Through a comprehensive analysis combining network pharmacology prediction and transcriptomics, this study systematically explained the multi-target mechanism of Cyanotis arachnoidea(CA) Gel in improving melasma. A melasma model was induced in female SD rats by progesterone injection combined with ultraviolet B(UVB) irradiation for 40 consecutive days, while the blank control group was only fed routinely. After successful model establishment, the rats were randomly divided into five groups and administered different doses of CA ethanol extract gel(high, medium, and low doses) or arbutin Gel(positive control), which were applied once daily for 28 consecutive days. Subsequently, the levels of superoxide dismutase(SOD), malondialdehyde(MDA), and tyrosinase(TYR) in the skin, serum, and liver tissues were measured. Hematoxylin-eosin(HE) staining and Masson-Fontana staining were used to observe the pathological changes in the tissues. Network pharmacology combined with transcriptomics was employed to identify core targets and pathways, and the differential gene expression was validated by quantitative real-time PCR(qPCR). Pharmacodynamic experiments showed that CA Gel significantly increased SOD activity and decreased MDA and TYR levels in the skin, serum, and liver of model rats. It also improved epidermal thickening, inflammatory infiltration, collagen loss, and melanin deposition. Network pharmacology analysis showed that CA mainly regulated core targets such as signal transducer and activator of transcription 3(STAT3), epidermal growth factor receptor(EGFR), and interleukin-6(IL-6), and modulated the phosphatidylinositol 3-kinase(PI3K)-protein kinase B(AKT) and interleukin-17(IL-17) signaling pathways. Transcriptomic analysis showed that CA Gel significantly downregulated the gene expression of heat shock protein 90β family member 1(Hsp90b1), heat shock protein 90α family member 1(Hsp90aa1), and the key steroid synthesis enzyme cytochrome P450 family 17 subfamily A member 1(Cyp17a1), while upregulating thioredoxin 1(Txn1). qPCR results confirmed that CA Gel regulated oxidative stress and inflammatory response by inhibiting the IL-17 signaling pathway and steroid hormone synthesis. This study, for the first time, reveals the molecular mechanism of CA Gel in improving melasma through multi-target synergistic regulation of oxidative stress, inflammatory response, and hormone metabolism pathways, providing a scientific basis for the treatment of pigmentation diseases with traditional Chinese medicine.
Animals ; Rats ; Female ; Rats, Sprague-Dawley ; Network Pharmacology ; Drugs, Chinese Herbal/administration & dosage* ; Melanosis/metabolism* ; Transcriptome/drug effects* ; Humans ; Superoxide Dismutase/genetics* ; Signal Transduction/drug effects* ; Malondialdehyde/metabolism*

INTRODUCTION

Melasma, characterized by dark patches on the skin, predominantly affects individuals with Fitzpatrick skin types III-V and is more common among women. Hydroquinone 4% is traditionally the gold standard for melasma treatment due to its efficacy in reducing pigmentation, but alternatives like β-White™, Tyrostat™, and Melanostatine-5™ or a combination of all are being explored for their potentially better safety profiles.

This study aims to determine the efficacy and safety of β-White + Tyrostat, + Melanostatine-5™ creams versus hydroquinone 4% in the treatment of melasma.

A randomized, double-blind clinical trial compared β-White, Tyrostat, and Melanostatine-5 cream to hydroquinone 4% cream in 40 melasma patients. The intervention consisted of 12-week split-face (left-right) application of the said topical medications. Efficacy was measured using modified Melasma Area and Severity Index (mMASI) Score and the Physician’s and Patient’s Global Assessments (PGA). Safety was used by assessing side effects noted during the application. ANOVA and Post hoc tests were used to measure differences in scores.

Forty out of 42 patients were included in the analysis. The trial found that both treatment regimens were effective, with no significant difference in the reduction of melasma severity over 12 weeks. Initially, the experimental group showed more rapid improvement, but by the third month, both groups reported similar outcomes. The experimental group reported no side effects, making it a potentially safer option for long-term management of melasma.

