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Pigmented Lesions (pigmented + lesion)

Distribution by Scientific Domains

Medical Sciences	92%

Selected Abstracts

I. Biopsy Techniques for Pigmented Lesions

DERMATOLOGIC SURGERY, Issue 1 2000
Jean L. Bolognia MD
[source]

Production of Melanocyte-Specific Antibodies to Human Melanosomal Proteins: Expression Patterns in Normal Human Skin and in Cutaneous Pigmented Lesions

PIGMENT CELL & MELANOMA RESEARCH, Issue 4 2001
Victoria Virador
Multiple factors affect skin pigmentation, including those that regulate melanocyte and/or keratinocyte function. Such factors, particularly those that operate at the level of the melanosome, are relatively well characterized in mice, but the expression and function of structural and enzymatic proteins in melanocytes in human skin are not as well known. Some years ago, we generated peptide-specific antibodies to murine melanosomal proteins that proved to be instrumental in elucidating melanocyte development and differentiation in mice, but cross-reactivity of those antibodies with the corresponding human proteins often was weak or absent. In an effort to characterize the roles of melanosomal proteins in human skin pigmentation, and to understand the underlying mechanism(s) of abnormal skin pigmentation, we have now generated polyclonal antibodies against the human melanocyte-specific markers, tyrosinase, tyrosinase-related protein 1 (TYRP1), Dopachrome tautomerase (DCT) and Pmel17 (SILV, also known as GP100). We used these antibodies to determine the distribution and function of melanosomal proteins in normal human skin (adult and newborn) and in various cutaneous pigmented lesions, such as intradermal nevi, lentigo simplex, solar lentigines and malignant melanomas. We also examined cytokeratin expression in these same samples to assess keratinocyte distribution and function. Immunohistochemical staining reveals distinct patterns of melanocyte distribution and function in normal skin and in various types of cutaneous pigmented lesions. Those differences in the expression patterns of melanocyte markers provide important clues to the roles of melanocytes in normal and in disrupted skin pigmentation. [source]

Delineating melanoma using multimodal polarized light imaging

LASERS IN SURGERY AND MEDICINE, Issue 1 2009
Zeina Tannous
Abstract Background and Significance Melanoma accounts for 3% of all skin cancers but causes 83% of skin cancer deaths. The first step in treatment of melanoma is the removal of the lesions, usually by surgical excision. Currently most lesions are removed without intraoperative margin control. Post-operative methods inspect 1,2% of the surgical margin and are prone to sampling errors. In this study we evaluate the use of reflectance and fluorescence polarization imaging for the demarcation of melanoma in thick fresh skin excisions. Materials and Methods Pigmented lesions clinically suspicious for melanoma were elliptically excised with proper margins. Elliptical surgical excisions were vertically bisected along the short axis of the specimen into two halves in the middle of the pigmented lesions. The vertically bisected tumor face was imaged. After that, one half of the sample was briefly stained in aqueous 2 mg/ml solution of tetracycline, whereas another half was stained in 0.2 mg/ml aqueous solution of methylene blue. Then both specimens were reimaged. Reflectance images were acquired in the spectral range between 390 and 750 nm. Fluorescence images of the tetracycline-stained tissue were excited at 390 nm and registered between 450 and 700 nm. Fluorescence of the methylene blue-stained samples was excited at 630 nm and registered between 650 and 750 nm. After imaging, the tissue was processed for standard H&E histopathology. The resulting histological and optical images were compared to each other. Results and Conclusions Our findings demonstrate that both tetracycline and methylene blue are suitable for imaging dysplastic and benign nevi. Melanoma is better delineated in the samples stained in methylene blue. Accurate and rapid delineation of melanoma in standard fresh surgical excisions appears feasible. Lasers Surg. Med. 41:10,16, 2009. © 2008 Wiley-Liss, Inc. [source]

Dermoscopic pattern of intermediate stage in seborrhoeic keratosis regressing to lichenoid keratosis: report of 24 cases

