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.

Humans ; Melanocytes ; Melanosis ; Fibroblasts ; Skin

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*

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

OBJECTIVE: To explore the therapeutic effect and mechanism of acupoint catgut embedding for chloasma in premenopausal women with liver stagnation. METHODS: A total of 92 patients of chloasma in premenopausal women with liver stagnation were randomized into an observation group and a control group, 46 cases in each one.In the observation group, acupoint catgut embedding was applied at Ganshu (BL 18), Pishu (BL 20), Sanyinjiao (SP 6), also the surrounding acupuncture was performed at facial part, once a week. In the control group, vitamin C (200 mg per time, 3 times a day) and vitamin E (100 mg per time, once a day) were prescribed for oral administration. Both of the two groups were given treatment for 12 weeks. The score of chloasma area and severity index (MASI), the serum levels of follicular stimulating hormone (FSH), leuteinizing hormone (LH) and estradiol (E) before and after treatment were observed in the two groups, and the clinical effect of the two groups were compared after 3 months of treatment. RESULTS: Finally, 44 cases in the observation group and 43 cases in the control group completed the study. The effective rate in the observation group was 88.6% (39/44), which was higher than 55.8% (24/43) in the control group (<0.01). Compared before treatment, the MASI scores after treatment were reduced in the two groups (<0.01, <0.05), the MASI score in follow-up in the observation group was reduced as compared with after treatment (<0.01), and the MASI scores after treatment and in follow-up in the observation group were lower than the control group (<0.01). Compared before treatment, the levels of FSH and LH in follow-up were reduced (<0.01), there was no significant difference between before treatment and in follow-up in the level of E in the observation group (>0.05). There was no significant difference between before treatment and in follow-up in the levels of FSH, LH and E in the control group (>0.05). In follow-up, the levels of FSH and LH in the observation group were lower than the control group (<0.01, <0.05), there was no significant difference in the level of E between the two groups (>0.05). CONCLUSION Acupoint catgut embedding can improve the clinical symptoms of chloasma in premenopausal women with liver stagnation, the mechanism may be related to regulate the serum level of sex hormone to reduce high sensitivity of melanocytes to estrogen.
Acupuncture Points ; Acupuncture Therapy ; Catgut ; Female ; Humans ; Liver ; Melanosis ; therapy ; Qi

OBJECTIVE: To screen for pathogenic variants in the coding regions of STK11 gene among Chinese patients with Peutz-Jeghers syndrome (PJS). METHODS: Peripheral blood samples were collected from 64 patients. The coding regions of the STK11 gene were detected by PCR and Sanger sequencing. RESULTS: Fourty-eight patients were found to harbor STK11 gene variants, which included 39 types of variants consisting of missense, nonsense, insertional, deletional and splice site variants. Among 64 PJS patients, the detection rate of point variants was 75.00% (48/64), of which missense variants accounted for 29.17% (14/48), nonsense variants accounted for 29.17%(14/48), insertion variants accounted for 2.08% (1/48), deletional variants accounted for 10.42% (5/48), and splice site variants accounted for 29.17% (14/48). The detection rates of sporadic cases and those with a family history were 71.8% (28/39) and 80.0% (20/25), respectively. Two variants (c.250A>T, c.580G>A) occurred in 3 PJS probands. Thirteen variants were unreported previously and were considered to be pathogenic. CONCLUSION The detection rate of variants among Chinese PJS patients is similar to that of other countries. A number of novel common variant sites were discovered, which enriched the spectrum of PJS-related variants.
Asian Continental Ancestry Group ; China ; DNA Mutational Analysis ; Humans ; Peutz-Jeghers Syndrome ; genetics ; Protein-Serine-Threonine Kinases ; genetics

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

No abstract available.
Cheek ; Melanosis ; Neck

We present 9-year-old fraternal twins from a family with piebaldism, having congenital depigmented macules and meeting the diagnostic criteria for neurofibromatosis type 1 (NF1) due to the multiple café-au-lait macules (CALMs) and intertriginous freckling at the same time. It's still a debatable issue that CALMs and intertriginous freckling may be seen in the clinical spectrum of piebaldism or these patients should be regarded as coexistence of piebaldism and NF1. However, based on recent literature and our patients' findings, we suggest that this rare phenotypic variant of piebaldism may not need the careful clinical follow-up and molecular testing for NF1. Besides, it may be suitable that these individuals with piebaldism showing NF1-like clinical phenotypes should be further tested for KIT and SPRED1 gene mutations.
Cafe-au-Lait Spots ; Child ; Follow-Up Studies ; Humans ; Melanosis ; Neurofibromatoses ; Neurofibromatosis 1 ; Phenotype ; Piebaldism ; Skin Diseases, Genetic ; Twins, Dizygotic

PURPOSE: Acanthosis nigricans (AN) is a hyperpigmented dermatosis associated with obesity and insulin resistance (IR). There is no consensus whether AN extension scoring offers added value to the clinical estimation of IR. In this study we aimed to assess and score AN using both a short and an extended version of the scale proposed by Burke et al. and analyze the relationships of both versions with hyperinsulinemia and IR. METHODS: We analyzed data from 139 overweight adolescents (body mass index ≥85th percentile) aged 12–18 with (n=67) or without (n=72) AN who were followed at a pediatric obesity clinic. RESULTS: Adolescents with AN had higher levels of insulin (d=0.56, P=0.003) and HOMA-IR (d=0.55, P=0.003) compared to those without. Neither the short nor the extended versions of AN scores explained either hyperinsulinemia (β=1.10, P=0.316; β=1.15, P=0.251) or IR (β=1.07, P=0.422; β=1.10, P=0.374). The presence of AN alone predicted hyperinsulinemia and the presence of IR in 7.3% (β=2.68, P=0.008) and 7.1% (β=2.59, P=0.009) of adolescents, respectively. CONCLUSIONS: Screening for AN at the neck and axilla is a noninvasive and cost-effective way to identify asymptomatic overweight adolescents with or at risk of developing IR.
Acanthosis Nigricans ; Adolescent ; Axilla ; Biomarkers ; Consensus ; Humans ; Hyperinsulinism ; Insulin Resistance ; Insulin ; Mass Screening ; Neck ; Obesity ; Overweight ; Pediatric Obesity ; Skin Diseases