Excavation of Ancient Prescription of Chinese Medicinals for Whitening and Freckle-Removing(Erbai Yixin)Based on the Theory of"Lung Governs the Skin and Hair" / 中药新药与临床药理

Objective Based on the theory of"lung governs the skin and hair"in"Yellow Emperor's Inner Classic",this paper analyzes the medication rules of whitening and freckle-removing.The aim of this study is to provide reference for the clinical practice of traditional Chinese medicine(TCM)theory and the medication in TCM cosmetics.Methods"Chinese Medical Classics"was used to search the records of whitening and freckle-related drugs.The frequency,nature,flavor,meridian tropism and compatibility laws of TCM for whitening and freckle-removal were analyzed by statistics and association rules.The network pharmacology research was used to analyze the whitening and freckle-removing effects and mechanisms of high-frequency drugs.Then,the potential active ingredients were analyzed.The whitening and anti-freckle effect was verified through cytotoxicity experiments and melanin content detection.Results A total of 171 external prescriptions were selected in eligible articles,including 261 Chinese medicinals,most of which were pungent and belong to the lung meridian.The most frequently used Chinese medicinals was"Erbai Yixin"(EBYX,Angelicae Dahuricae Radix,Typhonii Rhizoma,Asari Radix et Rhizoma).Network pharmacological analysis showed that the core targets of EBYX for whitening and removing freckles are TP53,EGFR,ALB,etc.,which are mainly involved in oxygen perception and response,skin immune regulation,skin cell growth,differentiation,stress,inflammatory response,and other biological processes.Based on the results of molecular docking,biological analysis proved that the active ingredients of EBYX are chrysophanol,gallic acid and caffeic acid,which have inhibitory effects on the proliferation of melanoma cells and melanin production.Conclusion Most of the ancient prescriptions for whitening and removing freckles are pungent and belong to the lung meridian,which embodies the theory of"lung governs the skin and hair".The high-frequency drug EBYX may play a role by regulating skin redox,immunity and inflammation.The active ingredients of EBYX have an inhibitory effect on melanin formation.This study enriches the scientific connotation of TCM whitening and freckle-removing prescriptions based on the theory of"lung governs the skin and hair",realizes interdisciplinary integration and provides support for the modernization of TCM.

A utilidade da microscopia confocal nas lesões de lentigo maligno / The utility of confocal microscopy in lentigo maligna lesions

O diagnóstico das lesões pigmentadas da face é considerado desafiador uma vez que lesões benignas e malignas podem compartilhar características clínicas e dermatoscópicas semelhantes, principalmente em lesões iniciais, sendo muitas vezes difícil de identificar as lesões de lentigo maligno da face. Assim, a microscopia confocal de reflectância pode se tornar uma ferramenta útil no diagnóstico dos lentigos malignos bem como para o seu planejamento cirúrgico.

The diagnosis of pigmented facial lesions is considered challenging since benign and malignant lesions might have similar clinical and dermoscopic features ­ especially in the early stages of the lesion ­ entailing that it is often difficult to identify lentigo maligna lesions in the face. In this way, confocal reflectance microscopy has the potential to become a useful tool both in the diagnosis and surgical planning of lentigo maligna.

Lentigo maligna and lentigo maligna melanoma: a clinicopathologic analysis of twenty-four cases / 中华病理学杂志