BRITISH JOURNAL OF DERMATOLOGY, Issue 2 2007
P. Zaballos
Summary Background, Lichenoid keratosis (LK) is a well-described entity which has been proposed to represent an immunological or regressive response to pre-existing epidermal lesions such as solar lentigines or seborrhoeic keratoses. Objectives, To evaluate the dermoscopic criteria of a series of cases of LK with remaining areas of seborrhoeic keratosis which were both dermoscopically and histologically diagnosed. Methods, Pigmented lesions with dermoscopic areas of seborrhoeic keratosis and LK in the same tumour were consecutively diagnosed and prospectively included in the study. All pigmented lesions were examined and registered using DermLite Foto equipment (3Gen, LLC, Dana Point, CA, U.S.A.), at 10-fold magnification, at the Dermatology Department of Hospital de Sant Pau i Santa Tecla (Tarragona, Spain), between 1 January 2003 and 31 December 2005. Results, In total, 24 cases of lesions with dermoscopic areas of seborrhoeic keratosis and LK were collected. In four lesions (17%), the clinical differential diagnosis without dermoscopy included malignant melanoma and in seven lesions (29%), basal cell carcinoma. The diagnosis of LK was clinically considered without dermoscopy in only six cases (25%). A granular pattern was observed to be distributed throughout the LK areas of the lesions. This pattern consisted of the presence of brownish-grey, bluish-grey or whitish-grey coarse granules that formed, in 11 cases (46%), globules and/or short lines. In one lesion, located on the face, these short lines produced annular or rhomboid structures as seen in lentigo maligna melanoma. Conclusions, Dermoscopy is a useful tool which assists in the correct clinical recognition of LK, which may also potentially illuminate the pathogenesis of these tumours, showing the intermediate stage of regressing epidermal lesions in an LK. [source]

Giant Melanoma Displaying Gross Features Reproducing Parameters Seen on Dermoscopy

DERMATOLOGIC SURGERY, Issue 7 2002
Vincenzo De Giorgi MD
background. The basis of dermoscopy is the strict relationship between dermoscopic features and histology of pigmented skin lesions. methods. When observed under dermoscopy, a pigmented lesion displays a series of features which enable an experienced clinician to classify the lesion with higher accuracy than that expected by visual inspection alone. results. We have observed a peculiar case of a giant cutaneous melanoma occurring on the abdomen of a 45-year-old woman, displaying clinical features strictly resembling those of melanoma under dermoscopy. discussion. The interest of this case is actually purely morphologic, showing for the first time, depending on the extraordinary growth of the lesion, the appearance of gross features strictly reproducing those microscopically found under dermoscopy in smaller lesions. [source]

Childhood melanoma: update and treatment

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 9 2005
Phung M. Huynh MD
Childhood melanoma is a rare but potentially fatal disease that is important to include in the differential diagnosis of any pigmented lesion in a child. The best prognosis is achieved with early diagnosis and definitive surgical excision. Adjuvant chemotherapy and immunotherapy are options for those with more advanced tumors. Melanoma in children must be treated as aggressively as in adults because childhood melanoma may be equally devastating. [source]

CD34+ Pigmented Fibrous Proliferations: The Morphologic Overlap Between Pigmented Dermatofibromas and Bednar Tumors

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005
J. Chu McAllister
Pigmented dermatofibrosarcoma protuberans (Bednar tumor) constitute 5,10% of all cases of dermatofibrosarcoma protuberans, and are usually considered mimics of melanocytic proliferations rather than fibrous lesions. We report two cases of pigmented fibrous proliferations that demonstrate features of both dermatofibromas and DFSP. The first case is a 19-year-old man with a three year history of a slowly growing pigmented lesion on the right arm. On clinical exam the lesion was a 7 mm firm pigmented papulonodular lesion. The second case is a 31-year-old woman with a 4,5 year history of a slowly enlarging, asymptomatic ,dark area' on the right buttock. On clinical exam the lesion is a 2 cm darkly pigmented flat nodule. Morphologically both lesions are primarily dermal proliferations of spindled cells admixed with pigmented dendritic melanocytes. The lesional cells trap collagen fibers at the periphery and there is basal cell hyperpigmentation. Adnexal structures are effaced but significant trapping of subcutaneous fat is not present. By immunohistochemistry both lesions show focal CD34 positivity but are negative for Factor XIIIa and melanocytic markers. Although overlap between dermatofibromas and DFSP is well documented in the literature, pigmented fibrous lesions with features of both entities are not well described. [source]

