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International Journal of Dermatology Dec 2023Since extracutaneous melanocytes in the eye may also be affected in vitiligo, a systematic review was conducted to explore the ocular manifestations of vitiligo. Studies...
Since extracutaneous melanocytes in the eye may also be affected in vitiligo, a systematic review was conducted to explore the ocular manifestations of vitiligo. Studies point to a higher risk of ocular findings in periorbital vitiligo. Dry eye disease is the most reported ocular abnormality in vitiligo. Additionally, several small studies have found potential links to uveitis and glaucoma. Various other chorioretinal pigmentary changes are also reported, but without accompanying functional consequences or changes in vision. Although there is a need for larger studies to further elucidate these associations, dermatologists should be aware of potential ocular comorbidities in vitiligo and refer to ophthalmology accordingly.
Topics: Humans; Vitiligo; Dermatologists; Pigmentation Disorders; Eye; Glaucoma
PubMed: 37919864
DOI: 10.1111/ijd.16883 -
Journal of Clinical Medicine Oct 2023Oral-pigmented lesions have raised aesthetic concerns, leading to multiple depigmentation techniques. This systematic review and network meta-analysis aimed to assess... (Review)
Review
BACKGROUND
Oral-pigmented lesions have raised aesthetic concerns, leading to multiple depigmentation techniques. This systematic review and network meta-analysis aimed to assess the efficacy of different treatments for oral hyperpigmentation.
METHODS
A computerized search was conducted on Science Direct, Medline via PubMed, Scopus, and Web of Science using the relevant keywords. English-language studies published between 2013 and 2023 that focused on patients with oral pigmented lesions subjected to different treatment modalities, such as laser or surgical intervention, were compared to determine their efficacy and safety profile. Data were analyzed using R software, applying frequentist models.
RESULTS
A total of 27 studies were included. In contrast to the CO laser, Er: YAG laser was linked to a higher risk of bleeding (RR = 2.73, < 0.01), whereas the diode laser had the most favorable score in minimizing bleeding index (P-score = 0.86). In terms of lower risk and postoperative pain score (RR = 0.01, < 0.01), the Er,Cr:YSGG laser had the most favorable result (P-score = 1.00). The Er: YAG laser demonstrated the highest probability of preventing recurrence (RR = 0.28, < 0.01), followed by the diode laser (RR = 0.42, < 0.01).
CONCLUSIONS
The choice of treatment for oral pigmentation should be based on individual patient needs and the desired outcomes. The Er: YAG laser seems highly effective in preventing pigment recurrence, the diode laser emerges as a top contender in managing bleeding risks, and the Er,Cr:YSGG laser is particularly efficacious in managing postoperative pain.
PubMed: 37892705
DOI: 10.3390/jcm12206567 -
Cureus Sep 2023Vitiligo is an acquired pigmentation disorder with different theorized etiologies, although the exact pathogenesis is still largely unknown. It presents as...
Vitiligo is an acquired pigmentation disorder with different theorized etiologies, although the exact pathogenesis is still largely unknown. It presents as well-demarcated white plaques throughout the body that result from the loss of melanocytes within the epidermis. Commonly, this condition presents alongside other autoimmune conditions, and it is associated with both genetic and non-genetic factors. We present a patient with no history of autoimmune disease who developed vitiligo after receiving her vaccines against COVID-19. This first occurred within 24 hours of receiving her first vaccine and then worsened after receiving her second vaccine. The depigmented rash was localized to the face, arms, and chest. She was treated with both oral and topical steroids, as well as topical tacrolimus cream. Despite adherence to treatment, the patient only reported subjective improvement in her skin lesions overall. While vitiligo arises sporadically, the temporal relationship between vaccinations and depigmentation makes a stronger case for the vaccine as the inciting factor for this patient, though coincidence is possible. A systematic review of the literature regarding the onset of vitiligo following both infection with and vaccination against COVID-19, this case offers a unique presentation that had a sudden onset and creates a learning opportunity for clinicians to investigate the potential relationship between the receipt of the vaccine and the onset of this skin condition. The goal of this report is to help clinicians be cognizant of the possibility of developing or worsening skin diseases after infection or vaccination so that they can be addressed and treated appropriately.