Overall, while hydroquinone remains effective, β-White + Tyrostat + Melanostatine-5 cream offers a viable alternative with potentially fewer side effects, making it an attractive option for patients seeking long-term melasma management.

14 workers in the 1, 8-diaminonaphthalene workshop of a chemical company in Nantong City had symptoms or signs of varying degrees of pruritus and pigmentation of the face, neck and waist. Pathological examination of skin biopsies showed hyperkeratosis, the basal cells were liquefied and denatured. Seven workers were eventually diagnosed with occupational melanosis. To explore the causes of occupational melanosis caused by exposure to 1, 8-dinitronaphthalene and 1, 8-diaminonaphthalene, and to provide reference for the prevention and treatment of occupational melanosis in the future, this paper reported 14 cases of melanosis in the skin of workers in chemical industry.
Humans ; Melanosis/pathology* ; Pigmentation ; Skin/pathology*

Humans ; Melanocytes ; Melanosis ; Fibroblasts ; Skin

INTRODUCTION: Pigmented contact dermatitis (PCD) is characterized by non-eczematous pigmentation associated with contact sensitizers, usually without any active or preceding pruritus and erythema. PCD was first described by Riehl, who identified patients with brown to gray facial pigmentation concentrated on the face most commonly associated with sensitizing chemical such as cosmetics, fragrances, and textiles. CASE REPORT: This is a case of a 48-year-old female Filipino who presents with blue-grey to brown patches on the forehead of 1-year duration with no significant pathologic history. Clinical examination, dermoscopy and histology were consistent with a variant of pigmented contact dermatitis known as Riehl melanosis. Since anamnesis was unremarkable, patch testing was done to identify the contact allergen triggering the symptom. Results obtained a positive reaction to nickel, potassium dichromate, and textile dye. CONCLUSION:Treatment includes the elimination of trigger factors, hence the importance of patch testing in the investigation of its cause. Alongside adequate photoprotection, a combination treatment of 1,064 nm Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, 20% tricholoacetic acid (TCA) peel and oral retinoids, were found safe and effective in the management of facial melanosis. Three-dimensional imaging and dermoscopy were utilized to obtain a more standard and objective pre- and post-treatment comparison.
Lasers, Solid-State ; Patch Tests ; Melanosis ; Skin Abnormalities ; Dermatitis, Contact

Background: Melasma is an acquired hyperpigmentary disorder occurring on sun-exposed areas of the face and neck. There is little information on its prevalence, epidemiology and clinical characteristics in the Philippines. Objective: To determine the prevalence, epidemiology and clinical characteristics of melasma in Philippine dermatology patients. Methods: This was a multicenter, cross-sectional study conducted from July to December 2013. The investigators determined the prevalence of melasma in 12,068 dermatology patients from six government hospitals and private clinics in Metro Manila, Philippines. The melasma patients, aged 18 years and above, were given self-administered questionnaires with topics related to demographic information and medical history. They were also examined by the investigators (dermatologists) to determine the clinical profile of their melasma. Results: Of the 12,068 dermatology patients who were seen at the selected hospitals and private clinics, 153 (1.26%) were clinically diagnosed with melasma. A majority of the melasma patients were Filipinos (73.20%), aged 41-50 years old (37.91%), with an average age of 42.40 + 9.68 years, and Fitzpatrick skin types III and IV (29.41% and 57.52%, respectively). Melasma was more prevalent in females (81.70%), most of whom had prior history of pregnancy (76.8%). Oral contraceptive use was also reported in 37.6% of the female patients from which 63.83% have used it for only 1 year or less. A majority had no coexisting thyroid disease (75.16%) and daily sun exposure was limited to 1 hour or less for most patients (43.14%). Their melasma was mostly malar in distribution (60.13%), epidermal (61.44%), and mild (51.63%) to moderate (27.45%) in severity. The average mMASI score was 4.63 + 3.32. Conclusion The prevalence of melasma was low among Philippine dermatology patients sampled. A majority of the melasma patients were Filipinos, aged 41-50 years old, with Fitzpatrick skin type IV, limited sun exposure, and no coexisting thyroid disease. They were mostly females with a prior history of pregnancy. Their melasma was mostly malar in location, epiderma type, and mild in severity. These descriptive data can serve as baseline information for further studies on melasma in the Philippines.
Melanosis ; Philippines

