OBJECTIVE: To explore the inhibitory effects of Nardostachys Jatamansi DC. volatile oil (NJVO) on psychological factors substance P (SP)/cortisol (CORT)-induced hyperpigmentation. METHODS: The model of psychologically-induced hyperpigmentation of B16F10 cells was created using SP (10 nmol/L) + CORT (10 µmol/L) for 72 h. The levels of melanin content, tyrosinase (TYR) activity using NaOH lysis and L-dihydroxyphenylalanine (L-DOPA) oxidation methods were assessed, respectively. The effect of NJVO on SP/CORT-induced normal human skin tissue pigmentation was detected by Masson staining. Protein expressions of tyrosinase-related protein 1 (TRP-1), tyrosinase-relative protein 2 (DCT), and microphthalmia-associated transcription factor were determined using Western blot. The melanosome number, maturation, and melanosomal structure changes were detected through transmission electron microscopy and immunofluorescence experiments. In vivo, zebrafish pigment content was evaluated in SP/CORT-induced zebrafish hyperpigmentation model. RESULTS: NJVO significantly reduced the melanin content (P<0.01) and inhibited tyrosinase activity (P<0.01), the pigmentation of the normal skin tissue in the NJVO group was significantly lower than that in the SP/CORT group (P<0.05). And NJVO considerably downregulated expressions of melanogenesis-related proteins (TYR, TRP-1, DCT) in cells (P<0.01). In addition, the number of melanosomes was decreased and the dentrites formation of B16F10 cells was inhibited after NJVO treatment (P<0.01). In vivo, NJVO significantly reduced the pigment content in the zebrafish body (P<0.01). CONCLUSION NJVO effectively reversed SP/CORT-induced hyperpigmentation by suppressing the activity and expression of TYR and TRPs and inhibiting melanosome maturation in mouse B16F10 melanoma cells.
Animals ; Hyperpigmentation/psychology* ; Zebrafish ; Oils, Volatile/therapeutic use* ; Melanins/metabolism* ; Humans ; Monophenol Monooxygenase/metabolism* ; Mice ; Nardostachys/chemistry* ; Substance P ; Hydrocortisone ; Skin Pigmentation/drug effects* ; Cell Line, Tumor ; Melanosomes/ultrastructure* ; Microphthalmia-Associated Transcription Factor/metabolism* ; Melanoma, Experimental ; Oxidoreductases/metabolism* ; Intramolecular Oxidoreductases/metabolism*

BACKGROUND

Disorders of hyperpigmentation can affect the quality of life and pose a significant psychological burden for patients. However, little is known about sun protective behaviors within patient populations with hyperpigmentation disorders.

This study aimed to evaluate the knowledge, attitudes, and practices on sun exposure and protection among patients with cutaneous hyperpigmentation.

This was a single center analytical cross-sectional study which used a self-administered questionnaire on knowledge, attitudes, and practices on sun exposure and protection. Study subjects were 135 patients aged 13-59 years old who sought consult at a tertiary hospital and diagnosed with cutaneous hyperpigmentation. The level of knowledge, type of attitude, and practices on sun exposure and protection were determined. The association between the sociodemographic factors and knowledge, attitudes, and practices was determined using multivariate logistic regression model.

In this study, majority of the patients have adequate knowledge (80%), desirable attitudes (82%), and good practices (79%) towards sun exposure and protection. None of the demographic factors were found to be significantly associated with knowledge. The odds of having a desirable attitude among those in the construction sector was 803 times the odds for those in the transportation sector. Only the attribution of hyperpigmentation to the sun was a factor found to be significantly associated with good practices.

This study recommends that dermatologists caring for patients with cutaneous hyperpigmentation continue to emphasize patient education on sun exposure and protection since adequate knowledge consistently translates to good practices for this group of highly motivated patients.

Epidermis ; Humans ; Hyperpigmentation ; Keratinocytes ; Particulate Matter/toxicity*

OBJECTIVE: To explore the clinical phenotype and genetic basis for a Chinese pedigree affected with familial progressive hyperpigmentation and hypopigmentation (FPHH). METHODS: Clinical data and family history for a child with FPHH were collected. Peripheral blood samples were collected from the child, his parents and two sisters. Following the extraction of DNA, high-throughput sequencing was carried out to screen for genetic variant associated with the disease. Candidate variant was verified by Sanger sequencing of his family members. RESULTS: The main clinical features of the proband have included progressive hyperpigmentation and hypopigmentation. High-throughput sequencing revealed that he has harbored a heterozygous c.105T>A (p.Asn35Lys) variant of the KITLG gene, which was unreported previously. Sanger sequencing confirmed that the variant has co-segregated with the disease phenotype in his pedigree. CONCLUSION For infants with progressive skin pigmentation and hypopigmentation spots, FPHH should be suspected. The heterozygous c.105T>A (p.Asn35Lys) variant of the KITLG gene probably underlay the FPHH in this pedigree.
Male ; Humans ; Pedigree ; Hypopigmentation/genetics* ; Phenotype ; Hyperpigmentation/genetics* ; China

