The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Rashmi Sarkar - One of the best experts on this subject based on the ideXlab platform.
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Diffuse Hyperpigmentation: A comprehensive approach
Wolters Kluwer Medknow Publications, 2018Co-Authors: Anupama Ghosh, Anupam Das, Rashmi SarkarAbstract:Skin color is determined by melanin and other chromophores and is influenced by physical factors (ultraviolet radiation) and other endocrine, autocrine, and paracrine factors. Being the largest organ of the body, any aberration in skin color (Hyperpigmentation and hypopigmentation) can have impact on the patients’ quality of life. Hyperpigmentation may be circumscribed or diffuse. Diffuse Hyperpigmentation can be multifactorial in origin; hence, a multipronged approach is needed in such cases. First, the cause (systemic or cutaneous) needs to be ascertained, and then disease-specific management needs to be performed. The biggest challenge in such cases is to treat the Hyperpigmentation itself; hence, counseling and general treatment (the use of broad-spectrum sunscreen, the avoidance of sun exposure, etc.) play crucial role, and an interdisciplinary approach may be required, especially when the Hyperpigmentation is due to a systemic cause
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periorbital Hyperpigmentation a comprehensive review
The Journal of clinical and aesthetic dermatology, 2016Co-Authors: Rashmi Sarkar, Vijay K Garg, Rashmi Ranjan, Shilpa Garg, Sidharth Sonthalia, Shivani BansalAbstract:Periorbital Hyperpigmentation is a commonly encountered condition. There is very little scientific data available on the clinical profile and pathogenesis of periorbital Hyperpigmentation. Periorbital Hyperpigmentation is caused by various exogenous and endogenous factors. The causative factors include genetic or heredity, excessive pigmentation, postinflammatory Hyperpigmentation secondary to atopic and allergic contact dermatitis, periorbital edema, excessive vascularity, shadowing due to skin laxity and tear trough associated with aging. There are a number of treatment options available for periorbital Hyperpigmentation. Among the available alternatives to treat dark circles are topical depigmenting agents, such as hydroquinone, kojic acid, azelaic acid, and topical retinoic acid, and physical therapies, such as chemical peels, surgical corrections, and laser therapy, most of which are tried scientifically for melasma, another common condition of Hyperpigmentation that occurs on the face. The aim of treatment should be to identify and treat the primary cause of Hyperpigmentation as well as its contributing factors.
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Cosmeceuticals for Hyperpigmentation: What is Available?
Journal of Cutaneous and Aesthetic Surgery, 2013Co-Authors: Rashmi Sarkar, Pooja Arora, K Vijay GargAbstract:Cosmeceuticals are topical cosmetic-pharmaceutical hybrids that enhance the beauty through constituents that provide additional health-related benefit. Cosmeceuticals are commonly used for Hyperpigmentation. These disorders are generally difficult to treat, hence the need for skin lightening agents including, cosmeceuticals. These agents selectively target hyperplastic melanocytes and inhibit key regulatory steps in melanin synthesis. With the recent safety concern regarding use of hydroquinone, the need for alternative natural, safe and efficacious skin lightening agents is becoming all the more necessary and the article attempts to look at other alternative cosmeceuticals available or maybe upcoming in the future. We carried out a PUBMED search using the following terms cosmeceuticals, Hyperpigmentation, skin lightening agents. We cited the use of various agents used for the treatment of Hyperpigmentation, mainly melasma and post-inflammatory Hyperpigmentation. We describe the safety and efficacy of these agents and their advantage over the conventional therapy.
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glycolic acid peels versus salicylic mandelic acid peels in active acne vulgaris and post acne scarring and Hyperpigmentation a comparative study
Dermatologic Surgery, 2009Co-Authors: Vijay K Garg, Surabhi Sinha, Rashmi SarkarAbstract:BACKGROUND Many clinicians have used glycolic acid (GA) peels for facial acne, scarring, and Hyperpigmentation, mainly in lighter skin types. Salicylic-mandelic acid combination peels (SMPs) are a newer modality, and there have been no well-controlled studies comparing them with other conventional agents. OBJECTIVE To compare the therapeutic efficacy and tolerability of 35% GA peels and 20% salicylic-10% mandelic acid peels in active acne and post-acne scarring and Hyperpigmentation. METHODS AND MATERIALS Forty-four patients with facial acne and post-acne scarring and Hyperpigmentation were divided into two groups, with one receiving GA peels and the other SMPs at fortnightly intervals for six sessions. The treating physician performed objective evaluation of treatment outcomes. The patients, the treating physician, and an independent observer made subjective assessments. Side effects of both agents were also noted. RESULTS Both the agents were effective, but SMPs had a higher efficacy for most active acne lesions (p<.001) and Hyperpigmentation (p<.001). Side effects were also lesser with SMPs. CONCLUSION Both the agents were effective and safe in Indian patients, with SMPs being better for active acne and post-acne Hyperpigmentation.
