A clinical, dermoscopic, histopathological and immunohistochemical study of melasma and facial pigmentary demarcation lines in the skin of color

Khunger, Niti; Kandhari, Rajat; Singh, Avninder; Ramesh, V.

doi:10.1111/dth.14515

Cited by 11 publications

(11 citation statements)

References 9 publications

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“…11 A comparative study indicated markedly increased expression of nerve growth factor receptor and neural endopeptidase compared to nonlesional skin, along with increased numbers of keratinocytes expressing nerve growth factor receptor, neural endopeptidase, and nerve fibers in the dermis of lesional skin. 79 We suggest that oxidative stress and neuroactive molecules are critical factors for the pathogenesis of melasma, which may directly affect the microenvironment and damage barrier function around melanocytes and lead to hyperpigmentation.…”

Section: Other Potential Factorsmentioning

confidence: 93%

New Mechanistic Insights of Melasma

Liu¹,

Chen²,

Xia³

2023

CCID

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Melasma is a common acquired disorder of pigmentation that negatively impacts quality of life. Present treatments show poor therapeutic effect with frequent recurrence. This in large part is due to the currently limited understanding of the disease's etiology. It is urgent to elucidate the pathogenesis of melasma to further the discovery of new therapeutic strategies. Recent studies show that melasma is triggered or aggravated by a variety of factors, including genetic susceptibility, ultraviolet radiation, and sex hormone dysregulation. Ultraviolet B radiation upregulates the expression of several melanocyte-specific genes and stimulates the release of key factors that participate in the synthesis of melanin. There is a significant increase in melanin in both the epidermal and dermal layers of affected skin, possibly due to abnormalities in crosstalk between the melanocytes and other cells. Melanogenesis is regulated through various signaling networks including the Wnt/β-catenin, PI3K/Akt, cAMP/PKA, and SCF/c-kit-mediated signaling pathways. In addition, inflammatory mediators, oxidative stress, neuroactive molecules, sebocytes, etc, have also been proved to be related to the pathogenesis of melasma. This review provides a comprehensive update on the current understanding of the pathogenesis of melasma.

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Section: Other Potential Factorsmentioning

confidence: 93%

New Mechanistic Insights of Melasma

Liu¹,

Chen²,

Xia³

2023

CCID

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“…Secondary results include scanning reflectance spectrophotometer detection technology (colorimetric method), [ 3 ] VISIA image analysis, noninvasive physiological function test, reflectance confocal microscopy (RCM), [ 23 ] dermoscopic observation and evaluation of the improvement of the number and shape of blood vessels in the skin lesions before and after treatment of melasma, [ 24 ] Physician's Global Assessment (PGA), [ 25 ] patient satisfaction evaluation, safety indicators, and the number of adverse events.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of acupuncture for melasma

et al. 2021

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Background: Melasma is a common acquired hyperpigmentation of the skin. The clinical manifestations are light brown or dark brown patches symmetrically distributed on the cheeks, forehead, and mandibular with different shades and unclear borders. The treatment of melasma is extremely challenging due to its easy relapse and hard to cure. As a classical method of traditional Chinese medicine, acupuncture has been used to treat melasma in clinical practice. However, there is no systematic review and meta-analysis of acupuncture on melasma. This study aims to assess the efficacy of acupuncture for melasma. Methods: We will perform a comprehensive retrieval in the following electronic databases: PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure (CNKI), Wan Fang Database, VIP database, Chinese Biomedical Literature Service System (SinoMed), Chinese Biomedicine (CBM) database, and TCM Literature Analysis from inception to July 1, 2021, to identify any eligible study. We include all randomized controlled trials (RCTs) without any limitation of blinding or publication language, and exclude cohort studies and case reports. The meta-analyses will be conducted by using the Stata16. We will use the Cochrane risk of bias tool for randomized trials to assess the risk of bias of included studies. The X 2 and I 2 tests will be utilized to assess the statistical heterogeneity of evidence. We will conduct a meta-analysis if the studies can be combined. Otherwise, a narrative synthesis will be performed. Article screening and data extraction will be independently evaluated by 2 reviewers trained in methodology according to the established selection criteria. Any disagreements between the 2 reviewers will be resolved by reaching a consensus with the other authors (the third reviewer). Results: This study will systematically evaluate the clinical efficacy of acupuncture for melasma. Conclusion: The conclusion of this study will provide evidence to ensure the efficacy of acupuncture for melasma, so as to provide an objective and scientific basis for clinical practice. Ethics and dissemination: No ethical approval will be required because the data used are not linked to individual patient. The results of this review will be published in a peer-reviewed journal. Registration number: INPLASY2021110097.

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“…A recent study comparing the histopathology of melasma versus PDLs found increased melanin in the suprabasal and basal layers, melanophages in the upper dermis, and solar elastosis in melasma with a much higher frequency than in PDL lesions 45 . In addition, PDLs have shown increased basal layer melanin and dermal melanophages as characteristic findings on histology 48 .…”

Section: Pdlsmentioning

confidence: 99%

Diagnostic tools for hyperpigmentation disorders in skin of color: An updated review

Pagan

Mitchell

Yousif

et al. 2022

Dermatological Reviews

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Hyperpigmentation disorders are highly prevalent and disproportionately affect patients with skin of color. Studies suggest that over 65% of Black or African American patients haveexperienced at least one episode of hyperpigmentation due to skin damage or irritation. Notably, melasma and postinflammatory hyperpigmentation are the two most common forms of dyschromia in patients with skin of color. Additionally, otherconditionssuch as lichen planus and erythema dyschromicum perstans can have a more severe presentation and significant morbidity in this patient population. Thus, hyperpigmentation disorders can benefit greatly from prompt and accurate diagnosis that results in more precise management. In this review, we present the most updated information regarding dermoscopy, reflectance confocal, and conventional light microscopy in the diagnosis of hyperpigmentation disorders in skin of color. In addition, we summarize the benefits and pitfalls of some of these techniques, with a special emphasis on their accuracy and potential to assess favorable treatment outcomes. We also describe recent studies that have compared these diagnostic techniques across many disorders of hyperpigmentation and the practical findings that can be applied to everyday practice. We recognize that the cost of equipment, clinician training, and device availability are all critical factors when choosing the ideal diagnostic tool and provide varied approaches to improve accuracy. Today, diagnosing and treating hyperpigmentation skin conditions has become easier through technological advances.More reliable, noninvasive techniques such as dermoscopy and reflectance confocal microscopy show promise as adjuncts to guide laser and light therapies and monitor treatment response in dermatology clinics and clinical trials.

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A clinical, dermoscopic, histopathological and immunohistochemical study of melasma and facial pigmentary demarcation lines in the skin of color

Cited by 11 publications

References 9 publications

New Mechanistic Insights of Melasma

New Mechanistic Insights of Melasma

Efficacy of acupuncture for melasma

Diagnostic tools for hyperpigmentation disorders in skin of color: An updated review

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