Esophageal anthracosis: Lesion mimicking malignant melanoma

PATHOLOGY INTERNATIONAL, Issue 7 2002
Tetsuya Murata
A case of anthracosis of the esophagus is reported. The patient was a previously healthy 69-year-old Japanese woman. A black and slightly elevated lesion was detected in her esophagus by upper gastroesophageal fiberoscopic examination. Endoscopically, the lesion looked like malignant melanoma. Thoracic esophagotomy was then performed. Histological examination revealed a pigmented lesion beneath the mucosal epithelial layer. The lesion consisted of an aggregation of histiocytes containing an abundance of tiny black pigments. A few mature lymphocytes and plasma cells were also evident in the periphery of the lesion. Histologically, these findings looked like lymph nodes in the pulmonary hilus; however, no lymph nodal structure was evident in the esophageal wall. Traction diverticula were also noted in the pigmented lesion. The patient has remained well without disease for 9 months since the surgery. Although anthracosis is a rare condition in the esophagus, the present case gave warning to pathologists and clinicians that it does indeed occur. Endoscopists and pathologists should differentiate anthracosis from malignant melanoma because the treatment and outcome are quite different for each. [source]

Malignant Melanoma on the Sole: How to Detect the Early Lesions Efficiently

PIGMENT CELL & MELANOMA RESEARCH, Issue 2000
TOSHIAKI SAIDA
Early detection of malignant melanoma (MM) is essential to improve the prognosis. In non-white populations, including Japanese, the sole is the most prevalent site of MM. On the sole, however, melanocytic nevus is also frequently found. Clinical differentiation of early MM from benign melanocytic nevus on the sole is sometimes difficult because both are observed as a brownish-black macule. For the effective early detection of MM on the sole, the author has proposed guidelines based on the data of hundreds of melanocytic lesions on the sole. The algorithmic guidelines are as follows: when you see a pigmented lesion on the sole, first exclude congenital melanocytic nevus and some other specified disorders, and then measure the maximum diameter of the lesion. If it is more than 7 mm, biopsy it for histopathologic evaluation. If it is 7 mm or less, just follow the course of the lesion and advise the patient to come back if it enlarges to more than 7 mm. Even when the lesion is 7 mm or less, a biopsy is recommended on it, if it shows marked irregularity in shape and/or color or it shows the parallel ridge pattern with epiluminescence microscopy (ELM). The author believes the guidelines surely work efficiently in screening early MM on the sole. [source]

Trichilemmal cyst with homogeneous blue pigmentation on dermoscopy

AUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 4 2009
Gulsum Gencoglan
ABSTRACT A 61-year-old woman was referred to our dermoscopy unit for a pigmented lesion that had been present on her left arm for 8 years. The patient did not notice any enlargement or change in colour. On dermoscopy, homogeneous blue pigmentation was seen. The lesion was excised with the pre-operative diagnosis of melanoma, blue naevus and dermatofibroma. Histopathological examination showed a trichilemmal cyst in the mid-dermis. Although homogeneous blue pigmentation on dermoscopy is the hallmark of blue naevus, it may be seen in metastatic melanoma and exceptionally in hemosiderotic and cellular types of dermatofibroma. Trichilemmal cyst should be borne in mind also in the dermoscopic differential diagnosis. [source]

Cutaneous collision tumour (melanocytic naevus, basal cell carcinoma, seborrhoeic keratosis): a clinical, dermoscopic and pathological case report

BRITISH JOURNAL OF DERMATOLOGY, Issue 4 2005
V. De Giorgi
Summary The association of contiguous or ,collision' tumours in the same biopsy specimen is not uncommon and is often reported in the literature. The most common association, basal cell carcinoma (BCC) and naevus, is very difficult to diagnose clinically. We describe a 38-year-old woman with a previous history of melanoma, who presented with a modified pigmented lesion of the hip that had begun to change 6 months earlier. Histologically, the lesion was a melanocytic compound naevus and a BCC with a seborrhoeic keratosis. The case was investigated clinically and by focusing on the dermoscopic features and their pathological correlates. Cutaneous collision tumours are extremely difficult to diagnose preoperatively, even with the help of dermoscopy, in particular when one of the lesions is melanocytic. [source]

One-year follow-up of a lentigo maligna: first dermoscopic signs of growth

BRITISH JOURNAL OF DERMATOLOGY, Issue 5 2004
R. Schiffner
Summary We report a 64-year-old man with a pigmented lesion on his forehead, initially thought to be actinic lentigo. At follow-up 1 year later the lesion had increased in size and showed new areas of pigmentation. Dermoscopic observation and biopsy led to a diagnosis of lentigo maligna and the lesion was excised. The dermoscopic features indicative of early growth of lentigo maligna are identified and discussed. [source]

