Adolescent ; Humans ; Male ; Pigmentation Disorders ; pathology ; Skin ; pathology

The evaluation of pigmentary skin lesions by clinical doctors has been based on subjective and qualitative judgements. Observations have mostly relied on visual inspection, making the effects of treatment difficult to evaluate with any precision. For this reason there is a real need for an objective method to evaluate prognosis after treatment. Recent scientific measurements such as reflectance spectrophotometry and reflectance colorimetry have provided accurate quantitative color information about skin lesions, but these techniques are costly and difficult to apply in the clinical field. The purpose of this study was to develop a simple and cost-effective way of evaluating treatment results. We have developed a software program using the L*a*b* color coordinate system to quantify the effect of treatment and have successfully demonstrated its clinical usefulness. Our method compares the relative color difference between normal skin and skin lesions before and after treatment, instead of measuring the absolute color of skin lesions. The accuracy of our quantitative color analysis was confirmed by the simulated images of hemangioma and ota nevus. Clinical efficacy was also confirmed through a blind test involving 3 clinicians who were asked to grade the treatment effects of 13 cases of hemangioma and 7 cases of ota nevus. These subjective clinical grades correlated well with the treatment results obtained using the proposed color analysis system (Correlation coefficient = 0.84).
Color* ; Female ; Hemangioma/therapy ; Hemangioma/pathology ; Human ; Nevus of Ota/therapy ; Nevus of Ota/pathology ; Outcome Assessment (Health Care)/methods* ; Pigmentation Disorders/therapy* ; Pigmentation Disorders/pathology* ; Skin Neoplasms/therapy ; Skin Neoplasms/pathology ; Skin Pigmentation* ; Software*

OBJECTIVETo observe the effects of traditional Chinese medicine mask combined with skin care in the treatment of facial pigmentation after burns.

METHODSForty-one patients with facial pigmentation after burns hospitalized from January 2009 to June 2010 were enrolled and divided into treatment group (n = 26, odd number) and control group (n = 15, even number) according to the visiting order. After cleaning, massaging, and steam spraying to faces, patients in treatment and control groups were respectively treated with traditional Chinese medicine mask developed by physicians in our hospital and common commercial beauty mask. Masks were removed when they became completely dry. The treatment was repeated every other day. Ten times made up a course of treatment. Three consecutive courses were carried out on each patient. Before treatment and at the end of each course, the skin color differences were measured with Vancouver Pigmented Scar Scale; image gray scale value of pigmented skin was measured with image analysis technique. Satisfaction degree acknowledged by both patients and physicians were recorded at the end of each course; adverse effects were recorded; and the overall efficacy between two groups was compared. Data were processed with chi-square test or t test.

RESULTSSkin color differences, image gray scale value of patients in treatment group were close to those in control group before treatment (with t value respectively 0.800 and 0.694, P values all above 0.05). Skin color differences, image gray scale value, and satisfaction degree acknowledged by both patients and physicians in treatment group were better than those in control group at the end of each course. At the end of the third course of treatment, the skin color differences in treatment and control groups scored 0.5 ± 0.4 and 1.1 ± 0.6, respectively, with image gray scale value of 55 ± 5 and 66 ± 6, respectively, which were statistically different from each other (with t value respectively 3.389 and 5.102, P values all below 0.01). The overall efficacy of the treatment group was 92.3%, which was much better than that of the control group (53.3%, χ(2) = 6.31, P < 0.05). No allergy caused by the traditional Chinese medicine mask was observed during the treatment.

CONCLUSIONSThe traditional Chinese medicine mask combined with skin care is effective for the treatment of facial pigmentation after burns.

