RESUMEN
AbstractBACKGROUND:Peri-orbital dark circles are a cosmetic concern worldwide, and have been attributed to hyperpigmentation from allergy or atopic dermatitis, blood stasis, structural shadowing effects, and a thin epidermis/dermis under the eye. It is of interest to better understand lifestyle and demographic risk factors and the relative impact of melanin, blood and epidermal/dermal factors on the severity of Peri-orbital dark circles.OBJECTIVE:To compare by non-invasive imaging the impact of biological factors to a visual grading scale for Peri-orbital dark circles, and test the correlation of various demographic factors with Peri-orbital dark circles.METHODS:Subjects completed a lifestyle and health survey, and Peri-orbital dark circles severity was evaluated using standardized photographs. Hyperspectral image analysis was used to assess the contributions of melanin, blood volume, degree of blood oxygen saturation, and dermal scattering.RESULTS:Family history was the most significant risk factor for Peri-orbital dark circles. The average age of onset was 24 years, and earlier onset correlated with higher severity scores. Asthma was significantly associated with Peri-orbital dark circles scores, but self-reported allergy was not. In this study, sleep was not correlated with Peri-orbital dark circles scores. Hyperspectral imaging indicated that melanin was the dominant correlate for Peri-orbital dark circles severity, while oxygen saturation was secondary. The difference between under-eye and cheek measurements for ΔL*and ΔE* were the most significant instrumental parameters correlated with visual assessment of Peri-orbital dark circles severity.CONCLUSION:Although typically associated with lack of sleep, risk of Peri-orbital dark circles is primarily hereditary. The main factors contributing to the appearance of Peri-orbital dark circles are melanin and (deoxygenated) blood.
Asunto(s)
Adolescente , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Adulto Joven , Oftalmopatías/etiología , Dermatosis Facial/etiología , Hiperpigmentación/etiología , Estilo de Vida , Distribución por Edad , Factores de Edad , Brasil , Oftalmopatías/fisiopatología , Dermatosis Facial/fisiopatología , Hiperpigmentación/fisiopatología , Melaninas/análisis , Órbita , Oxígeno/sangre , Factores de Riesgo , Índice de Severidad de la Enfermedad , Espectrofotometría , Estadísticas no Paramétricas , Piel/fisiopatologíaRESUMEN
A doença de Addison (DA) é uma endocraniopatia potencialmente fatal, decorrente da destruição do córtex adrenal qie leva à redução dos níveis de cortisol e conseqüente aumento de hormônio adrenocorticotrófico (ACTH) circulante. A abordagem correta desses pacientes pelo cirurgião-dentista é importante para minimizar o risco de uma crise addisoniana que pode ter evolução fatal. No presente trabalho, relatamos três casos de DA cuja suspeição foi baseada na presença de pigmentações melânicas bucais. Outros achados importantes foram presença de cefaléia, dor abdominal, hipotensão, tonturas, irritabilidade, emagrecimento e avidez por sal. Além disso, foram também identificadas anemia, eosinofilia e hiponatremia. O teste rápido com ACTH foi realizado em todos os casos, sendo importante na definição do diagnóstico de DA. Baseados nessas observações, nós discutimos aspectos relevantes do diagnóstico clínico-laboratorial da DA, sua patogenia e tratamento, bem como os cuidados relacionados à abordagem odontológica desses pacientes.