A clinically challenging pigmented lesion on the scalp

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 4 2010
R. Morris-Jones
No abstract is available for this article. [source]

Non-contiguous recurrence or secondary choroidal melanoma following plaque radiotherapy

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 7 2007
Mauricio Maia MD
Abstract Non-contiguous local recurrence of posterior uveal melanoma occurs rarely after plaque therapy. A 50-year-old white first presented with choroidal melanoma. He underwent therapy with episcleral iodine-125 radioactive plaque therapy. Nine years later fundus evaluation revealed a new pigmented lesion in the inferotemporal equatorial area. Patient was considered to have a non-contiguous recurrent melanoma and the eye was enucleated. Histologic microscopic examination disclosed a 3 × 1.8 mm densely pigmented tumour internal to the choroid at the equator. The tumour was composed of large round cells with round nuclei, prominent nucleoli, abundant cytoplasm and spindle-shaped cells with spindle-shaped nuclei and prominent nucleoli. The tumour extended through the retina. The superior nasal area of plaque therapy had extensive chorioretinal atrophy with loss of retinal pigment epithelium, thinning of the retina and thinning and depigmentation of the choroids. Within this area of atrophy, there was a pigmented lesion composed by densely packed, spindle-shaped cells with spindle-shaped nuclei. Our patient illustrated non-contiguous recurrence of choroidal melanoma, such finding raises concerns about physiopathology and treatment of choroidal melanoma. [source]

Frequency of Seborrheic Keratosis Biopsies in the United States: A Benchmark of Skin Lesion Care Quality and Cost Effectiveness

DERMATOLOGIC SURGERY, Issue 8 2003
Maria I. Duque MD
Background. Most seborrheic keratoses may be readily clinically differentiated from skin cancer, but occasional lesions resemble atypical melanocytic neoplasms. Objective. To evaluate the frequency, cost, and intensity of procedures performed that result in the removal and histopathologic evaluation of seborrheic keratoses. Methods. Episodes of surgical removal of lesions that were identified as seborrheic keratoses by histologic identification were determined using Medicare Current Beneficiary Survey data from 1998 to 1999. These episodes were defined by a histopathology procedure code that is associated with a diagnosis code for seborrheic keratosis. We then identified what procedure(s) generated the histopathology specimen. Biopsy and shave procedures were considered "low intensity," whereas excision and repair procedures were considered "high intensity." Results. Dermatologists managed 85% of all episodes of seborrheic keratoses. Dermatologists managed 89% of seborrheic keratosis episodes using low-intensity procedures compared with 51% by other specialties. For nondermatologists, 46% of the treatment cost ($9 million) to Medicare was generated from high-intensity management compared with 15% by dermatologists ($6 million). Conclusion. There is a significant difference in the management of suspicious pigmented lesions between dermatologists and other specialists. This affects both the cost and quality of care. [source]

Oral Isotretinoin as Part of the Treatment of Cutaneous Aging

DERMATOLOGIC SURGERY, Issue 7 2000
Enrique Hernandez-Perez MD
Background. A number of drugs have been used to prevent aging changes. However, studies of oral isotretinoin, the commonly used acne drug, as an antiaging drug are lacking. Objective. To determine improvement in cutaneous aging utilizing oral isotretinoin combined with different procedures of facial rejuvenation. Methods. Sixty patients ranging in age from 35 to 65 years, in whom additional modalities of rejuvenation were also used, were randomly assigned to receive treatment with oral isotretinoin (10,20 mg three times a week for 2 months, group A). Their results were compared with 60 patients who had undergone the same surgical procedures but with no oral isotretinoin (group B). Results. All patients treated with oral isotretinoin noted improvement in wrinkles, thickness and color of the skin, size of pores, skin elasticity, tone, and reduction in pigmented lesions and mottled hyperpigmentation. A statistically significant difference was found in the improvement of group A (Wilcoxon test <0.01). Using minimal amounts of this drug, the side effects were practically negligible. Conclusion. Utilizing various procedures with oral isotretinoin allowed us to improve the effects of cutaneous aging. Our results using isotretinoin in these cases have been satisfactory. We believe that this is one of the first reports of the use of oral isotretinoin in intrinsic and photoaged skin. [source]

Melanin-associated pigmented lesions of the oral mucosa: presentation, differential diagnosis, and treatment

