Formula Development of Red Palm (Elaeis guineensis) Fruit Extract Loaded with Solid Lipid Nanoparticles Containing Creams and Its Anti-Aging Efficacy in Healthy Volunteers

Palm fruits (Elaeis guineensis) comprise antioxidants that can be used as skin care agents. This study developed a cosmeceutical cream containing E. guineensis extract, loaded with solid lipid nanoparticles (SLNs), and assessed its efficacy on female volunteers. The E. guineensis extract exhibited a good antioxidant activity with high levels of vitamin E, β-carotene, and palmitic acid. Day and night creams containing E. guineensis fruit extract, loaded with SLNs, were formulated and exhibited acceptable physical characteristics and good stability. Subsequently, their clinical efficacy and safety were evaluated on female volunteers. Both creams were non-irritating and had good cutaneous compatibility. Skin hydration, transepidermal water loss (TEWL), skin elasticity, melanin index, and skin texture were measured before and 30 min after the first application, as well as after 7, 14, and 30 days of daily application. A satisfactory survey was implemented using a questionnaire, and volunteer satisfaction scores were high for the product’s performance. Overall, the results showed that skin hydration, TEWL, cutaneous elasticity, and melanin index were improved, compared to the baseline data, after 30 days. Thus, the formulated facial day and night creams made the skin moist, reduced wrinkles, increased elasticity, and cleared the skin to the consumers’ satisfaction.

Effects of Hypopigmentation Alleles and Ancestry on Skin Color in the Kalinago of Dominica

Admixture analysis of 458 Kalinago individuals from the Commonwealth of Dominica shows 55% Native American ancestry grouping with East Asian ancestry at K=3, 32% African, and 11% European ancestry. Skin pigmentation measures (Melanin Index) ranged from 20 to 80, averaging 46. Three albino individuals were found to be homozygous for a multi-nucleotide polymorphism OCA2NW273KV of African origin whose single allele effect size was -8 melanin units. European hypopigmenting allele frequencies for SLC24A5A111T and SLC45A2L374F were 0.14 and 0.05, with effect sizes per allele of -6 and -3, respectively. Native American Ancestry contributed an effect size of about -22 melanin units.

The Prevalence and Extent of Physiological and Pathological Gingival Pigmentation in Patients Visiting Riyadh Elm University Clinics

Background: Gingival pigmentation presents as a diffuse deep discoloration or as irregularly shaped brown and light brown or black patches, striate, or strands. It is generally agreed that pigmented areas are solely pre-sent when melanin granules, synthesized by melanocytes, are transferred to keratinocytes. Aim: To study the prevalence, extent, and etiology of gingival pigmentation among Riyadh Elm University clin-ics’ attendees. Design and Settings: Examinations were done in Riyadh Elm University by four calibrated examiners. Methods: Patients underwent a Gingival Index examination, followed by an assessment of the presence or ab-sence of gingival pigmentations. If the latter were present, the patient underwent a Hedin’s Melanin Index, a Gingival Melanosis Record, and a Von Luschan Scale examination to evaluate the extent, distribution, and col-or of the pigmentation. Statistical analysis: Cohen’s Kappa Test and Chi-Square Test Results: A total of 139 (80.3%) patients had gingival pigmentation, of which 79 (56.8%) were males. Gingival pigmentations were found in 42 (93.3%) cigarette smokers, 40 (83.3%) hubbly bubbly smokers, and 20 (86.9%) electronic cigarette smokers. Both arches were affected in 102 patients, the canines’ area had the highest incidence of pigmentation (88.9%) while the molars had the least incidence (18.1%). Scores of 2 and 3 on the Hedin’s Index were the highest at 51 and 52 patients respectively. The mean color of the pigmentations on the Von Luschan scale was 21.49 ± 4.59, but it was higher for smokers and patients with severe inflamma-tion. Conclusions : Gingival pigmentation was more prevalent among all types of smokers—cigarettes, hubbly bubbly, and e-cigarettes compared to non-smokers. More pigmentations were also associated with the higher intake. The major patterns of pigmentation distribution were the short-connected-continuous ribbons and the more-than-two-solitary-papillae. Keywords: Gingival Pigmentation, Hedin’s Index, Color, Distribution, Smokers

Long-term Efficacy of Q-switched 1064 nm Nd-YAG Laser for Treatment of Split-thickness Skin Graft: A Randomized Controlled Trial