Noonan syndrome (NS) and NS-related disorders (cardio-facio-cutaneous syndrome, Costello syndrome, NS with multiple lentigines, or LEOPARD [lentigines, ECG conduction abnormalities, ocular hypertelorism, pulmonic stenosis, abnormal genitalia, retardation of growth and sensory neural deafness] syndrome) are collectively named as RASopathies. Clinical presentations are similar, featured with typical facial features, short stature, intellectual disability, ectodermal abnormalities, congenital heart diseases, chest & skeletal deformity and delayed puberty. During past decades, molecular etiologies of RASopathies have been growingly discovered. The functional perturbations of the RAS-mitogen-activated protein kinase pathway are resulted from the mutation of more than 20 genes (PTPN11, SOS1, RAF1, SHOC2, BRAF, KRAS, NRAS, HRAS, MEK1, MEK2, CBL, SOS2, RIT, RRAS, RASA2, SPRY1, LZTR1, MAP3K8, MYST4, A2ML1, RRAS2). The PTPN11 (40–50%), SOS1 (10–20%), RAF1 (3–17%), and RIT1 (5–9%) mutations are common in NS patients. In this review, the constellation of overlapping clinical features of RASopathies will be described based on genotype as well as their differential diagnostic points and management.
Congenital Abnormalities ; Costello Syndrome ; Diagnosis ; Ectoderm ; Electrocardiography ; Genitalia ; Genotype ; Heart Diseases ; Humans ; Hypertelorism ; Intellectual Disability ; Lentigo ; Noonan Syndrome ; Panthera ; Protein Kinases ; Puberty, Delayed ; Pulmonary Valve Stenosis ; Thorax

Segmental neurofibromatosis, a subtype of neurofibromatosis type 1, is characterized by neurofibromas and/or café-au-lait spots limited to an area or segment of the body. Checkerboard pattern is a rare type of cutaneous mosaic manifestation, characterized by squares or broad ribbons of affected skin with sharp demarcation at the midline. Herein, we report the case of a patient with bilateral segmental neurofibromatosis with lentiginosis showing a checkerboard pattern. Our patient had multiple hyperpigmented macules on her entire body in a checkerboard pattern since birth. Several café-au-lait patches were observed on the left buttock and right axilla. A neurofibroma was incidentally found beneath the café-au-lait patch by histological examination, which showed ill-defined spindle cells with elongated nuclei at the deep dermis that stained positive for S-100. Based on the clinical presentation and histopathologic results, the patient was diagnosed with bilateral segmental neurofibromatosis with lentiginosis showing a checkerboard pattern.
Axilla ; Body Patterning ; Buttocks ; Dermis ; Humans ; Lentigo ; Neurofibroma ; Neurofibromatoses ; Neurofibromatosis 1 ; Parturition ; Skin

No abstract available.
Acanthosis Nigricans ; Diabetes Mellitus

Adenocarcinoma of the cervix is less common than squamous cell carcinoma. Minimal deviation adenocarcinoma (adenoma malignum) is considered an extremely well-differentiated variant of GAS. An association exists between GAS and Peutz-Jeghers syndrome, which is a rare autosomal dominant disorder characterized by mucocutaneous pigmentation and multiple hamartomatous polyps in the gastrointestinal tracts. The incidence of GAS in patients with Peutz-Jeghers syndrome is estimated to be 11–17%. We present a rare case of adenoma malignum, diagnosed using colposcopic biopsy in a woman with Peutz-Jeghers syndrome, which was histopathologically confirmed to be GAS after surgery.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Adenoma ; Biopsy ; Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Gastrointestinal Tract ; Humans ; Incidence ; Mucins ; Peutz-Jeghers Syndrome ; Pigmentation ; Polyps ; Uterine Cervical Neoplasms