Postinflammatory Hyperpigmentation

Epidermal growth factor inhibitors (EGFRI), the first targeted cancer therapy, are currently an essential treatment for many advance-stage epithelial cancers. These agents have the superior ability to target cancers cells and better safety profile compared to conventional chemotherapies. However, cutaneous adverse events are common due to the interference of epidermal growth factor receptor (EGFR) signaling in the skin. Cutaneous toxicities lead to poor compliance, drug cessation, and psychosocial discomfort. This paper summarizes the current knowledge concerning the presentation and management of skin toxicity from EGFRI. The common dermatologic adverse events are papulopustules and xerosis. Less common findings are paronychia, regulatory abnormalities of hair growth, maculopapular rash, mucositis, and postinflammatory hyperpigmentation. Radiation enhances EGFRI rash due to synergistic toxicity. There is a positive correlation between the occurrence and severity of cutaneous adverse effects and tumor response. To date, prophylactic systemic tetracycline and tetracycline class antibiotics have proven to be the most effective treatment regime.

Download Full-text

The Clinical Effectiveness of Intralesional Injection of 2% Zinc Sulfate Solution in the Treatment of Common Warts

Scientifica ◽

10.1155/2016/1082979 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4

Author(s):

Essam-elden Mohamed Mohamed ◽

Khaled Mohamed Tawfik ◽

Asmaa Moneir Mahmoud

Keyword(s):

Zinc Sulfate ◽

Randomized Study ◽

Clinical Effectiveness ◽

Sulfate Solution ◽

Late Complications ◽

Intralesional Injection ◽

Significant Relation ◽

Zinc Sulfate Solution ◽

Common Warts ◽

Postinflammatory Hyperpigmentation

Objective.To investigate the clinical efficacy and safety of intralesional injection of 2% zinc sulfate solution in the treatment of common warts.Patients and Methods.One hundred and twenty patients (78 females and 42 males) aged 5–55 years with 225 common warts participated in this prospective monocentric randomized study. All lesions were treated with intralesional injection of 2% zinc sulfate.Results.From 225 warts injected, 135 warts (60%) cured from the first session, 51 warts (22.67%) cured from the second session, and 12 warts (5.33%) cured from the third session. There is no significant relation between improvement and patient’s ages, duration, or number of warts (P<0.05). All patients complained from pain during injection, and all treated lesions showed redness, tenderness, and swelling in the first 3 days after injection. Late complications were postinflammatory hyperpigmentation in 90 patients (75%), scaring in 9 patients (7.5%), and ulceration in 3 patients (2.5%). Recurrence occurred in 3 lesions (1.33%).Conclusion.The clinical data indicate that intralesional injection of 2% zinc sulfate is an effective maneuver in the treatment of common warts; however, its associated complications limit its use.

Download Full-text

Case studies of combination treatment with a solution of mequinol 2%/tretinoin 0.01% with chemical peels for mild-to-moderate postinflammatory hyperpigmentation

Journal of the American Academy of Dermatology ◽

10.1016/j.jaad.2006.10.792 ◽

2007 ◽

Vol 56 (2) ◽

pp. AB173

Keyword(s):

Case Studies ◽

Combination Treatment ◽

Chemical Peels ◽

Postinflammatory Hyperpigmentation

Download Full-text

A Case of Facial Partial Unilateral Lentiginosis Treated with Low-Fluence 1,064 nm Q-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser

Case Reports in Dermatology ◽

10.1159/000477376 ◽

2017 ◽

Vol 9 (2) ◽

pp. 30-34 ◽

Cited By ~ 1

Author(s):

En Hyung Kim

Keyword(s):

Nd:Yag Laser ◽

Standard Treatment ◽

Yttrium Aluminum Garnet ◽

Normal Skin ◽

Patient Response ◽

Yttrium Aluminum Garnet Laser ◽

Selective Photothermolysis ◽

Yttrium Aluminum ◽

Postinflammatory Hyperpigmentation ◽

Good Cosmetic

Partial unilateral lentiginosis (PUL) is an unusual pigmentary disorder characterized by numerous lentigines grouped within an area of normal skin. Although treatment is not necessary, many patients with facial PUL seek medical help for cosmetic reasons. There is no established standard treatment for PUL. Conventional lasers may cause postinflammatory hyperpigmentation because keratinocytes are injured during the process. Also, scarring, long downtime, and pain are important issues. A 19-year-old patient with facial PUL was successfully treated with low-fluence 1,064-nm Q-switched neodymium-doped yttrium aluminum garnet (QS Nd:YAG) laser. Although the exact mechanism by which low-fluence 1,064-nm QS Nd:YAG laser improves pigmentary lesions is unclear, the terms “subcellular selective photothermolysis” and “melanocyte apoptosis and replacement” have been proposed. If appropriate measures are taken to monitor patient response during and after the procedure, low-fluence 1,064-nm QS Nd:YAG laser may achieve good cosmetic results in the treatment of PUL with a very safe and effective profile.