PubMed: 37868489
DOI: 10.7759/cureus.45546 -
Annals of Plastic Surgery Jan 2024Treatment management for congenital melanocytic nevi (CMN) on the face (FCMN) is highly variable and requires a thorough assessment of multiple factors. To date, a...
BACKGROUND
Treatment management for congenital melanocytic nevi (CMN) on the face (FCMN) is highly variable and requires a thorough assessment of multiple factors. To date, a systematic review of FCMN treatment is lacking. The purpose of the present study was to elucidate the frequency, variety, and outcomes of treatment modalities for FCMN with different levels of complexity.
METHODS
A comprehensive review of Pubmed, Embase, and Google Scholar databases from 1950 to 2022 was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles reporting on FCMN treatment approaches, outcomes, and associated complications were screened and data were extracted according to inclusion criteria. Data were tabulated for thematic analysis of FCMN treatment types, anatomic locations, outcomes, and complications.
RESULTS
Of the 561 studies retrieved, 34 met inclusion criteria including 19 surgical treatments, 14 nonsurgical treatments, and one combined surgical and nonsurgical treatment study, totaling 356 patients. The majority of treated FCMN were small-to-medium-sized (56%). Facial CMN treated conservatively were mostly located on the cheek (27%) and/or perinasal region (21%), whereas FCMN treated with surgery were primarily located in the periorbital region (44%) and/or the cheek (17%). Across all treatment cohorts, 22% of patients experienced at least one complication, with 12% of complications experienced by patients treated by surgery.
CONCLUSIONS
There is a greater need for standardized FCMN nomenclature that encompasses nevi pattern, dimensions, anatomical coverage, and quantitative measurements of treatment outcome. Future studies should focus on identifying anatomic locations of FCMN that are more prone to complications and determine which treatment approach optimizes outcomes.
Topics: Humans; Nevus, Pigmented; Treatment Outcome; Cheek; Databases, Factual; Skin Neoplasms
PubMed: 37856246
DOI: 10.1097/SAP.0000000000003676 -
F1000Research 2023Utilizing the bioactive compounds found in pigmented rice might significantly reduce the risk of breast cancer. This study aims to systematically review existing...
Utilizing the bioactive compounds found in pigmented rice might significantly reduce the risk of breast cancer. This study aims to systematically review existing literature on the benefit of Asian pigmented rice bioactive compounds and their implication in breast cancer. Searches of the literature were conducted in two databases (Scopus and PubMed) for a systematic review. The keywords resulted in a total of 407 articles, consisting of 103 PubMed and 304 Scopus articles. 32 manuscripts were excluded because the article was over 10 years old. After excluding book chapters and non-English languages, we had 278 potential articles to be reviewed. After checking and screening the title and abstract and eliminating duplicate articles, then 66 articles were obtained. After the selection and elimination of the full-text manuscripts, finally 10 of them which met the inclusion criteria. The included studies in this review were entirely based in Asia. The year of publication ranged from 2013 to 2020. Half of included studies used black rice extract, two used red jasmine rice extracts, and three used Korean rice extracts (black, red, dark purple and brown rice). All studies were conducted and three studies were compared with tests on female mice. The pigmented rice is mainly black, red, and dark purple rice, and contains a variety of peonidin-3-glucoside, cyanidin-3-glucoside, γ-oryzanol, γ-tocotrienol, proanthocyanidin, cinnamic acid, and anthocyanins that may act as pro-apoptotic, anti-proliferative, and anti-metastasis of the breast cancer cells. Pigmented rice is a beneficial food which possessed bioactive compounds that may have significant potential concerning a breast cancer.