Objective@#To study the clinicopathologic features, differential diagnosis and prognosis of lentigo maligna (LM) and lentigo maligna melanoma (LMM).@*Methods@#Histopathologic evaluation and immunohistochemical study by HRP multimer method were carried out in 24 cases of LM and LMM from 2012 to 2017 at Fudan University Shanghai Cancer Center. The clinical information and follow-up data were analyzed.@*Results@#Of total 24 cases, there were 7 cases of LM and 17 cases of LMM; 10 males and 14 females. The age of patients ranged from 32 to 88 years (mean 67 years). The male-to-female ratio was 1.0∶1.4. Tumors were all located on head and face. Clinically, all patients presented with mottled light brown or sepia macule located on head and face for a long time, and some of them followed by nodules or ulceration within the lesion. The diameter of lesions ranged from 0.5 to 3.0 cm. Microscopically, LM and in-situ component of LMM were all characterized by a predominantly junctional proliferation of atypical melanocytes with marked pleomorphism, frequently extending down the walls of hair follicles and sweat ducts. Multinucleate cells were frequently present. The invasive components of LMM mainly consisted of atypical melanocytic spindle cells (13 cases, 76.5%), and the mean Breslow thickness was 1.2 mm (0.1-2.7 mm). The lesions of LM/LMM were generally associated with severe actinic damage, scattered infiltration of lymphocytes and melanophages. Statistically, the number of cases whose diameter of lesion ≥0.6 cm, mitotic rates ≥4/mm2 and nests of melanocytes within epidermis in group of LMM were significantly more than those in group of LM. Immunohistochemically, atypical melanocytes in LM and LMM were generally positive for S-100, HMB45, PNL2, Melan A and SOX-10. Follow-up was available in all cases, ranging from 1 to 64 months. Only one out of 23 patients with wide surgical excision had local recurrence, and the remaining 22 patients were all alive with no evidence of disease. One LM patient who was merely treated with biopsy was alive with disease progression after 20 months follow-up.@*Conclusions@#LM/LMM is a special subtype of melanoma predominantly located on the sun-exposed skin of elderly people. Recognition of its specific histologic features can help distinguish with sun-damaged diseases and other subtypes of melanoma. The prognosis of LM/LMM patients treated with surgical excision is considered relatively favorable. However, long term follow-up should be recommended in patients with LM/LMM because of high recurrence rates indicated by previous studies.

Synchronous conjunctival melanoma and lentigo maligna melanoma

Abstract: Lentigo maligna has an extensive and neoplastic character. It typically progresses slowly and may eventually develop into an invasive melanoma, which is called lentigo maligna melanoma. Ocular melanoma is the second most common type of melanoma. The uvea is the most common site of origin of ocular melanomas, while conjunctival melanoma accounts for about 1-5% of cases. In this article, we describe a rare case of synchronic conjunctival melanoma and lentigo maligna on the face.

Lentigo maligno na face: um desafio na conduta / Lentigo maligna on the face: a challenging conduct

Resumo O lentigo maligno é um melanoma in situ, de crescimento radial e lento, que acomete áreas fotoexpostas principalmente em idosos. Quando acomete a pálpebra, devido à proximidade a um órgão nobre, a conduta é controversa, porém a cirurgia é o método mais usado, com margens que variam de acordo com a referência utilizada. Terapias conservadoras são descritas, como o imiquimode 5% e a radioterapia. O presente relato tem como objetivo demonstrar a escassez de estudos sobre a margem cirúrgica e citar opções de tratamentos não cirúrgicos para o lentigo maligno da face.

Abstract Lentigo maligna is a melanoma in situ, of slow radial growth, which affects sun-exposed areas, especially in the elderly. When it affects the eyelid, due to the proximity to a noble organ, the conduct is controversial, but surgery is the method most commonly used, with with margins varying according to the reference used. Conservative treatments are described, such as imiquimod 5% and radiotherapy. This report aims to demonstrate the lack of studies on the surgical margin, and to name nonsurgical treatment options for lentigo maligna of the face.

Cutaneous Melanoma in Asians / 전남의대학술지

Malignant melanoma is a rare disease in Asians but potentially the most aggressive form of skin cancer worldwide. It can occur in any melanocyte-containing anatomic site. Four main cutaneous melanoma subtypes are recognized: lentigo maligna melanoma, superficial spreading melanoma, acral lentiginous melanoma (ALM), and nodular melanoma. Generally, excessive exposure to ultraviolet (UV) radiation increases the risk of melanoma. The exception is ALM, which is the most common melanoma subtype in Asians and is not associated with UV radiation. ALM presents as dark brownish to black, irregular maculopatches, nodules, or ulcers on the palms, soles, and nails. The lesions may be misdiagnosed as more benign lesions, such as warts, ulcers, hematomas, foreign bodies, or fungal infections, especially in amelanotic acral melanomas where black pigments are absent. The aim of this brief review is to improve understanding and the rate of early detection thereby reducing mortality, especially regarding cutaneous melanoma in Asians.