Download Full-text

Prurigo Pigmentosa: A Clinicopathological Report of Three Middle Eastern Patients

Case Reports in Dermatological Medicine ◽

10.1155/2018/9406797 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6

Author(s):

N. Almaani ◽

A. H. Al-Tarawneh ◽

H. Msallam

Keyword(s):

Middle Eastern ◽

Sudden Onset ◽

Clinicopathological Features ◽

Inflammatory Disorder ◽

Histological Features ◽

The Third ◽

Strict Diet ◽

Postinflammatory Hyperpigmentation ◽

High Index Of Suspicion ◽

Distinct Features

Prurigo pigmentosa is a unique cutaneous inflammatory disorder characterized by a sudden onset of pruritic and erythematous macules, urticarial papules, and plaques that may coalesce to form a reticulated pattern. Lesions typically heal within weeks leaving a reticulated and mottled postinflammatory hyperpigmentation. The majority of reported cases originate from Japan with much fewer cases described worldwide without predominant ethnicity. The histopathological features of prurigo pigmentosa can be nonspecific; however, distinct features exist for each stage of the disease. The aetiology of prurigo pigmentosa is not fully understood. However, ketoacidosis has been implicated in the pathogenesis and indeed prurigo pigmentosa has been associated with ketoacidotic states such as diabetes mellitus, fasting, dieting, and anorexia nervosa. In this report, we present 3 Jordanian patients with prurigo pigmentosa and describe their clinicopathological features. One patient developed prurigo pigmentosa while fasting during the month of Ramadan and another was undertaking a strict diet. No associations were identified in the third patient. In view of the largely nonspecific clinical and histological features, a high index of suspicion is required as many cases of prurigo pigmentosa are probably undiagnosed.

Download Full-text

Evaluation of salicylic acid peeling in comparison with topical tretinoin in the treatment of postinflammatory hyperpigmentation

Journal of Cosmetic Dermatology ◽

10.1111/jocd.12301 ◽

2016 ◽

Vol 16 (1) ◽

pp. 52-60 ◽

Cited By ~ 8

Author(s):

Basma Morad Mohamed Ali ◽

Shereen Farouk Gheida ◽

Nageh Ahmed El Mahdy ◽

Shery Nashaat Sadek

Keyword(s):

Salicylic Acid ◽

Topical Tretinoin ◽

Postinflammatory Hyperpigmentation

Download Full-text

1927 nm Thulium Laser Successfully Treats PostInflammatory Hyperpigmentation in Skin of Color

Dermatology Research and Practice ◽

10.1155/2021/5560386 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Mana Abdullah Alharbi

Keyword(s):

Laser Treatment ◽

Low Energy ◽

Body Parts ◽

Efficacy And Safety ◽

Thulium Laser ◽

Dark Skin ◽

Type Iv ◽

Postinflammatory Hyperpigmentation ◽

Darker Skin Types

Background. Treatment of postinflammatory hyperpigmentation (PIH) in patients with dark skin is challenging as the treatment itself might provoke paradoxical PIH. Only few studies examined the safety and efficacy of nonablative laser treatment in these patients. The objective was to examine efficacy and safety of nonablative 1927 nm wavelength laser followed by bleaching creams in the treatment of PIH. Methods. It was a prospective interventional pilot study that was conducted during 2019. All patients were of Fitzpatrick skin type IV who had unsatisfactory response to topical bleaching creams used for at least three months. Patients received one to four sessions of laser treatment (6 weeks apart) followed by topical hydroquinone 4% cream twice daily for 6 weeks. Improvement was assessed by two blinded independent dermatologist evaluators. Results. A total of nine patients were enrolled and the outcome could not be assessed in one patient who was lost for follow-up. The affected sites were the abdomen, face, and other body parts. Three of the eight evaluated patients had excellent response (37.5%), four had satisfactory response (50.0%), and one had nonsatisfactory response (12.5%). The downtime was manifested as edema and erythema that disappeared after 5 to 7 days. Improvement was more evident in first session and it declined in subsequent sessions. None of the patients had paradoxical pigmentation after treatment. Conclusions. Low energy low density nonablative fractional 1927 nm wavelength laser treatment followed by topical hydroquinone 4% cream for 6 weeks is a safe and effective modality for improving PIH in patients with darker skin types.

Download Full-text

Disorders of Pigmentation

10.2310/fm.1109 ◽

2012 ◽

Author(s):

Pearl E. Grimes

Keyword(s):

Differential Diagnosis ◽

Narrow Band ◽

Skin Pigmentation ◽

Ultraviolet B ◽

Response To Treatment ◽

Therapeutic Approaches ◽

Drug Induced ◽

Degos Disease ◽

Postinflammatory Hyperpigmentation ◽

Disease And Disorders

The disorders of skin pigmentation discussed in this chapter fall into two categories: disorders of hyperpigmentation (melasma, postinflammatory hyperpigmentation, drug-induced hyperpigmentation, erythema dyschromicum perstans, lentigines, confluent and reticulated papillomatosis of Gougerot and Carteaud, and Dowling-Degos disease) and disorders of hypopigmentation (vitiligo, albinism, piebaldism, and idiopathic guttate hypomelanosis). The definition, epidemiology, etiology and pathogenesis, diagnosis, differential diagnosis, and treatment are discussed for each condition. Figures show examples of melasma, hyperpigmentation secondary to acne, vitiligo and its response to treatment with tacrolimus and with narrow-band ultraviolet B (UVB) light, Vogt-Koyanagi-Harada syndrome, and piebaldism. A table lists therapeutic approaches to vitiligo. This chapter contains 182 references.

Download Full-text