Topics: Female; Animals; Mice; Anthocyanins; Oryza; Asia; Neoplasms
PubMed: 37854873
DOI: 10.12688/f1000research.130329.1 -
International Journal of Dermatology Mar 2024Chronic solar ultraviolet radiation (sUVR) exposure leads to an increased incidence of non-melanoma skin cancer (NMSC) development, particularly when accumulated over... (Review)
Review
Chronic solar ultraviolet radiation (sUVR) exposure leads to an increased incidence of non-melanoma skin cancer (NMSC) development, particularly when accumulated over decades. Workers in certain industries, such as construction, agriculture, postal workers, and the military, are at higher risk due to cumulative sUVR exposure in their line of work. By assessing the relationship between sUVR exposure in outdoor workers and their skin cancer risk and defining methods of prevention, clinicians can offer focused sun protection counseling to this unique population. PubMed was used to perform a literature review to address the following research questions: 1. How is ultraviolet radiation measured? 2. What is the modern utility of the ultraviolet index in modifying sun protection behaviors in outdoor industry workers? 3. What is the risk of non-melanoma skin cancer development in individuals working in outdoor occupations? 4. What is the prevalence of skin cancer among outdoor workers? 5. Is the number of nevi and solar lentigines elevated among individuals employed in outdoor occupations? The literature suggests that individuals in outdoor occupations are exposed to UV levels that often surpass safety limits for occupational UVR exposure, increasing their risk of developing skin cancer and precursor and pigmented lesions. Individuals in high-risk occupations experience significantly higher levels of sUVR exposure than their indoor worker counterparts, increasing their risk of malignant cutaneous transformation. Accordingly, these individuals must be counseled on effective solar protection methods, and employers should advocate for actionable change.
Topics: Humans; Ultraviolet Rays; Sunlight; Skin Neoplasms; Occupations; Occupational Exposure
PubMed: 37853576
DOI: 10.1111/ijd.16877 -
Retina (Philadelphia, Pa.) Feb 2024To identify the prevalence of retinal pigment epithelium tear (RPET) after anti-vascular endothelial growth factor (VEGF) therapy and determine the efficacy of continued... (Meta-Analysis)
Meta-Analysis
PURPOSE
To identify the prevalence of retinal pigment epithelium tear (RPET) after anti-vascular endothelial growth factor (VEGF) therapy and determine the efficacy of continued anti-VEGF therapy in patients with RPET.
METHODS
All relevant clinical trials and observational studies in several online databases were screened. The main outcomes were the incidence of RPET after anti-VEGF therapy and changes in visual acuity for patients with RPET treated with continued anti-VEGF.
RESULTS
The pooled incidence of RPET after anti-VEGF therapy from 24 studies with 17,354 patients was 1.9% (95% CI: 1.3-2.7). Most new RPET cases were concentrated in the first month at baseline or after the first injection during anti-VEGF therapy and gradually decreased by the subsequent month or injection. 13 studies with 157 patients reported that for patients who received anti-VEGF therapy after RPET, their pooled best-corrected visual acuity improved, but did not reach a significant level (standardized mean differences 0.34; 95% CI: -0.03 to 0.71).
CONCLUSION
The incidence of RPET after anti-VEGF therapy is low. The intravitreal anti-VEGF injection may accelerate this process. For patients with RPET, maintenance of anti-VEGF therapy ensures visual acuity stability.
Topics: Humans; Ranibizumab; Angiogenesis Inhibitors; Bevacizumab; Vascular Endothelial Growth Factor A; Endothelial Growth Factors; Antibodies, Monoclonal, Humanized; Retinal Pigment Epithelium; Intravitreal Injections
PubMed: 37824816
DOI: 10.1097/IAE.0000000000003922 -
BMJ Open Ophthalmology Oct 2023The rising prevalence of myopia is a concern in ophthalmology, with myopic choroidal neovascularisation (m-CNV) significantly affecting vision. However, long-term...
INTRODUCTION
The rising prevalence of myopia is a concern in ophthalmology, with myopic choroidal neovascularisation (m-CNV) significantly affecting vision. However, long-term outcomes of m-CNV management have been unsatisfactory, leading to high recurrence rates. These studies aim to identify risk factors for m-CNV recurrence.
METHODS
Comprehensive review followed a pre-registered plan in the International Prospective Register of Systematic Reviews (PROSPERO). The search strategy used various databases including PubMed, Cochrane Library, Embase, Scopus and ScienceDirect using the keywords 'Myopic Choroidal Neovascularization', 'Recurrence' and 'Risk'. Eligible studies were identified and analysed based on predetermined criteria. This study was registered on PROSPERO (CRD4202343461).