Adult ; Burns ; complications ; therapy ; Face ; pathology ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Pigmentation Disorders ; etiology ; therapy ; Skin Care

Adolescent ; Adrenal Cortex Diseases ; complications ; pathology ; surgery ; Adult ; Child ; Female ; Humans ; Hydrocortisone ; blood ; urine ; Male ; Middle Aged ; Pigmentation Disorders ; complications ; pathology ; surgery

BACKGROUND: Argyria is a rare irreversible cutaneous pigmentation disorder caused by prolonged exposure to silver. Herein, we report a case of generalized argyria that developed after chronic ingestion of soluble silver-nano particles and presented with muscle weakness. CASE PRESENTATION: A 74-year-old woman visited our emergency room, complaining of fever and mental deterioration. She was diagnosed with acute pyelonephritis and recovered after antibiotic therapy. At presentation, diffuse slate gray-bluish pigmented patches were noticed on her face and nails. Two months prior to visiting our hospital, she was diagnosed with inflammatory myopathy and given steroid therapy at another hospital. We performed a nerve conduction study that revealed polyneuropathy. In skin biopsies from pigmented areas of the forehead and nose, the histopathologic results showed brown-black granules in basement membranes of sweat gland epithelia, which are diagnostic findings of argyria. We reviewed pathology slides obtained from the left thigh muscles and found markedly degenerated myofibers with disorganization of myofibrils without inflammatory reactions, consistent with unspecified myopathy, rather than inflammatory myopathy. The patient was diagnosed with generalized argyria with polyneuropathy and myopathy and transferred to a rehabilitation institution after being tapered off of steroids. CONCLUSIONS: Clinicians should be aware of clinical manifestations of argyria and consider it in differential diagnosis when they examine patients who present with skin pigmentation and muscle weakness.
Aged ; Argyria* ; Basement Membrane ; Biopsy ; Diagnosis, Differential ; Eating ; Emergency Service, Hospital ; Female ; Fever ; Forehead ; Humans ; Muscle Weakness* ; Muscles ; Muscular Diseases ; Myofibrils ; Myositis ; Neural Conduction ; Nose ; Pathology ; Pigmentation Disorders ; Polyneuropathies ; Pyelonephritis ; Rehabilitation ; Silver ; Skin ; Skin Pigmentation ; Steroids ; Sweat Glands ; Thigh

OBJECTIVETo evaluate the clinical response of Nevus of Ota to Q-switched Alexandrite laser, and analyze factors that influence the treatment outcome.

METHODSA total of 522 patients treated with Q-switched Alexandrite laser were included in the study. Single and multiple variate analyses of various factors were performed.

RESULTSSatisfactory result was observed in all patients, none of whom developed scarring. Clinical response was improved with additional treatment sessions. The clinical response of the 20 - 27-week treatment interval group was significantly better than that of the 12 - 19-week interval group, but showed no significant difference as compared with both the 28 - 35 and > or = 36-week interval group. Zygomatic, buccal and frontal areas showed better response than ocular and temporal areas. Treatment session, interval, and fluence were significant factors identified by multivariate analysis.

CONCLUSIONSQ-switched Alexandrite laser is an ideal method for treating Nevus of Ota without injury. The number of treatment sessions is more important than interval or fluence.

Adolescent ; Adult ; Child ; Child, Preschool ; Facial Neoplasms ; pathology ; surgery ; Female ; Humans ; Infant ; Laser Therapy ; adverse effects ; methods ; Male ; Middle Aged ; Nevus of Ota ; pathology ; surgery ; Pigmentation Disorders ; etiology ; Skin Neoplasms ; pathology ; surgery

An unusual grayish brown discoloration of the synovium was found during a knee arthroscopy of a 72-year-old man. He also had similar pigmentation affecting the skin on the legs, arms, hands, and face. It was found he had been taking 400 mg of amiodarone hydrochloride daily for last 7 years. Amiodarone is known to cause a slate grey pigmentation of skin and cornea, but we believe this is the first report of amiodarone-induced pigmentation of the synovium. The arthroscopist should be aware of the possibility of drug-related synovial pigmentation and include this in differential diagnosis.
Aged ; Amiodarone/*adverse effects/therapeutic use ; Anti-Arrhythmia Agents/*adverse effects/therapeutic use ; Arrhythmias, Cardiac/complications/drug therapy ; Arthroscopy ; Diagnosis, Differential ; Humans ; Knee Joint/surgery ; Male ; Pigmentation Disorders/*chemically induced/*diagnosis ; Skin/pathology ; Synovial Membrane/*pathology