Objective: The aim of this study was to investigate the efficacy of the Q-switched 1064 nm Nd:YAG laser for reducing hyperpigmentation and erythema and increasing pliability in skin grafts.Material and Methods: This was a prospective randomized controlled trial. Half of each skin graft was treated with a Q-switched 1064 nm Nd:YAG laser 4 times, and the other half was left untreated and collectively used as the controls. The treatment results were evaluated by clinical photographs, and assessment of the melanin index (MI), erythema index (EI), and elasticity parameters at baseline and at 2 weeks after each session and 1 month after the final treatment.Results: Ten skin graft sites from 10 patients were included. Most patients had lesions at a lower extremity. After 4 sessions of treatment, average melanin index at the treated sites was non-significantly decreased compared to both baseline (p-value=0.232) and the untreated sites (p-value=0.770). The elasticity of the treated sites increased significantly when compared to baseline (p-value=0.039), but non-significantly when compared to the untreated sites (p-value=0.846). The EI at the treated sites non-significantly decreased compared to both baseline (p-value=0.432) and the untreated sites (p-value=0.164). Conclusion: This study found the Q-switched 1064 nm Nd:YAG laser treatment to be a potentially promising modality for increasing the pliability of skin grafts, but reductions in hyperpigmentation and erythema were only clinically significant.

Effectiveness and safety of a combination of sun protection and depigmentation agent in the treatment of epidermal hyperpigmentation

<p class="Default"><strong>Background: </strong>Medication adherence is recognized as a worldwide public health problem. As a multi-modality approach with sun protection and depigmentation is quintessential in patients with epidermal hyperpigmentation, a combination of day and night cream may be prudent for long-term improvement and compliance. Aim of the current investigation was to assess treatment outcomes and medication compliance in patients with epidermal hyperpigmentation using day and night cream in a combi-kit packaging (Melaglow day and night^TM combi-kit).</p><p><strong>Methods: </strong>Sixty patients (18-45 years) with epidermal pigmentation were enrolled in this 12-week study. Treatment effectiveness was determined by melanin index/erythema measure (dermacatch), extent, depth and density of pigmentation (fotofinder), and clinical/dermoscopic aspects (grade-1: &lt;25%; grade-2: 25%-50%; grade-3: 50%-75%; grade-4: &gt;75% reduction in the amount of epidermal pigment), safety, satisfaction, and compliance were assessed.</p><p><strong>Results: </strong>Out of 60 patients, 52 completed the study. The overall percentage of melanin and erythema improvement was 22.51% and 13.85%, respectively. Based on fotofinder images, 36.54% had grade-2, 34.62% had grade-3, 15.38% had grade-1, and 13.46% patients had grade-4 improvement. Based on the photographic images, 40.38% had grade-2, 32.69% had grade-3, 17.31% had a grade-1, and 9.62% had grade-4 improvement in skin color. All patients agreed that combi-kit helped in remembering and adhering to treatment. Most patients were satisfied with the treatment (84.62%), with compliance rate of 97.72%. No adverse events were reported.</p><p><strong>Conclusions:</strong> Combi-kit containing day and night cream (Melaglow day and night^TM combi-kit) was safe and effective in the treatment of epidermal pigmentation, ensuing treatment compliance, and patient satisfaction. <strong></strong></p>

Genetic loci associated with skin pigmentation in African Americans and their effects on vitamin D deficiency

A recent genome-wide association study (GWAS) in African descent populations identified novel loci associated with skin pigmentation. However, how genomic variations affect skin pigmentation and how these skin pigmentation gene variants affect serum 25(OH) vitamin D variation has not been explored in African Americans (AAs). In order to further understand genetic factors that affect human skin pigmentation and serum 25(OH)D variation, we performed a GWAS for skin pigmentation with 395 AAs and a replication study with 681 AAs. Then, we tested if the identified variants are associated with serum 25(OH) D concentrations in a subset of AAs (n = 591). Skin pigmentation, Melanin Index (M-Index), was measured using a narrow-band reflectometer. Multiple regression analysis was performed to identify variants associated with M-Index and to assess their role in serum 25(OH)D variation adjusting for population stratification and relevant confounding variables. A variant near the SLC24A5 gene (rs2675345) showed the strongest signal of association with M-Index (P = 4.0 x 10−30 in the pooled dataset). Variants in SLC24A5, SLC45A2 and OCA2 together account for a large proportion of skin pigmentation variance (11%). The effects of these variants on M-Index was modified by sex (P for interaction = 0.009). However, West African Ancestry (WAA) also accounts for a large proportion of M-Index variance (23%). M-Index also varies among AAs with high WAA and high Genetic Score calculated from top variants associated with M-Index, suggesting that other unknown genomic factors related to WAA are likely contributing to skin pigmentation variation. M-Index was not associated with serum 25(OH)D concentrations, but the Genetic Score was significantly associated with vitamin D deficiency (serum 25(OH)D levels less than 12 ng/mL) (OR, 1.30; 95% CI, 1.04–1.64). The findings support the hypothesis suggesting that skin pigmentation evolved responding to increased demand for subcutaneous vitamin D synthesis in high latitude environments.