DERMATOLOGIC THERAPY, Issue 3 2010
Susan Müller
ABSTRACT Intraoral pigmentation is quite common and has numerous etiologies, ranging from exogenous to physiological to neoplastic. Many pigmented lesions of the oral cavity are associated with melanin pigment. The differential diagnosis of mucosal pigmented lesions includes hematomas, varices, and petechiae which may appear to be pigmented. Unlike cutaneous melanomas, oral melanomas are diagnosed late and have a poor prognosis regardless of depth of invasion. As such, the clinical presentation and treatment of intraoral melanoma will be discussed. Developing a differential diagnosis is imperative for a clinician faced with these lesions in order to appropriately treat the patient. This article will focus on the most common oral melanocytic lesions, along with mimics. [source]

Treatment of melanocytic nevi

DERMATOLOGIC THERAPY, Issue 3 2005
Harue Suzuki
ABSTRACT:, Pigmented nevi are a heterogeneous group of lesions that range from uniquely curable with laser treatment, to partially responsive, to unresponsive or dangerous. This article presents laser and IPL treatment strategies from a clinical perspective for nevi organized by their typical responsiveness. A rationale for surgical excision, laser, and/or medical therapy in individual patients is also presented. Despite significant recent progress, it is clear that much understanding are still lacking about optimal laser treatment for pigmented lesions. [source]

Efficacy of skin self-examination for the early detection of melanoma

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2 2010
Reyhaneh Hamidi BA
The National Cancer Institute's "Melanoma Action Plan" calls for reduction of melanoma mortality through early detection. Routine skin self-examination (SSE) has the potential to increase chances of early detection and treatment and may be the key to melanoma survival. We provide a focused review of the accuracy of SSE for detecting premalignant lesions and cutaneous risk factors for melanoma, with suggestions for future directions for enhancing measurement of SSE accuracy and ways in which to improve the public's perceptions of melanoma efficacy. We examined published data on the efficacy of skin self-examination for the early detection of melanoma. We searched the MEDLINE database for publications between January 1, 1987 and June 1, 2007 using search terms for "melanoma" and "self-examination." We found that sensitivity of skin self-examination is low, ranging from 25% to 93%, while specificity is generally higher (83% to 97%). Attempts to increase improve the lay public's perceptions of the early signs of melanoma have proved effective, while those aimed at increasing accuracy of SSE with targeted interventions have been moderately successful. SSE's insensitivity for detection of pigmented lesions should prompt further investigation of educational interventions to enhance its accuracy and lead to its adoption as a cheap, simple screening tool. Assessment of the accuracy and efficacy of SSE should proceed using standardized definitions and measurements such that it is easier to pool data on the overall value of SSE as a screening modality. [source]

Legal considerations in cosmetic laser surgery

JOURNAL OF COSMETIC DERMATOLOGY, Issue 2 2006
David J Goldberg MD
Summary Cosmetic laser surgery is a continuously evolving field of medicine. According to the American Society for Dermatologic Surgery, over 100 million laser and light source cosmetic procedures were performed by its members. Procedures including hair removal, nonablative treatments, as well as removal of pigmented lesions, tattoos, and unwanted vascular lesions have revolutionized this field. With an increasing number of physicians and nonphysicians performing these procedures, and with the availability of increasingly powerful laser technologies, the potential for problems and their legal consequences continue to increase. This chapter will deal with the concept of negligence and the potential for a resultant medical malpractice that may arise in such a setting. An understanding of the basic principles of a cause of action in medical malpractice will likely protect a physician from losing such a case in a court of law. [source]

Prevalence of oral mucosal lesions in elderly people in Santiago, Chile

JOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 10 2003
I. Espinoza
Abstract Background:, Oral prevalence studies are important to know the state of health and the needs of treatment. Our aim was to determine the prevalence of oral mucosal lesions and associated factors among aging Chileans. Methods:, A random sample by age, gender, and socioeconomic status was obtained, comprising 889 individuals older than 65 years. Individuals were interviewed and examined in Santiago, the capital of Chile, according to the World Health Organization guidelines. Results:, The prevalence of one or more oral mucosal lesions in the sample was 53%. Logistic regression model revealed that denture use increased the probability of one or more oral mucosal lesions by threefold, while age, gender, smoking, medication use, xerostomia, and social or cultural factors had no effect. The most common lesion was denture stomatitis (22.3%), followed by irritative hyperplasia (9.4%), oral mucosal varicosities (9%), solitary pigmented lesions (4%), traumatic ulcer (3.5%), angular cheilitis (2.9%), multiple pigmented lesions (2.8%), hemangioma (2.3%), lichen planus (2.1%), leukoplakia (1.7%), recurrent aphthous stomatitis (1.4%), nicotine stomatitis (1.3%), median rhomboid glossitis (0.9%), actinic cheilitis (0.9%), pyogenic granuloma (0.7%), oral squamous papiloma (0.6%), and mucocele (0.2%). One case of oral cancer was observed. Different factors increased the probability of specific oral mucosal pathologies. Conclusions:, We can conclude that oral mucosal lesions are common in elderly people in Santiago, suggesting the necessity for improved standards of prevention, and diagnostic and opportune treatment of these lesions. [source]

