investigational therapies.


Assuntos
Fármacos Dermatológicos/uso terapêutico , Melanose , Administração Cutânea , Face/patologia , Feminino , Humanos , Queratinócitos/fisiologia , Mastócitos/fisiologia , Melanócitos/patologia , Melanose/etiologia , Melanose/patologia , Melanose/fisiopatologia , Melanose/terapia , Pele/patologia , Pele/fisiopatologia , Luz Solar/efeitos adversos , Protetores Solares/uso terapêutico
9.
J Drugs Dermatol ; 18(11): 1104-1107, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31741350

RESUMO

Introduction: Melasma is a common disorder where patients develop hyperpigmented macules and patches on the face and is thought to be the result of sun exposure and hormonal contributions, although the pathogenesis is not completely understood. Lasers have been used for melasma treatment with varying degrees of success. Objectives: The objective of this study was to examine the safety and efficacy of a novel picosecond laser for the treatment of melasma. Materials and Methods: Ten subjects received nine weekly laser treatments with a picosecond laser to a randomized half of their face. A lightening cream was applied to the entire face to serve as a control. The primary outcome measure was clinical efficacy measured by a patient-reported outcome survey, the Melasma Quality of Life (MELASQOL) questionnaire, and physician assessment with the Global Aesthetic Improvement Scale (GAIS). The secondary outcome measure was safety, which was assessed by monitoring for adverse events. Photos were taken before every treatment and at a 1-week follow-up. Results: Ninety percent of subjects rated their melasma as at least slightly better, and 90% percent of subjects would recommend this laser treatment to others with melasma. MELASQoL questionnaire scores improved by an average of 5.7 points after laser treatment. Assessments by two board-certified dermatologists using the GAIS revealed an overall improvement in 80% of patients on the laser treatment side versus 20% on the control side. Side effects, including erythema and discomfort, were minimal and transient post-treatment. Conclusions: This study suggests that picosecond laser treatments are a safe and efficacious way to treat melasma. J Drugs Dermatol. 2019;18(11):1104-1107.


Assuntos
Dermatoses Faciais/cirurgia , Lasers de Estado Sólido/uso terapêutico , Melanose/cirurgia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
10.
J Drugs Dermatol ; 18(11)2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31741361

RESUMO

Background: Melasma is an acquired skin disease characterized by symmetric hyperpigmentation on sun-exposed areas, particularly on the face. Recently, there has been tremendous scientific interest in novel, safe, and effective topical agents to manage melasma. Objective: To evaluate topical treatments for melasma and provide evidence-based recommendations for clinical use and further research. Methods: We performed a systematic review of randomized controlled trials (RCTs) on topical agents for the treatment of melasma on March 4th, 2019 using PRISMA guidelines. Clinical recommendations were based on the American College of Physicians guidelines. Results: After screening, we identified 35 original RCTs using azelaic acid, cysteamine, epidermal growth factor, hydroquinone (liposomal-delivered), lignin peroxidase, mulberry extract, niacinamide, Rumex occidentalis, triple combination therapy, tranexamic acid, 4-n-butylresorcinol, glycolic acid, kojic acid, aloe vera, ascorbic acid, dioic acid, ellagic acid and arbutin, flutamide, parsley, or zinc sulfate for melasma. Conclusions: Cysteamine, triple combination therapy, and tranexamic acid received strong clinical recommendations for the treatment of melasma. Cysteamine has excellent efficacy and is reported to have anti-cancer properties, but has not been directly compared with hydroquinone. Triple combination agents and tranexamic acid are effective, but carry theoretical risks for ochronosis and thrombosis, respectively. Natural compounds are associated with low risk for adverse events, but more research is needed to determine the efficacy, optimal formulation, and appropriate concentration of novel treatments. J Drugs Dermatol. 2019;18(11):1156-1171.


Assuntos
Fármacos Dermatológicos/uso terapêutico , Melanose/tratamento farmacológico , Administração Cutânea , Fármacos Dermatológicos/administração & dosagem , Humanos , Guias de Prática Clínica como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
Biol Lett ; 15(10): 20190582, 2019 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-31615373

RESUMO

The rise of dark (melanic) forms of many species of moth in heavily coal-polluted areas of nineteenth- and twentieth-century Britain, and their post-1970s fall, point to a common selective pressure (camouflage against bird predators) acting at the community level. The extent to which this convergent phenotypic response relied on similar genetic and developmental mechanisms is unknown. We examine this problem by testing the hypothesis that the locus controlling melanism in Phigalia pilosaria and Odontopera bidentata, two species of geometrid moth that showed strong associations between melanism and coal pollution, is the same as that controlling melanism in Biston betularia, previously identified as the gene cortex. Comparative linkage mapping using family material supports the hypothesis for both species, indicating a deeply conserved developmental mechanism for melanism involving cortex. However, in contrast to the strong selective sweep signature seen in British B. betularia, no significant association was detected between cortex-region markers and melanic morphs in wild-caught samples of P. pilosaria and O. bidentata, implying much older, or diverse, origins of melanic morph alleles in these latter species.