Comparison between effects of laser and intensive pulsed light on freckles / 中华医学美学美容杂志

Objective To compare the effect of Q-switch Nd ∶ YAG laser and intensive pulsed light on freckles.Methods 80 patients with freckles were divided into 2 groups randomly.One group of patients were treated with Q-switch Nd ∶ YAG 532 nm frequency-doubled laser,the interval was 8 weeks.The other group of patients were treated with 570 nm intensive pulsed light,the interval was 8 weeks.Results We used Mann-Whitney U test to compare the curative effect of the two groups (P ＜0.05),and the mean rank (34.00) of the Q-switch Nd;YAG laser treatment group was greater than that (47.00) of the intense pulsed light treatment group.Conclusions The curative effect of Q-switch Nd ∶ YAG laser is better than that of intensive pulsed light on freckles.

Cutaneous Melanoma in Asians / 전남의대학술지

Malignant melanoma is a rare disease in Asians but potentially the most aggressive form of skin cancer worldwide. It can occur in any melanocyte-containing anatomic site. Four main cutaneous melanoma subtypes are recognized: lentigo maligna melanoma, superficial spreading melanoma, acral lentiginous melanoma (ALM), and nodular melanoma. Generally, excessive exposure to ultraviolet (UV) radiation increases the risk of melanoma. The exception is ALM, which is the most common melanoma subtype in Asians and is not associated with UV radiation. ALM presents as dark brownish to black, irregular maculopatches, nodules, or ulcers on the palms, soles, and nails. The lesions may be misdiagnosed as more benign lesions, such as warts, ulcers, hematomas, foreign bodies, or fungal infections, especially in amelanotic acral melanomas where black pigments are absent. The aim of this brief review is to improve understanding and the rate of early detection thereby reducing mortality, especially regarding cutaneous melanoma in Asians.

Contoured technique for lentigo maligna

The surgical approach to lentigo maligna is a challenge to dermatologists, given the difficulty of clinical delimitation of borders. We report here a case of a 69-year-old female patient presenting with brownish macules on her face, since 10 years ago, with histopathological diagnosis of lentigo maligna. The surgical management employed was excision of visible borders with the contoured technique and immediate submission of these borders for histopathological analysis before complete excision of the tumor. This technique is a variant of staged excision, with lower rates of recurrence and acceptable aesthetic results.

Sedum freckle capsule combined with hydroquinone cream phonophoresis in the treatment of chloasma / 国际中医中药杂志

ObjectiveTo evaluate the clinical efficacy of Sedum freckle capsule combined with hydroquinone cream phonophoresis in the treatment of chloasma.MethodsA total of 180 patients with chloasma were recruited into two groups according to the random number table, 100 in the treatment group and 80 in the control group. The patients in the control group were treated with 2% hydroquinone cream phonophoresis, and those in the treatment group received 2% hydroquinone cream phonophoresis and Sedum freckle capsules, both for 2 months. The symptom and lesion score were usedto evaluate the clinical efficacy. ResultsThe cure rates were 81.00% in the treatment group and 67.50% (χ2=4.320,P=0.038) in the control group at the end of treatment, 92.0% and 76.3% (χ2=5.538,P=0.019) at 2 months follow-up. The total lesion scores at the end of treatment and at 2 months follow-up were significantly lower than before the treatment in the treatment group (1.61 ± 0.84 and 1.30 ± 0.85vs.3.48 ± 1.02;t=14.152, 16.419, allP<0.01) and also in the control group (2.04 ± 0.61 and 2.03 ± 0.51vs.3.45 ± 1.09;t=10.097, 10.554, allP<0.01). The total lesion score at the end of treatment and at 2 months follow-up were significantly lower than in the treatment group was significantly decreased than the control group (t=3.839, 6.767; allP<0.01).ConclusionSedum freckle capsule combined with hydroquinone cream phonophoresis could effectively treat patients with chloasma.

