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Indian Dermatology Online Journal 2023Melasma is an acquired disorder, which presents with well-demarcated, brown-colored hyperpigmented macules, commonly involving the sun-exposed areas such as the face. It... (Review)
Review
INTRODUCTION
Melasma is an acquired disorder, which presents with well-demarcated, brown-colored hyperpigmented macules, commonly involving the sun-exposed areas such as the face. It is a chronic and distressing condition, affecting the patients' quality of life, and has been conventionally treated with "first-line" agents including hydroquinone (HQ) alone or as a part of a triple combination cream (TCC), while "second-line" options include chemical peels, and third line options include laser therapy.
MATERIALS AND METHODS
A systematic search was performed for all topical and systemic treatments for melasma up till May 4, 2021, using the PubMed and EMBASE databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The search terms "melasma" and "treatment" were used to search for the relevant articles on both these databases, and a total of 4020 articles were identified. After removing the duplicate entries and screening the titles, abstracts, and full-text articles, we identified 174 randomized controlled trials (RCTs) or controlled clinical trials.
RESULTS
Based on our review, HQ, TCCs, sunscreens, kojic acid (KA), and azelaic acid receive grade A recommendation. Further large-scale studies are required to clearly establish the efficacy of topical vitamin C, resorcinol, and topical tranexamic acid (TXA). Several newer topical agents may play a role only as an add-on or second-line drugs or as maintenance therapy. Oral TXA has a strong recommendation, provided there are no contraindications. Procyanidins, Polypodium leucotomos (PL), and even synbiotics may be taken as adjuncts.
DISCUSSION
Several newer topical and systemic agents with multimodal mechanisms of action have now become available, and the balance seems to be tipping in favor of these innovative modalities. However, it is worth mentioning that the choice of agent should be individualized and subject to availability in a particular country.
PubMed: 38099013
DOI: 10.4103/idoj.idoj_490_22 -
Oral Surgery, Oral Medicine, Oral... Apr 2024To evaluate the prevalence of oral manifestations of leprosy. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate the prevalence of oral manifestations of leprosy.
STUDY DESIGN
This systematic review with meta-analysis was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included cross-sectional studies by 2 independent reviewers in 2 phases, who reported bacilloscopic-confirmed oral manifestations of leprosy. Studies were selected based on predetermined eligibility criteria. Searches in 6 main databases were performed, such as PubMed/MEDLINE, Embase, Scopus, Web of Science, LILACS/BVS, and LIVIVO, in addition to the gray literature. The risk of bias was assessed using the JBI Checklist for Analytical Cross-Sectional Studies, and the quantitative synthesis of the data was performed using the Jamovi 2.3 application.
RESULTS
Ten studies were included, and the meta-analysis was performed with 917 patients with different types of leprosy. The overall prevalence of oral alterations was 6.0% (95% IC, 0.02-0.11; I = 97.01%; Q = 75.56), with plaques (27.2%), infiltrations (18.1%), and macules (15.1%) being the most prevalent fundamental lesions, especially in multibacillary patients.
CONCLUSIONS
Even though there is no oral pathognomonic lesion of leprosy, this infectious disease can manifest in oral tissues in different ways, depending mainly on the leprosy type and stage of treatment.
Topics: Humans; Cross-Sectional Studies; Prevalence; Leprosy
PubMed: 38262774
DOI: 10.1016/j.oooo.2023.12.787 -
Journal of Cutaneous Pathology May 2024Macular amyloidosis (MA) is a primary localized cutaneous amyloidosis, characterized by amyloid deposition in the papillary dermis. The clinical presentation includes... (Review)
Review
Macular amyloidosis (MA) is a primary localized cutaneous amyloidosis, characterized by amyloid deposition in the papillary dermis. The clinical presentation includes pruritic hyperpigmented macules and patches with a reticulated or rippled pattern, primarily found on the upper back and extremities. Biopsy is an essential diagnostic tool for confirming MA. This systematic review focused on the biopsy outcomes in patients diagnosed with MA.
Topics: Humans; Amyloidosis; Skin; Amyloidosis, Familial; Biopsy; Skin Diseases; Skin Diseases, Genetic
PubMed: 38328942
DOI: 10.1111/cup.14592 -
Child's Nervous System : ChNS :... Jan 2024Autosomal dominantly inherited neurofibromatosis type I (NF1) is a systemic disorder caused by a mutation of a gene on chromosome 17q11.2 and characterized by multiple... (Review)
Review
Autosomal dominantly inherited neurofibromatosis type I (NF1) is a systemic disorder caused by a mutation of a gene on chromosome 17q11.2 and characterized by multiple café-au-lait spots, lentiginous macules, Lisch nodules of the iris, and tumors of the nervous system. Bony manifestations such as scoliosis, dysplasia of the greater sphenoidal wing, tibial pseudoarthrosis, short stature, and macrocephaly have been reported in approximately 50% of patients. However, calvarial bone defects are rare. After screening 324 articles, 23 cases (12 adult and 11 pediatric patients) of occipital bone defects in NF1 patients were selected. All patients had a single/multiple bone defect over the lambdoid suture. Adjacent benign plexiform neurofibromas were observed in 14 patients (60.8%, 7 adults and 7 children); one adult patient was diagnosed with neurofibrosarcoma. Meningoencephalocele over the occipital defect was noted in 8 cases (34.78%, all adults). Cranioplasty was performed in only 17.39% of patients. Histologic examination was performed in 7 of the 15 patients with associated neurofibromas/neurofibrosarcomas. Biopsy of the bone margins surrounding the defect was performed in only one case. Pathologic examination of the herniated parieto-occipital or cerebellar tissue was not performed in any of the patients studied. We report the case of a 9-year-old girl with NF1 and a significant occipital bone defect and performed a systematic review of the relevant literature to highlight the challenges in treating this condition and to investigate the underlying mechanisms contributing to bone defects or dysplasia in NF1.
Topics: Adult; Female; Humans; Child; Neurofibromatosis 1; Cafe-au-Lait Spots; Mutation; Encephalocele; Occipital Bone
PubMed: 37993698
DOI: 10.1007/s00381-023-06232-4