Paradoxical postoperative hyperpigmentation from Q-switched YAG laser treatment of pigmented lesions in children with fair skin types

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 7 2009
LW Idorn
[source]

The prevalence of melanocytic naevi among schoolchildren in South Hungary

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 12 2008
Z Csoma
Abstract Background, Malignant melanoma is an increasing public health problem worldwide; accordingly, identification of the constitutional and environmental factors which contribute to the development of the disease, and hence identification of the individuals at high risk of melanoma, is an indispensable step in all primary prevention efforts. Objectives, This paper aims to assess the prevalence of different pigmented lesions among schoolchildren and to investigate their relationship with phenotypic pigmentary characteristics, sun exposure and other factors. Patients/methods, A cross-sectional study was performed in two secondary schools in Szeged, Hungary. A total of 1320 schoolchildren, aged 14 to 18 years, underwent a whole-body skin examination. A standardized questionnaire was used to collect data on phenotypic, sun exposure and other variables. Results, One to 10 common melanocytic naevi were found in 27% of the participants, and the naevus numbers were in the range of 10,100 in 67%; 5.4% of them had more than 100 common melanocytic naevi. The prevalence of clinically atypical naevi was 24.3%. Statistically significant associations were found between the number of pigmented lesions and gender, hair colour, eye colour, skin phototype, a history of severe painful sunburns and a family history of a large number of melanocytic naevi. Conclusion, Our study population displayed a markedly high prevalence of clinically atypical melanocytic naevi. Moreover, a considerable proportion of the investigated individuals had multiple common melanocytic naevi. Since the presence of a large number of melanocytic naevi is a strong predictor for future melanoma development, health educational programmes on melanoma prevention should be aimed at young age groups. [source]

Intense pulsed light (IPL): A review

LASERS IN SURGERY AND MEDICINE, Issue 2 2010
Philipp Babilas MD
Abstract Background Intense pulsed light (IPL) devices use flashlamps and bandpass filters to emit polychromatic incoherent high-intensity pulsed light of determined wavelength spectrum, fluence, and pulse duration. Similar to lasers, the basic principle of IPL devices is a more or less selective thermal damage of the target. The combination of prescribed wavelengths, fluences, pulse durations, and pulse intervals facilitates the treatment of a wide spectrum of skin conditions. Objective To summarize the physics of IPL, to provide guidance for the practical use of IPL devices, and to discuss the current literature on IPL in the treatment of unwanted hair growth, vascular lesions, pigmented lesions, acne vulgaris, and photodamaged skin and as a light source for PDT and skin rejuvenation. Methods A systematic search of several electronic databases, including Medline and PubMed and the authors experience on intense pulsed light. Results Numerous trials show the effectiveness and compatibility of IPL devices. Conclusion Most comparative trials attest IPLs similar effectiveness to lasers (level of evidence: 2b to 4, depending on the indication). However, large controlled and blinded comparative trials with an extended follow-up period are necessary. Lasers Surg. Med. 42:93,104, 2010. © 2009 Wiley-Liss, Inc. [source]

Delineating melanoma using multimodal polarized light imaging

Production of Melanocyte-Specific Antibodies to Human Melanosomal Proteins: Expression Patterns in Normal Human Skin and in Cutaneous Pigmented Lesions

Six novel mutations of the ADAR1 gene in patients with dyschromatosis symmetrica hereditaria: Histological observation and comparison of genotypes and clinical phenotypes