STUDY DESIGN: Retrospective study. PURPOSE: To report the prevalence of patients with multidrug-resistant (MDR) tubercular spondylodiscitis and their outcomes. Additionally, to assess the role of Xpert MTB/RIF assay in early detection of MDR tuberculosis. OVERVIEW OF LITERATURE: MDR tuberculosis is increasing globally. The World Health Organization (WHO) has strongly recommended Xpert MTB/RIF assay for early detection of tuberculosis. METHODS: From 2006 to 2015, a retrospective study was conducted on patients treated for MDR tuberculosis of the spine. Only patients whose diagnosis was confirmed using either culture and/or the Xpert MTB/RIF assay were included. Diagnostic method, treatment regimen, time taken to initiate second-line antituberculosis treatment (ATT), drug-related complications, and cost of medications were analyzed. All patients with MDR were treated according to the WHO recommendations for 2 years. The outcome parameters analyzed included clinical, biochemical, and radiological criteria to assess healing status. RESULTS: From 2006 to 2015, a total of 730 patients were treated for tubercular spondylodiscitis. Of those, 36 had MDR tubercular spondylitis (prevalence, 4.9%), and three had extremely drug resistant tubercular spondylitis (prevalence, 0.4%). In this study, 30 patients, with a mean age of 29 years and a mean post-treatment follow-up of 24 months, were enrolled. The majority (77%) had secondary MDR, 17 (56%) underwent surgery, and 26 (87%) completed treatment for 2 years and were healed. Drug-related complications (33%) included ototoxicity, hypothyroidism, and hyperpigmentation of the skin. The average time taken for initiation of second line ATT for MDR patients with Xpert MTB/RIF assay as the diagnostic tool was 18 days, when compared to patients for whom the assay was not available which was 243 days. CONCLUSIONS: The prevalence of MDR tubercular spondylodiscitis was 4.9%. In total, 87% of patients were healed with adequate treatment. The sensitivity and specificity of the Xpert MTB/RIF assay to detect MDR was 100% and 92.3%, respectively.
Diagnosis ; Discitis ; Early Diagnosis ; Follow-Up Studies ; Humans ; Hyperpigmentation ; Hypothyroidism ; Methods ; Prevalence ; Retrospective Studies ; Sensitivity and Specificity ; Skin ; Spine ; Spondylitis ; Tuberculosis ; Tuberculosis, Multidrug-Resistant ; World Health Organization

BACKGROUND: Many researchers have sought to identify safe, natural herbal extracts that exert an anti-melanogenesis effect. Cinnamomi cortex has been widely used as a herbal medicine in Asia and Europe. OBJECTIVE: To confirm the inhibitory effects of Cinnamomi cortex extract against melanogenesis and inflammation and to elucidate the underlying mechanism of these actions. METHODS: Effects of Cinnamomi cortex extract on melanin synthesis and tyrosinase activity in B16F10 melanoma cells were evaluated using an ELISA reader. Tyrosinase and MITF protein expression was determined using western blotting. Nitric oxide production in RAW 264.7 cells was measured using Griess reaction. PGE₂ was assayed with an ELISA kit. RESULTS: Cinnamomi cortex extracts inhibited melanin synthesis, tyrosinase activity, and MITF and tyrosinase expression through regulation of the ERK and CREB genes in α-MSH-induced B16 melanoma cells. In addition, Cinnamomi cortex extracts inhibited the expression of NO, PGE₂, and pro-inflammatory cytokines in lipopolysaccharide-induced RAW 264.7 cells. CONCLUSION: We suggest that Cinnamomi cortex may be a potentially useful agent for treating inflammatory skin diseases such as hyperpigmentation based on its inhibitory effects against melanin synthesis and inflammation response in vitro.
Anti-Inflammatory Agents ; Asia ; Blotting, Western ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Europe ; Herbal Medicine ; Hyperpigmentation ; In Vitro Techniques ; Inflammation ; Melanins ; Melanoma ; Melanoma, Experimental ; Microphthalmia-Associated Transcription Factor ; Monophenol Monooxygenase ; Nitric Oxide ; RAW 264.7 Cells ; Skin Diseases