Dermatoscopia das lesões pigmentadas na face: um desafio diagnóstico / Dermoscopy of pigmented lesions of the face: a diagnostic challenge

A dermatoscopia do lentigo maligno na face tem parâmetros confiáveis e bem testados para sua diagnose. Algumas lesões benignas, como as queratoses actínicas pigmentadas, apresentam, contudo, aspectos dermatoscópicos comuns aos lentigos malignos, dificultando a correta diagnose. Isso muitas vezes leva a excisões desnecessárias de lesões benignas. Este artigo discute esses parâmetros morfológicos no escopo de analisar os pontos em comum entre lentigo maligno e queratose actínica pigmentada com a dermatoscopia, assim como coteja os aspectos já descritos para a diagnose das queratoses actínicas pigmentadas.

Dermoscopy of lentigo maligna on the face has reliable and well-tested parameters for its diagnosis. However, some benign lesions such as pigmented actinic keratoses have dermoscopic aspects that are common in malignant lentigo, making the correct diagnosis difficult. This fact often leads to unnecessary excisions of benign lesions. The present article discusses these morphological parameters in light of the dermoscopic analysis of the commonalities between lentigo maligna and pigmented actinic keratosis, also touching upon the aspects already described for the diagnosis of pigmented actinic keratoses.

Remissão de lentigo maligno extenso após tratamento com imiquimod / Remission of extensive lentigo maligna after treatment with imiquimod

Lentigo maligno é um melanoma in situ que mais comumente surge em áreas expostas à radiação ultravioleta, nos pacientes idosos. O tratamento é realizado, principalmente, para minimizar o risco de progressão para lentigo maligno melanoma. O presente relato se refere a uma paciente idosa com lesões recorrentes de lentigo maligno na face, tratada com sucesso com imiquimod tópico, mostrando que este pode ser um tratamento útil, em determinados casos da doença.

Lentigno maligna is a melanoma in situ that most commonly appears on areas exposed to ultraviolet radiation, in elderly patients. Treatment is required mainly to minimize the risk of progression to lentigo maligna melanoma. The present report refers to an elderly patient with recurrent lesions of lentigo maligna in her face, who was successfully treated with topical imiquimod, which showed to be a useful therapy for some cases of the disease.

Histopathological changes of skin in freckle patients after phenol chemical peel / 中华医学美学美容杂志

Objective To study the histopathological changes of skin after phenol chemical peeling.Methods Immunohistochemical staining (ABC method) and transmission electron microscopy were used to investigate the skin of changes 15 cases of freckle.Results After phenol chemical peeling,the melansomes in basal layer cells decreased dramatically, the elastic and collagenous fibers in dermis enlarged ,and the skin thickened .Conclusions After phenol chemical peeling,the melansomes in cuticular layer cells decrease remarkably and the freckle disappears.The proliferative activitities of fibroblasts in dermis have been improved,resulting in thickness of elastic and collagenous fibers in dermis. It may be the reason why the skin delays to be aged.

Determination of Active Components in Whitening and Freckle-removing Cosmetics by High Performance Liquid Chromatography / 环境与健康杂志

Objective To develop a high performance liquid chromatography(HPLC)method for the determination of active components,sodium ascorbic phosphate,?-arbutin,hydroquinone,niacinamide,brillian-280 and phenol,in the whitening and Freckle-removing cosmetics.Methods Whitening and freckle-removing active components were separated on a C8 column(250 mm?4.6 mm,5 ?m)by using triethanolamine solution(11.15g triethanolamine dissolved in 1 L water,pH=7.7 adjusted with 1.75 ml H3PO4)+methanol=70+30 as the mobile phase at a flow rate of 1.2 ml/min,using diode array detector(DAD)with the detection wavelengh of 273 nm and the column temperature of 25℃.Results The coefficient of variation was less than 4.7% and the recovery rates were 87.3%-112.9%.Conclusion The method introduced in this paper is simple,rapid,accurate and is suitable for the analysis of various cosmetic samples.