THE JOURNAL OF DERMATOLOGY, Issue 7 2008
Taisuke KONDO
ABSTRACT Dyschromatosis symmetrica hereditaria (DSH), is a pigmentary genodermatosis of autosomal dominant inheritance. Since we clarified that the disease is caused by a mutation of the adenosine deaminase acting on the RNA 1 gene (ADAR1) in 2003, the molecular pathogenesis of a peculiar clinical feature of the disease has been expected to be clarified. We examined five familial cases and one sporadic case of Japanese families with DSH. The mutation analyses were done with single-strand conformation polymorphism/heteroduplex (SSCP/HD) analysis and direct sequencing of ADAR1. The DNA analysis of each patient revealed one missense mutation (p.F1091S), two nonsense mutations (p.C893X, p.S581X) and three frame-shift mutations (p.E498fsX517, p.F1091fsX1092, p.L855fsX856). Visual and electron microscopic findings showed abundant melanin pigment deposited all over the basal layer, and enlarged melanocytes with long dendrites located in the pigmented lesions with small or immature melanosomes scattered sparsely in the cytoplasm, but in the adjacent keratinocytes many small melanosomes were singly dispersed or aggregated. The hypopigmented areas showed little melanin deposition and reduced numbers of melanocytes in which much degenerative cytoplasmic vacuole formation could be observed by electron microscopy. Herein, we report six cases of DSH with six novel mutations. The variety of their clinical phenotypes even in the pedigree may suggest the presence of factors other than the ADAR1 gene influencing the extent of the clinical skin lesion. Microscopic findings suggest that the clinical appearance must have developed directly by melanocyte variations mainly induced by the ADAR1 gene mutations. [source]

Treatment of pigmented lesions of neurofibromatosis 1 with intense pulsed,radio frequency in combination with topical application of vitamin D3 ointment

THE JOURNAL OF DERMATOLOGY, Issue 4 2007
Yuichi YOSHIDA
ABSTRACT Cafe-au-lait spots and pigmented freckling are found in most of patients with neurofibromatosis 1 (NF1). Although many modalities have been used for treating the pigmented lesions, the response to treatment has been variable. Therefore, we performed the treatment of pigmented lesions with NF1 by intense pulsed,radio frequency (IPL,RF) in combination with topical application of vitamin D3 ointment. Eight patients were treated in this study and the improvement was moderate to good in six cases (75%) although the response was relatively mild. Thus, results from our study indicate that IPL,RF irradiation in combination with topical application of vitamin D3 ointment would be useful as new modalities, especially for treatment of numerous small pigmented lesions in patients with NF1. Although further studies with large groups of patients should be performed for a better conclusion, it could improve quality of life with NF1 patients who are concerned with serious cosmetic and social problems. [source]

Dermoscopy of pigmented lesions on mucocutaneous junction and mucous membrane

BRITISH JOURNAL OF DERMATOLOGY, Issue 6 2009
J. Lin
Summary Background, The dermoscopic features of pigmented lesions on the mucocutaneous junction and mucous membrane are different from those on hairy skin. Differentiation between benign lesions and malignant melanomas of these sites is often difficult. Objective, To define the dermoscopic patterns of lesions on the mucocutaneous junction and mucous membrane, and assess the applicability of standard dermoscopic algorithms to these lesions. Patients and methods, An unselected consecutive series of 40 lesions on the mucocutaneous junction and mucous membrane was studied. All the lesions were imaged using dermoscopy devices, analysed for dermoscopic patterns and scored with algorithms including the ABCD rule, Menzies method, 7-point checklist, 3-point checklist and the CASH algorithm. Results, Benign pigmented lesions of the mucocutaneous junction and mucous membrane frequently presented a dotted-globular pattern (25%), a homogeneous pattern (25%), a fish scale-like pattern (18·8%) and a hyphal pattern (18·8%), while melanomas of these sites showed a multicomponent pattern (75%) and a homogeneous pattern (25%). The fish scale-like pattern and hyphal pattern were considered to be variants of the ring-like pattern. The sensitivities of the ABCD rule, Menzies method, 7-point checklist, 3-point checklist and CASH algorithm in diagnosing mucosal melanomas were 100%, 100%, 63%, 88% and 100%; and the specificities were 100%, 94%, 100%, 94% and 100%, respectively. Conclusion, The ring-like pattern and its variants (fish scale-like pattern and hyphal pattern) are frequently observed as well as the dotted-globular pattern and homogeneous pattern in mucosal melanotic macules. The algorithms for pigmented lesions on hairy skin also apply to those on the mucocutaneous junction and mucous membrane with high sensitivity and specificity. [source]