皮肤病学和皮肤病杂志

Dermoscopy has recorded continuous development in the past decades. Both global and individual features of dermoscopic morphology that play an role in identifying melanomas have enjoyed particular attention by researchers. Dermoscopy has gained an undoubted place in the detection of early melanomas. This paper is a review of data existent in literature that approach of dermoscopic morphology features of melanocytic pigmented skin lesions. This work highlights such situations where these features may be found in non-melanocytic pigmented skin lesions thus inducing confused diagnosis.

Pigmented squamous cell carcinoma is a rare neoplasm arising mostly in mucous membranes or in sun-exposed skin. We describe a case of this tumor in a 70 year-old man who presented with a pigmented ulcerated nodule on his lower back. Microscopic examination revealed a squamous cell carcinoma (SCC) with atypical proliferation of cells with individual cell keratisation and keratin pearls’ formation. Apart from the squamous cell carcinoma a population of cytologically bland dendritic melanocytes was also present, a process that has been described as tumor cell colonization. Differential diagnosis of pigmented SCC includes melanoma with pseudoepitheliomatous hyperplasia, pigmented metatypical basal cell carcinoma and squamomelanocytic tumor, a recently described combined tumor. A small number of cases of pigmented SCC have been referred in the literature mainly located in mucosal surfaces such as the oral and nasal cavity and the conjunctiva but also in sun-exposed cutaneous sites especially at the skin of the head. In the present study, a case of pigmented SCC arising in sun protected skin is described. The authors review the published literature and discuss the histologic differential diagnosis of pigmented SCC as well as the possible mechanisms of melanocytes’ colonization in pigmented non-melanocytic malignant neoplasms.

Objectives: To evaluate the efficacy of an oral supplement containing carotenoids as an adjunct to a topical cosmetic lightening cream for the treatment of melasma.

Methods: 44 subjects with melasma were recruited into a double-blinded, randomized, placebo controlled trial over 84 days at the Singapore National Skin Centre, to receive either an oral dietary supplement containing carotenoids or a placebo. All were prescribed a commercially available cream. Patients were assessed at onset, day 54 and day 84 by the Modified Melasma area and Severity Index (mMASI), photographic documentation, melanin and erythema indexes using a Mexameter®.

Results: 44 patients completed the study. The median mMASI score fell significantly in both groups (both p<0.001). There was a greater decrease seen in those who received the oral supplement group (-2.1 vs -1.8, p <0.379). The erythema score showed significant improvements in both groups, with greater improvement in the group on the oral supplement, compared to placebo (median difference = -30, p =0.018, vs median difference = -20, p =0.020). Conclusion: Oral supplements containing carotenoids are potential adjuncts in melasma treatment. 1.5 Limitations: Small sample size and short study duration limit the observations noted in this study. Further larger-scale studies are required.

Antioxidants are chemicals that can prevent oxidative stress or slow cell damage. Natural antioxidants are mainly found in fruits and vegetables, marine plants, and some seafood that eat marine plants. Most commonly used antioxidants in vitiligo are; vitamin C, vitamin E, ginkgo biloba, vitamin A, polypodium leucotomas extract, polyunsatured fatty acids, quercetin flavonoids, tea polyphenols, soy isoflavones, resveratrol, curcumin, capsaicin, gluthathione, alpha lipoic acid, phenylalanine, cucumis melo, minerals.

Acne has a complex multifactorial etiology. Inflammatory acne lesions often heal with sequelae. In skin of color the post acne healing phase often reflects post inflammatory hyperpigmentation which is very commonly seen. Though this hyperpigmentation is often transient and fades with time, in certain cases the life of pigmentary marks post acne is prolonged and is not conducive to therapy with topical agents and sunscreens alone. Chemical peels are often used an interventional therapy in dark- skinned individuals for treatment of post acne hyperpigmented marks. This article reviews efficacy, and complications of chemical peels on post acne hyperpigmented marks.

Neurofibromatosis type I (NF1), or Von Recklinghausen disease, is characterized by café-au-lait spots and neurofibromas of the skin, bone defects, iris hamartomas (Lisch nodules) and tumors in the central nervous system. The central giant cell lesion (CGCL) is a non-neoplastic entity, intra-osseous, radiolucent, uni or multilocular, well-defined edges, and it can change the position of the teeth, but rarely causes resorption of them. The association between CGCL and NF1 has been described in the literature. Patient C.R.P, 42 years old, female, who has NF1 attended the service presenting asymptomatic swelling in the anterior maxilla and discrete painless intraoral bulge in the anterior mandible with approximate evolution of one year. Incisional biopsy was performed, and the result was CGCL. The patient didn’t have hyperparathyroidism. Treatment consisted of curettage of the lesion and bone regularization performed three years ago, without signs of recurrence. The occurrence of CGCL in multiple locations is uncommon and it is usually associated with hyperparathyroidism, cherubism, and can be also found in syndromes such as: Ramon Jaffe Campanacci, Noonan-like and NF1. The patient presented four features of NF1 (multiple skin neurofibromas, caféau- lait spots, Lisch nodules and freckles in the armpits) and CGCL in two locations, which corroborate the existence of this association in the literature. The apparent relationship between NF1 and an increased incidence of CGCL s in the jaws could represent a coincidental association, genetic relationship, or susceptibility to developing CGCL in abnormal bone quality. In cases of multiple CGCL, the presence of hyperparathyroidism, cherubism and syndromes such as NF1, should be considered. One realizes the importance of investigation of systemic factors and clinical signs for performing differential diagnosis. The differentiation of these lesions in aggressive and nonaggressive should be done to improve individual treatment plan. Surgical curettage is acceptable for the treatment of non-aggressive CGCL.