Assuntos
Melanose , Mariposas , Alelos , Animais , Mapeamento Cromossômico , Pigmentação
13.
Ultrastruct Pathol ; 43(4-5): 135-144, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31575311

RESUMO

Melasma represents the most obvious and disfiguring change of the face leading to psychological problems especially in females. Ablative lasers have also been used by many professionals to treat melasma, although there is few scientific data supporting this indication. The exact mechanism of action of ablative lasers in melasma is not yet clear enough. We aimed to evaluate the ultrastructural effect of fractional ablative CO2 (FrCo2) laser on facial melasma. Eleven melasma patients evaluated clinically by clinical modified area and severity index (MASI) score, treated by two sessions of fractional CO2 laser one month a part. Two punch biopsies of 2 mm diameter were obtained from all subjects one before and the other 3 months after treatment. All biopsies were analyzed by light and electron microscopy. Clinically, significant improvement of pigmentation and 48% reduction of (MASI) score were observed after two sessions of laser treatments. Light microscopic analysis of specimens revealed significant decrease in melanocyte count after treatment. Electron microscopic analysis of specimens after treatment revealed significant decrease in the number and size of melanocytes and significant decrease or complete absence of melanin granules in the surrounding keratinocytes compared to pre-treatment specimens. No scarring or post inflammatory hyper or hypopigmentation. We concluded that repeated application of Fractional CO2 laser on melasma skin may result in long lasting improvement due to its destructive effect on melanocytes.


Assuntos
Lasers de Gás , Melanose/cirurgia , Pele/ultraestrutura , Adulto , Feminino , Humanos , Masculino , Melanócitos/ultraestrutura , Pessoa de Meia-Idade , Resultado do Tratamento
14.
Zhongguo Zhen Jiu ; 39(9): 932-5, 2019 Sep 12.
Artigo em Chinês | MEDLINE | ID: mdl-31544379

RESUMO

OBJECTIVE: To explore the therapeutic effect and mechanism of acupoint catgut embedding for chloasma in premenopausal women with liver qi stagnation. METHODS: A total of 92 patients of chloasma in premenopausal women with liver qi stagnation were randomized into an observation group and a control group, 46 cases in each one.In the observation group, acupoint catgut embedding was applied at Ganshu (BL 18), Pishu (BL 20), Sanyinjiao (SP 6), also the surrounding acupuncture was performed at facial part, once a week. In the control group, vitamin C (200 mg per time, 3 times a day) and vitamin E (100 mg per time, once a day) were prescribed for oral administration. Both of the two groups were given treatment for 12 weeks. The score of chloasma area and severity index (MASI), the serum levels of follicular stimulating hormone (FSH), leuteinizing hormone (LH) and estradiol (E2) before and after treatment were observed in the two groups, and the clinical effect of the two groups were compared after 3 months of treatment. RESULTS: Finally, 44 cases in the observation group and 43 cases in the control group completed the study. The effective rate in the observation group was 88.6% (39/44), which was higher than 55.8% (24/43) in the control group (P<0.01). Compared before treatment, the MASI scores after treatment were reduced in the two groups (P<0.01, P<0.05), the MASI score in follow-up in the observation group was reduced as compared with after treatment (P<0.01), and the MASI scores after treatment and in follow-up in the observation group were lower than the control group (P<0.01). Compared before treatment, the levels of FSH and LH in follow-up were reduced (P<0.01), there was no significant difference between before treatment and in follow-up in the level of E2 in the observation group (P>0.05). There was no significant difference between before treatment and in follow-up in the levels of FSH, LH and E2 in the control group (P>0.05). In follow-up, the levels of FSH and LH in the observation group were lower than the control group (P<0.01, P<0.05), there was no significant difference in the level of E2 between the two groups (P>0.05). CONCLUSION: Acupoint catgut embedding can improve the clinical symptoms of chloasma in premenopausal women with liver qi stagnation, the mechanism may be related to regulate the serum level of sex hormone to reduce high sensitivity of melanocytes to estrogen.


Assuntos
Pontos de Acupuntura , Terapia por Acupuntura , Melanose , Qi , Categute , Feminino , Humanos , Fígado , Melanose/terapia
15.
J Drugs Dermatol ; 18(9): 918-923, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31524348

