ABSTRACT
BACKGROUND: Treatment of postinflammatory hyperpigmentation (PIH) in patients with dark skin is challenging as the treatment itself might provoke paradoxical PIH. Only few studies examined the safety and efficacy of nonablative laser treatment in these patients. The objective was to examine efficacy and safety of nonablative 1927 nm wavelength laser followed by bleaching creams in the treatment of PIH. METHODS: It was a prospective interventional pilot study that was conducted during 2019. All patients were of Fitzpatrick skin type IV who had unsatisfactory response to topical bleaching creams used for at least three months. Patients received one to four sessions of laser treatment (6 weeks apart) followed by topical hydroquinone 4% cream twice daily for 6 weeks. Improvement was assessed by two blinded independent dermatologist evaluators. RESULTS: A total of nine patients were enrolled and the outcome could not be assessed in one patient who was lost for follow-up. The affected sites were the abdomen, face, and other body parts. Three of the eight evaluated patients had excellent response (37.5%), four had satisfactory response (50.0%), and one had nonsatisfactory response (12.5%). The downtime was manifested as edema and erythema that disappeared after 5 to 7 days. Improvement was more evident in first session and it declined in subsequent sessions. None of the patients had paradoxical pigmentation after treatment. CONCLUSIONS: Low energy low density nonablative fractional 1927 nm wavelength laser treatment followed by topical hydroquinone 4% cream for 6 weeks is a safe and effective modality for improving PIH in patients with darker skin types.
ABSTRACT
INTRODUCTION: Chronic skin diseases including vitiligo could have profound psychological burden. The factors influencing the expression of depression in patients with vitiligo received little attention both nationally and internationally. AIM: The aim of the current study was to estimate the burden and severity of depression and to characterize their associated sociodemographic and clinical characteristics among patients with vitiligo. METHODS: A cross-sectional survey study was conducted among patients with vitiligo of both genders attending dermatology outpatient clinics at a tertiary care hospital during 2019. Modified Beck Depression Inventory Scale was used for screening for depression. RESULTS: A total 308 patients with vitiligo have been included in the current analysis. The average age was 27±14.5 years. Approximately 59.7% of the patients were males and the majority (63.6%) were single. A total 168 (54.5%) patients had some depressive symptoms. The majority of these patients had mild depression (52.4%), followed by moderate (33.3%) and severe (14.3%) depression. Moderate and/or severe depression were significantly higher among children and adolescents (p=0.036), single patients (p=0.006), those with lower than high school education (p<0.001), those with shorter duration of the disease (p<0.001), and those using phototherapy (p=0.003). Depression burden and severity were not significantly associated with gender and lesion distribution. CONCLUSION: Sociodemographic and clinical characteristics can easily characterize the risk of depression among patients with vitiligo. The current findings may help dermatologist to pick patients at higher risk of depression early after diagnosis of vitiligo. Dermatologists should have low threshold for referring such patients to psychiatry clinics.
ABSTRACT
INTRODUCTION: Lip darkening is a relatively common condition, especially in the Middle East and Southeast Asia. It is well documented in the literature and generally considered to be multifactorial. The presentation can be physiologic or pathologic and caused by a variety of local or systemic factors. CASE PRESENTATION: A 32-year-old female with skin type IV presented to the clinic with concerns of darkening lips with no associated symptoms or history of disease. On examination, her lips were homogenously dark brown with the upper lip slightly darker than the lower lip. OBJECTIVE: To report effectivness of Q-switched 532 nm laser for treatment of lip pigmentation. METHOD: Topical 2.5% lidocaine/prilocaine (EMLA) cream was applied 30 minutes prior to laser therapy. The region was treated with Q-switched 532 nm laser (Medlite). RESULT: Two weeks after laser treatment , threre was satisfying subjective and objective improvment in lip pigmnetation. CONCLUSION: Q-Switched 532 nm laser effectively reduces lip pigmentation after one session with minimal adverse effects and lasting results.