Manal M Azzeh - One of the best experts on this subject based on the ideXlab platform.
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treatment of gingival Hyperpigmentation by erbium doped yttrium aluminum and garnet laser for esthetic purposes
Journal of Periodontology, 2007Co-Authors: Manal M AzzehAbstract:Background: The normal color of gingiva is pink. Gingival Hyperpigmentation is mostly caused by the physiologic deposition of melanin by melanocytes. In “gummy smile” patients, melanin gingival Hyperpigmentation causes an esthetic problem and may cause physiologic disturbances. Methods to remove gingival Hyperpigmentation vary, but it seems that the most reliable and satisfactory procedure is laser ablation.Methods: Six white patients (five females and one male), who complain of having dark-brown to black gingival Hyperpigmentation were included in the study. Three of them were smokers. Laser ablation was performed by an erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser (settings: 250 mJ, 15 Hz, with water and air and using the defocused mode) without using topical or local anesthesia. Each patient required about 20 to 25 minutes for completion of the procedure. After 4 days, another laser ablation (with the same previous settings) was performed to ensure good results. Patients were evaluated a mo...
Asad Ahmad - One of the best experts on this subject based on the ideXlab platform.
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minocycline induced Hyperpigmentation comparison of 3 q switched lasers to reverse its effects
Clinical Cosmetic and Investigational Dermatology, 2013Co-Authors: Mahrukh S Nisar, Karthik Iyer, Jenifer R Lloyd, Thuzar M Shin, Robert T. Brodell, Asad AhmadAbstract:Minocycline is a tetracycline derivative antibiotic commonly prescribed for acne, rosacea, and other inflammatory skin disorders. Minocycline turns black when oxidized, leading to discoloration of the skin, nails, bulbar conjunctiva, oral mucosa, teeth, bones, and thyroid gland. Hyperpigmentation has been reported after long-term minocycline therapy with at least 100 mg/day. Three types of minocycline-induced cutaneous Hyperpigmentation can result. Type I is the most common, and is associated with blue-black discoloration in areas of previous inflammation and scarring. Type II most commonly affects the legs and is characterized by blue-gray pigmentation of previously normal skin. Type III is the least common and is characterized by diffuse muddy-brown discoloration predominantly on sun exposed skin. Minocycline-induced Hyperpigmentation may be cosmetically disfiguring and prompt identification is essential. Without treatment, symptoms may take several months, to years to resolve, after discontinuation of the drug. However, the pigmentation may never completely disappear. In fact, there have been few reports of complete resolution associated with any therapeutic intervention. We report a case of a patient on long-term minocycline therapy utilized as an anti-inflammatory agent to control symptoms of rheumatoid arthritis, which led to minocycline-induced Hyperpigmentation of the face. To remove the blue-gray cutaneous deposits, 3 Q-switched lasers (Neodymium: yttrium aluminum garnet (Nd:YAG) 1064 nm, Alexandrite 755 nm, and Ruby 694 nm) were used in test areas. The Alexandrite 755 nm laser proved to provide effective clearing of the minocycline Hyperpigmentation requiring just 2 treatments, with minimal treatment discomfort and down time.
Neelam A. Vashi - One of the best experts on this subject based on the ideXlab platform.
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patterns of over the counter lightening agent use among patients with Hyperpigmentation disorders a united states based cohort study
The Journal of clinical and aesthetic dermatology, 2018Co-Authors: Dana Saade, Mayra B.c. Maymone, Eric A. Secemsky, Kevin F. Kennedy, Neelam A. VashiAbstract:Background: Over-the-counter (OTC) lightening agents are commonly used to treat Hyperpigmentation disorders. Objective: We sought to determine the characteristics, trends, and preferences of patients with Hyperpigmentation disorders seeking OTC agents in the United States. Design: The study was a cross-sectional study of consecutive patients with a disorder of Hyperpigmentation seen in a United States-based outpatient dermatology clinic. Multivariable logistic regression models were used to identify factors associated with the use of OTC lightening agents. Setting: The study setting was an outpatient US-based dermatology clinic in Boston, Massachusetts. Results: Of the 406 patients studied, the majority were women (88.9%) with Fitzpatrick Skin Types IV to VI (64.5%). The most frequent diagnoses were melasma (42.9%) and post-inflammatory Hyperpigmentation (PIH, 33.9%). Of our responders, 51.0 percent reported use of OTC agents and 44.9 percent reported use of prescription lightening products. Hydroquinone was the most commonly used cream (59.1%), followed by triple combination cream (fluocinolone acetonide, hydroquinone, and tretinoin, 16.3%). Of the cohort, 28.9 percent felt that the greater expense of the product correlated with greater efficacy. After multivariable adjustment, factors associated with a greater odds of using an OTC lightening agent included having a diagnosis of melasma (odds ratio [OR] 5.36; 95% CI: 2.98, 9.63; P<0.01) or PIH (OR 2.38; 95% CI: 1.25, 4.53; P≤0.01). Conclusion: The use of OTC lightening agents is widespread among those patients with Hyperpigmentation disorders who reside in the United States. Those with melasma and PIH were more likely to use an OTC lightening cream. The majority of patients believed that OTC creams were safe to use without physician supervision. In those who had also tried prescription products, triple combination was deemed most effective compared to other lightening agents.
