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Stay up-to-date on new clinical findings in Pigmentary Disorders.

The appearance of dull skin, uneven skin tone, dark spots, and hyperpigmentation is often bothersome, especially in individuals with darker skin tones. Management of skin dyschromia can be difficult. Several topical ingredients, such as niacinamide and vitamin C, are clinically proven to inhibit pigmentation formation and improve overall skin tone. A skincare regimen formulated to minimize irregular melanin deposition levels has been specifically developed to help improve uneven skin tone for a more radiant appearance. This regimen consists of an exfoliating cleanser (EC), an antioxidant C serum (ACS), a day cream with SPF (DC), and a renewing cream (RC).

Tyrosinase is the rate-limiting enzyme of melanogenesis and thus an ideal inhibitory target for treating hyperpigmentation. There are many commercially available tyrosinase inhibitors with limited clinical efficacy. A recent screen of 50,000 compounds found isobutylamido thiazolyl resorcinol (ITR) to be the most potent inhibitor of human tyrosinase.

 Facial hyperpigmentation, characterized by the excessive production of melanin in the skin, is a prevalent dermatological concern affecting individuals of various ethnic backgrounds.

Numerous melanoma-specific dermoscopic features have been described in invasive melanomas, while fewer features are found in melanoma in situ (MIS) and atypical nevi (ATN). Consensus regarding which features are critical for the differentiation of MIS from ATN has not been reached.

Melasma and post-inflammatory hyperpigmentation (PIH) are common cosmetic dermatologic conditions that predominantly affect patients with skin phototypes III-VI. Comparing treatment coverage for these pigmentary disorders to treatment coverage for acne vulgaris may demonstrate disparities in insurance coverage for diseases that primarily affect patients of color.

Squamous cell carcinoma (SCC) is one of the most common malignant neoplasms, and its incidence is increasing.1 Some patients are considered poor candidates for surgery due to the location of the tumor, health conditions, or having numerous lesions simultaneously.

Dyschromia is one of the most common reasons for patients to seek dermatological care, especially among individuals with skin of color. Most cases present as melasma or post-inflammatory hyperpigmentation (PIH); both are chronic issues requiring long-term treatment. 

Oral tetracyclines (TCNs) are commonly prescribed for acne, but they have been shown to increase the risk of hyperpigmentation, particularly in the setting of sun exposure.

Linear lichen planus pigmentosus (LPP) of the face is a rare variant of lichen planus, with only a few cases published in the literature.¹ It is an inflammatory condition with unknown etiology, characterized by blue-gray hyperpigmented macules, and tends to affect sun-exposed areas of the head and neck.^1-4 

The treatment of primary scarring alopecias is challenging and patients may be susceptible to koebnerization. This predisposes cicatricial alopecia patients to worsening of their disease following procedural treatments or interventions.

Background: Hydroquinone is effective in melasma treatment, but side effects may limit its use. Silymarin cream may be a safer alternative. Objective: To compare the efficacy of 1.4% silymarin with 2%…

Background: In the last several years, oral tofacitinib has become an increasingly utilized off-label treatment option for immune-mediated skin conditions such as alopecia areata (AA), vitiligo, plaqu…

Key cellular players regulating human skin pigmentation include melanocytes in the epidermis that synthesize melanin, neighboring keratinocytes that receive and distribute melanin in the upper layers, and fibroblasts in the dermis that affect overlying melanocytes and keratinocytes. In addition, endocrine factors from the blood supply (endothelial cells) and inflammation-related factors play a role. Thus, new strategies for affecting pigmentation need to consider these multiple cell lines to adequately cover various causes and disease processes associated with hyperpigmentation.

Cysteamine is an aminothiol naturally present in cells of the human body as an antioxidant resulting from the degradation of Coenzyme A. Physiologically it is well distributed in mammalian tissues. Highly concentrated in human milk, cysteamine acts as an intrinsic antioxidant and is known for its protective role. Multiple studies now document that cysteamine is a potent skin depigmenting agent.

New development of cell-targeted therapies to enable site-specific skin tissue drug delivery may reduce off-target effects, decrease unwanted toxicities, and enhance drug efficacy.

Melasma is a photoaging condition with a typical clinical and histological pattern under a genetic and epigenetic context. Over the years, many treatments modalities have been proposed including topical agents, oral medication, procedures, and combination treatments aiming at different aspects of the pathogenesis including photodamage, inflammation, vascularity, and pigmentation.

Melasma is a chronic dermatologic condition with an incompletely understood pathogenesis and well-demonstrated impact on patient quality of life. Melasma is a common cause for seeking dermatologic care, and with no universally efficacious therapy or cure, com-bination treatment is the best approach for many cases.

Post-inflammatory hyperpigmentation (PIH) is a reactive process resulting from increased melanin or abnormal distribution of melanin secondary to inflammatory skin conditions, dermatologic therapies, and external stimuli. Because PIH is a common condition that has a substantial effect on the quality of life, an understanding of its treatment modalities is essential.

Recent years have seen a growth in the Asian cosmeceutical industry and an expanding worldwide marketplace with increasing consumer use of plant-based skin care products. The rising prevalence of Asian cosmeceuticals has led to research studies assessing the safety and efficacy of these products.

Skin dyspigmentation is a common dermatologic concern, particularly in patients with skin of color.¹ Hydroquinone is often used as a first-line therapy for dyschromia, and is approved for treatment of melasma, chloasma, freckles, senile lentigines, and hyperpigmentation.²

The risk of post-inflammatory hyperpigmentation (PIH) in patients undergoing dermatologic procedures is well known. It is especially common after laser procedures and chemical peels but can be seen with any procedure.

I read with interest the informative article by Spencer et al¹ that describes the efficacious use as a novel skin lightening agent (LumaPro-C) for the treatment of patients with melasma.

Melasma and postinflammatory hyperpigmentation (PIH) are the most common forms of dyschromia in patients with skin of color.

Next Steps in Derm, in partnership with ODAC Dermatology, Aesthetic and Surgical Conference, interviewed Dr. Vic Ross, Director of the Scripps Clinic Laser and Cosmetic Dermatology Center in San Diego, CA, on his approach and the various interventions he uses for the treatment of Melasma. Watch as he shares fresh practical pearls immediately useful in your practice.