Skin disease can be caused by high temperature, and it is related to the temperature regulation mechanism of human body, adaptation reaction to temperature change, and health problems due to the recent problematic climate change. In hyperthermia, hot and dry skin is typical manifestation, and sometimes the skin color turns red. On the other hand, the skin color can become pale in severe febrile convulsion. Burn is a skin damage caused by heat, and not only the skin but also the underlying tissues can be destroyed in severe case. It is important to determine the degree and extent of the burn to treat adequately. In the case of severe burns, systemic treatment and prevention of infection or shock should be needed. Miliaria, also called “sweat rash,” occurs when the sweat is accumulated as the sweat gland is closed and sweat cannot be secreted to the surface of the skin. The basis of treating miliaria is to keep the patient in a cool environment. Erythema ab igne is defined as a network of hyperpigmentation that occurs after prolonged exposure to heat that is not enough to cause burn. It may disappear when exposure to heat is interrupted, but it may remain permanently. The extent and mechanism of heat-induced skin disease very diverse and it should be carefully assessed for the severity of each disease, the treatment method and prognosis.
Burns ; Climate Change ; Erythema ; Fever ; Hand ; Hot Temperature ; Human Body ; Humans ; Hyperpigmentation ; Methods ; Miliaria ; Prognosis ; Seizures, Febrile ; Shock ; Skin Diseases ; Skin Pigmentation ; Skin ; Sweat ; Sweat Glands

BACKGROUND: Postinflammatory hyperpigmentation (PIH) is one of the most common adverse effects associated with dermatologic procedures, especially those for cosmetic purposes. Low fluence Q-Switched Nd:YAG laser (LFQS) has been widely used for this condition in the field, but reports in the literature are scarce. OBJECTIVE: We aimed to evaluate the clinical benefit and limitation of LFQS in the treatment of PIH after cosmetic procedures. METHODS: Patients with PIH after laser treatment were enrolled in the study. Patients were treated with LFQS at an interval of 2 to 3 weeks. Photographs were taken. Objective measurement included erythema and melanin indices at the same site. Two blinded assessors graded the degree of improvement using a photograph based on a quartile scale (0~3). Patient satisfaction after treatment was also reported. RESULTS: A total of 45 patients were included in the analysis. Patients received 10 treatment sessions. Patients who started LFQS treatment within 3 months after the causal event showed a better treatment outcome. Those who had a higher erythema index before treatment tended to respond less to the treatment. CONCLUSION: LFQS may be a good treatment modality for patients with PIH. Earlier treatment can provide rapid resolution and better clinical results. However, for patients with PIH combined with intense erythema, LFQS may not be the first choice to consider in the clinical field.
Erythema ; Humans ; Hyperpigmentation* ; Melanins ; Patient Satisfaction ; Treatment Outcome

No abstract available.
Hand* ; Hyperpigmentation* ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

BACKGROUND: As nonsurgical interventions for vitiligo are not always successful, various surgical modalities have been used in patients with refractory vitiligo. Of these, non-cultured epidermal suspension transplantation (NCES) was recently introduced to treat large recipient sites using cells from small donor tissue. OBJECTIVE: We assessed the effectiveness and safety of NCES as a surgical treatment for patients with refractory vitiligo. METHODS: We retrospectively reviewed 20 cases in 17 patients (11 females; median age 25 years) who underwent NCES from July 2015 through March 2018. Suction blisters (20 mm in diameter) were collected from the patient's inner thigh at a donor-to-recipient area ratio of 1:5. After the addition of 5 mL recombinant trypsin solution to the suction blisters, followed by incubation at 37℃ for 60 min, epidermal cells were manually scraped off the blister surface, and epidermal cell suspension was obtained by centrifugation at 1,500 RPM for 5 min. The suspension was applied to the vitiligo regions after epidermal ablation of those regions. Phototherapy resumed 1 month later. Treatment success was defined as ≥75% repigmentation of the surgical site, and all adverse events were noted. RESULTS: Overall, 85.0% of cases (17/20) exhibited treatment success. Adverse events included hyperpigmentation (20%) and surgical site infection (5%), but the treatment was tolerable in all cases. CONCLUSION: NCES is a reliable surgical option for patients with vitiligo refractory to nonsurgical treatment. Large areas of vitiligo can be treated by NCES, and use of this technique should be encouraged in Korea.
Blister* ; Centrifugation ; Female ; Humans ; Hyperpigmentation ; Korea ; Phototherapy ; Retrospective Studies* ; Suction* ; Surgical Wound Infection ; Thigh ; Tissue Donors ; Transplantation ; Trypsin ; Vitiligo*