Comparison of the Effectiveness 3% Tranexamic Acid Cream Versus 4% Hydroquinone Cream for Treatment of Epidermal Type Melasma

A B S T R A C TBackground: Melasma is an acquired hypermelanosis in areas that are exposed tosun. especially in face. Severity of melasma is measured using modified MelasmaArea Severity Index (mMASI) and Melanin Index (MI). Hydroquinone (HQ) is aneffective drug and also a gold standard in terms of melasma treatment. However. thedrawback of hydroquinone is the treatment duration which is quite long. theoccurence of side effects. and also recurrence potential. Several recent studies showsthat one of the anti-pigmentation agent options. the tranexamic acid (TA). is able toprevent melanocyte activation. The results of various studies found that the use ofTA showed a significant improvement in MASI scores. Objective: To compare theeffectivity of 3% TA cream with 4% HQ cream as an alternative therapy in epidermaltype melasma treatment. Methods: A double-blind. matched. randomized clinicaltrial was conducted during July 2019 until August 2019 at Dr. Mohammad HoesinGeneral Hospital Palembang. Subjects were divided into two groups. The first group.consists of 30 participants. get 3% TA cream; and the second group. consists of 30participants. get 4% HQ cream. Subjects who fulfilled the inclusion criteria wasincluded through a simple randomization. Study subjects wer given random creampot (with label A or B on it) according to the result of simple randomization. Finally.every subjects’ melasma severity was measured using mMASI and mexameter ® .Results: There were differences in terms of baseline. 4 th weeks and 8 th weeks aftertreatment mMASI scores in 3% TA and 4% HQ group. At 8 th week. the mMASI scorethe 3% TA group was lower than 4% HQ group. There was no differences in baseline.4 th weeks and 8 th after treatment MI between the two groups. Melanin index for 3%TA group was lower than 4% HQ group. Conclusion: Three-percent TA cream and4% HQ cream is effective in decreasing mMASI score and MI in epidermal typemelasma. There were differences in terms of the mMASI score during the 8th weekafter treatment between 3% TA and 4% HQ group.

Comparison of the Effectiveness 3% Tranexamic Acid Cream Versus 4% Hydroquinone Cream for Treatment of Epidermal Type Melasma

Background: Melasma is an acquired hypermelanosis in areas that are exposed to sun. especially in face. Severity of melasma is measured using modified Melasma Area Severity Index (mMASI) and Melanin Index (MI). Hydroquinone (HQ) is an effective drug and also a gold standard in terms of melasma treatment. However. thedrawback of hydroquinone is the treatment duration which is quite long. the occurence of side effects. and also recurrence potential. Several recent studies shows that one of the anti-pigmentation agent options. the tranexamic acid (TA). is able to prevent melanocyte activation. The results of various studies found that the use of TA showed a significant improvement in MASI scores. Objective: To compare the effectivity of 3% TA cream with 4% HQ cream as an alternative therapy in epidermal type melasma treatment. Methods: A double-blind. matched. randomized clinical trial was conducted during July 2019 until August 2019 at Dr. Mohammad Hoesin General Hospital Palembang. Subjects were divided into two groups. The first group. consists of 30 participants. get 3% TA cream; and the second group. consists of 30 participants. get 4% HQ cream. Subjects who fulfilled the inclusion criteria was included through a simple randomization. Study subjects wer given random cream pot (with label A or B on it) according to the result of simple randomization. Finally. every subjects’ melasma severity was measured using mMASI and mexameter ® . Results: There were differences in terms of baseline. 4 th weeks and 8 th weeks after treatment mMASI scores in 3% TA and 4% HQ group. At 8 th week. the mMASI score the 3% TA group was lower than 4% HQ group. There was no differences in baseline. 4 th weeks and 8 th after treatment MI between the two groups. Melanin index for 3% TA group was lower than 4% HQ group. Conclusion: Three-percent TA cream and 4% HQ cream is effective in decreasing mMASI score and MI in epidermal type melasma. There were differences in terms of the mMASI score during the 8th week after treatment between 3% TA and 4% HQ group.