RESUMO

Background: Facial chemical peels are highly sought after by patients with photodamage, acne, and melasma. An advanced, physician-strength superficial peel, containing 3% retinol with other firming and volumizing ingredients was developed to exfoliate, improve the appearance of fine lines and wrinkles, and plump and firm skin, while promoting a bright, even complexion. Objective: A clinical study was conducted to evaluate the tolerability, safety, and efficacy of the 3% retinol peel with a supportive homecare regimen across a range of peel candidates, females aged 18-65 years, with photodamage, acne, hyperpigmentation or melasma, and skin of color, over a series of 2-4 peels. Method: The 3% retinol peel formulation was administered under physician direction in 6-week intervals. Subjects with photodamaged skin, acne, hyperpigmentation/melasma, or skin of color (Fitzpatrick skin types IV-VI) received 2-4 peels along with a supportive homecare regimen. Dermatologist grading, self-assessment, and digital photography documented tolerability and efficacy parameters. Results: 24 subjects participated in the study with a total of 78 peels administered (Photodamage group, n=14 [with an Acne subgroup, n=5]; Melasma group, n=5; Skin of Color, n=5). The 3% retinol peel along with the homecare regimen was well tolerated under physician direction in all skin types and conditions assessed. Obvious peeling was noticeable in many subjects 3 days post-peel and resolved by day 7. In the photodamaged group, dermatologist clinical grading of fine lines, wrinkles, pore size, laxity, mottled pigmentation, lack of clarity/radiance, and overall photodamage was significantly improved (P<0.05). Benefits were observed in all groups and supported by self-assessment. Digital photography demonstrated tolerability in the days immediately post-peel, along with benefits to photodamage. Conclusion: The 3% retinol superficial peel was well tolerated and an efficacious cosmetic treatment under physician supervision in subjects of all skin types to firm skin, improve fine lines and wrinkles, and promote a bright, even complexion. J Drugs Dermatol. 2019;18(9):918-923.


Assuntos
Acne Vulgar/tratamento farmacológico , Abrasão Química/métodos , Melanose/tratamento farmacológico , Envelhecimento da Pele/efeitos dos fármacos , Vitamina A/administração & dosagem , Administração Cutânea , Adolescente , Adulto , Idoso , Abrasão Química/efeitos adversos , Relação Dose-Resposta a Droga , Feminino , Humanos , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Autoadministração , Pele/efeitos dos fármacos , Pigmentação da Pele/efeitos dos fármacos , Resultado do Tratamento , Vitamina A/efeitos adversos , Adulto Jovem
16.
BMJ Case Rep ; 12(8)2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31473636

RESUMO

Diffuse melanosis cutis (DMC) is an extremely rare and late complication of metastatic melanoma (MM). It involves the progressive blue-grey discolouration of the skin and mucous membranes, occurring approximately 1 year after diagnosis of MM. The pathogenesis of DMC is unknown, although specific growth factors, such as alpha-melanocyte stimulating hormone, hepatocyte growth factor and endothelin-1, released by cancer cells, along with release of melanin precursors in the bloodstream and dermal MM micrometastases producing melanin have been attributed. Even with appropriate therapy, DMC seems to be a poor prognostic factor, with a mean survival time of 4-5 months. Here, we report a case of BRAF-mutated MM who presented with DMC. The patient underwent BRAF/MEK inhibition followed by anti-PDL1 therapy, yet passed away approximately 1 year after diagnosis.


Assuntos
Melanoma/complicações , Melanose/etiologia , Neoplasias Cutâneas/complicações , Evolução Fatal , Feminino , Humanos , Melanoma/patologia , Melanose/patologia , Pessoa de Meia-Idade , Pele/patologia , Neoplasias Cutâneas/patologia
18.
J Drugs Dermatol ; 18(8): 718-729, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31424704

RESUMO

Melasma and postinflammatory hyperpigmentation (PIH) are the most common forms of dyschromia in patients with skin of color. Both are associated with a high psychological burden of disease. To exacerbate this burden, the need for treatment is chronic, and the results are often suboptimal in the eyes of the patient. Successful treatment is therefore contingent upon a correct diagnosis, patient education, and a carefully considered therapeutic approach. The latter is often multimodal in its design, incorporating sun protection, topical and systemic medications, and in some cases, procedural intervention. Although topical hydroquinone is a mainstay of treatment for melasma and PIH, there are alternatives that have emerged as of late that have shown varying degrees of promise, both in terms of safety and efficacy. In this article, we review the epidemiological, clinical, and histologic features of melasma and postinflammatory hyperpigmentation, and discuss important considerations for both established and emerging treatments for these vexingly common and difficult to treat conditions.


Assuntos
Dermatite/complicações , Hiperpigmentação/terapia , Melanose/terapia , Administração Cutânea , Administração Oral , Abrasão Química , Fármacos Dermatológicos/administração & dosagem , Humanos , Hiperpigmentação/epidemiologia , Hiperpigmentação/etiologia , Terapia com Luz de Baixa Intensidade , Melaninas/metabolismo , Melanose/epidemiologia , Prevalência , Pele/metabolismo , Pele/patologia , Preparações Clareadoras de Pele/administração & dosagem , Pigmentação da Pele/efeitos dos fármacos , Pigmentação da Pele/efeitos da radiação , Luz Solar/efeitos adversos , Protetores Solares/administração & dosagem
20.
Ophthalmology ; 126(9): e67-e68, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31443794
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