RESULTS
The systematic review included three retrospective studies investigating risk factors associated with m-CNV recurrence. These factors are: (1) requiring three or more injections for initial disease control, (2) older age, (3) larger myopic macular neovascularisation, (4) juxtafoveal CNV, (5) larger height of hyper-reflective foci (HRF) and (6) destruction or absence of the ellipsoid zone (EZ) and retinal pigment epithelium (RPE).
CONCLUSION
Risk factors for m-CNV recurrence include a greater number of required injections, older age, large macular CNV, juxtafoveal location, increased HRF height and changes in EZ and RPE structure. Understanding these factors can inform personalised treatment approaches and improve patient outcomes by identifying individuals at higher risk of recurrence and implementing proactive measures to mitigate the impact of m-CNV recurrence and progression. Further investigation is needed to enhance our understanding of the underlying mechanisms and develop innovative therapeutic approaches for effective m-CNV management.
PROSPERO REGISTRATION NUMBER
CRD4202343461.
Topics: Humans; Choroidal Neovascularization; Myopia, Degenerative; Retrospective Studies
PubMed: 37816549
DOI: 10.1136/bmjophth-2023-001396 -
The Journal of Investigative Dermatology Feb 2024Although light skin types are associated with increased skin cancer risk, a lower incidence of both melanoma and nonmelanoma skin cancer (NMSC) has been reported in... (Meta-Analysis)
Meta-Analysis Review
Although light skin types are associated with increased skin cancer risk, a lower incidence of both melanoma and nonmelanoma skin cancer (NMSC) has been reported in patients with vitiligo. We performed a systematic review and meta-analysis on the NMSC risk in patients with vitiligo, indicating a reduced relative risk ratio of NMSC in vitiligo. Furthermore, we propose a series of hypotheses on the underlying mechanisms, including both immune-mediated and nonimmune-mediated pathways. This study reveals insights into the relationship between vitiligo and keratinocyte cancer and can also be used to better inform patients with vitiligo.
Topics: Humans; Keratinocytes; Melanoma; Risk; Skin Neoplasms; Vitiligo
PubMed: 37791932
DOI: 10.1016/j.jid.2023.08.012 -
Wound Repair and Regeneration :... 2023Across scar studies, there is a lack of dark-skinned individuals, who have a predisposition for keloid formation, altered pigmentation and poorer quality of life (QOL).... (Review)
Review
Across scar studies, there is a lack of dark-skinned individuals, who have a predisposition for keloid formation, altered pigmentation and poorer quality of life (QOL). There is a need for patients of colour to be included in scar scale development and validation. In this study, we evaluate the racial diversity of patients included in the validation of scar assessment scales. A systematic review was conducted for articles reporting on the validation of a scar assessment tool. Racial, ethnic and Fitzpatrick skin type (FST) data were extracted. Fifteen scar scale validation studies were included. Nine of the studies did not mention FST, race or ethnicity of the patients. Two of the studies that reported FST or race information only included White patients or included no FST V/VI patients: mapping assessment of scars (MAPS) and University of North Carolina '4P'. Only four studies included non-White patients or dark-skinned patients in the validation of their scar scale: the modified Vancouver Scar Scale (VSS), modified Patient and Observer Scar Assessment Scale (POSAS), acne QOL and SCAR-Q scales. The patients included in the modified VSS validation were 7% and 13% FST V/VI, 14% African in the modified POSAS and 4.5% FST V/VI in the SCAR-Q. We highlight the severe lack of diversity in scar scale validation, with only 4 out of 15 studies including dark-skinned patients. Given the susceptibility of darker-skinned individuals to have poorer scarring outcomes, it is critical to include patients of colour in the very assessment tools that determine their scar prognosis. Inclusion of patients of colour in scar scale development will improve scar assessment and clinical decision-making.
Topics: Humans; Cicatrix; Quality of Life; Skin Pigmentation; Wound Healing; Skin
PubMed: 37768279
DOI: 10.1111/wrr.13120