The Study of Efficacy of Excimer Light 308 Nanometers for Chronic Hand Dermatitis

Background: Chronic hand dermatitis is one of the most common dermatological disease worldwide resulting from high incidence, prevalence, and recurrent rate. Nowadays, there are various kinds of treatments in chronic hand dermatitis. The previous studies only consisted of prospective non-randomized pilot study and retrospective cohort study of 308 nanometers excimer devices in chronic hand dermatitis. Objective: To study the efficacy and side effect of the excimer light 308 nanometer in chronic hand dermatitis. Materials and Methods: The researchers conducted a prospective non-randomized clinical trial to study the efficacy of 308 nanometers excimer light to treat chronic hand dermatitis. Thirty-five patients were enrolled in the eight weeks protocol. The efficacy of device was assessed by the HECSI, the PGA score, the erythema index by Mexameter MX16, and the NRS for pruritus level. In addition, the adverse effect of changing melanin index was assessed by the Mexameter MX16. The researchers also assessed the DLQI and the patient’s satisfaction score. Results: The results revealed that the mean of the HECSI, PGA, NRS, and erythema index were statistically significantly decreased after complete treatment (p<0.001). The result of subgroup analysis of percent of complete remission rates were 88.89 in mild group, 83.33 in moderate group, and 42.86 in severe group, which was statistically significant (p=0.029). In addition, the complete remission rates of pruritus were 88.89 in the mild group, 94.44 in the moderate group, and 57.14 in the severe group, and there was no statistically significant difference between the groups (p=0.21). On the other hand, the mean of melanin index demonstrated no statistically significant change in palmar and dorsal side of both hands (p=0.79, 0.57, 0.78, and 0.07, respectively). Furthermore, the DLQI was also statistically significantly improved (p<0.001), and the patients were very satisfied to the treatment. The adverse effects, which included burning sensation, skin dryness, and progressive itchiness, were observed (5.88, 5.88, and 8.82%, respectively) and spontaneously resolved within 24 hours without clinical skin change. Conclusion: The excimer light 308 nanometers is the alternative treatment of chronic hand dermatitis by reducing the severity score statistically significantly without hyperpigmentation after treatment. Mild adverse effects such as itchiness, dry skin, and burning sensation without major adverse event were observed. Keywords: Excimer light, Chronic hand dermatitis

The correlation between severity of melasma with facial wrinkles in Yogyakarta, Indonesia

Melasma is a common disfiguring condition involving acquired hyperpigmentation especially on the face, for which the pathogenesis is still uncertain, however histopathological studies showed that there is not only hyperpigmentation in the epidermis, but also solar elastosis or photo-aging due to abnormality of dermal extracellular matrix which contributes to clinical wrinkles. This study aimed to examine a link between the severity of melasma and facial wrinkles as a manifestation of photoaging in a tropical area. This study was an observational study with crosssectional design, conducted in Yogyakarta, Indonesia involving 51 patients with melasma aged 30-50 years who had fulfilled the inclusion and exclusion criteria. The melasma severity was measured clinically with the modified Melasma Severity Index (mMASI), and objectively with the Melanin Index (MI) and Erythema Index (EI) assessed with Mexameter Courage Khazaka. The wrinkle severity was measured clinically by scoring from forehead horizontal lines, crow’s feet, glabellar and nasolabial lines, and total scores were obtained from all of them. The correlation analysis was done statistically with Spearman’s rank tests. The results showed a weak positive but not significant correlation between the mMASI score and total facial wrinkle score (r: 0.165), and a weak positive non-significant correlation between EI and total facial wrinkle score (r: 0.06). There were significant positive moderate correlations between MI and total facial wrinkle score (r: 0.441), due to significant positive moderate correlations between MI and glabella wrinkle (r: 0.392), and between MI and nasolabial wrinkle (r: 0.339). In conclusion, a positive moderate correlation was found between MI and total facial wrinkle score, especially relating to glabellar and nasolabial wrinkles. However, there was no correlation between mMASI score and total facial wrinkle score.