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Sun-protective behaviors in patients with cutaneous Hyperpigmentation: A cross-sectional study.
Journal of the American Academy of Dermatology, 2017Co-Authors: Mayra B.c. Maymone, Hind H. Neamah, Stephen A. Wirya, Nicole M. Patzelt, Pedro Q. Zancanaro, Neelam A. VashiAbstract:Background Disorders of Hyperpigmentation are seen commonly in clinical practice. Despite numerous studies investigating sun-protective habits among healthy persons, little is known about these behaviors within patient populations with Hyperpigmentation disorders. Objective We sought to examine photo-protective behaviors and their associations in individuals with disorders of Hyperpigmentation. Methods This cross-sectional study was conducted with 404 adults who complained of cutaneous Hyperpigmentation. Results About 67.5% reported using a product containing sunscreen, and 91% endorsed using one with a sun protection factor of 21 or higher. Among the participants, 48.5% were not sure if their sunscreen provided broad-spectrum protection, and only 7.6% reapplied every 2 hours. The odds of a patient with melasma using sunscreen were 6.7 times the odds of a patient with postinflammatory Hyperpigmentation using sunscreen ( P P = .0004) and disease duration of ≥1 year (OR = 2.1, P = .003). In a multivariate analysis, the odds ratio of sunscreen use among African Americans compared to whites was 0.31 ( P = .008). Limitations Limitations included recall bias, question misinterpretation, and reporter bias. Conclusion Patients diagnosed with postinflammatory Hyperpigmentation, men, and those with disease duration
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facial Hyperpigmentation causes and treatment
British Journal of Dermatology, 2013Co-Authors: Neelam A. Vashi, Roopal V KunduAbstract:Summary By midcentury, the U.S.A. will be more ethnically and racially diverse. Skin of colour will soon constitute nearly one-half of the U.S. population, and a full understanding of skin conditions that affect this group is of great importance. Structural and functional differences in the skin, as well as the influence of cultural practices, produce variances in skin disease and presentation based on skin type. In the skin of colour population, dyschromia is a growing concern, and a top chief complaint when patients present to the physician. A thorough understanding of the aetiology and management strategies of facial Hyperpigmentation is of importance in caring for those afflicted and also in the development of new therapies.
Harutsugu Sodeyama - One of the best experts on this subject based on the ideXlab platform.
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familial gastrointestinal stromal tumor with Hyperpigmentation association with a germline mutation of the c kit gene
Gastroenterology, 2001Co-Authors: Hironobu Maeyama, Eiko Hidaka, Hiroyoshi Ota, Satoshi Minami, Masashi Kajiyama, Akira Kuraishi, Hiromitsu Mori, Yoshiaki Matsuda, Shuichi Wada, Harutsugu SodeyamaAbstract:Abstract We describe 2 siblings with multiple gastrointestinal stromal tumors (GISTs) and cutaneous Hyperpigmentation. Both had a point mutation of the c-kit gene. The patients were sisters who had exhibited cutaneous Hyperpigmentation since their late teens, but the diagnosis of multiple gastrointestinal submucosal tumors was not made until they were 41 and 45 years old. Histologic examination showed that these tumors were GISTs expressing CD34 and Kit protein. Both patients died of GISTs. Single-strand conformation polymorphism analysis showed a mutation of c-kit in tumor DNA extracted from paraffin-embedded specimens. Direct sequencing analysis showed that the point mutation occurred at codon 559 of exon 11 (Val→Ala). The same single-point mutation was detected in DNA extracted from peripheral leukocytes obtained from the younger sister and her 2 children (who had similar general Hyperpigmentation) as well as in DNA from a skin biopsy specimen taken from the older sister. The germline mutation at codon 559 of the c-kit gene found in the present familial GISTs differed from that in a previously reported case of familial GISTs. We propose that GISTs caused by a germline mutation of the c-kit gene should be referred to as GIST–cutaneous Hyperpigmentation disease. GASTROENTEROLOGY 2001;120:210-215
