ABSTRACT
A 42-year-old woman with phototype V, presented a 9-year history of refractory centrofacial melasma to topical bleaching agents and peelings, untreated for the last 90 days. One session of microneedling with 1.5 mm needles was performed with hydroquinone 4% sterile serum drug delivery; after 3 days, modified Kligman's formula (hydroquinone 4% + fluocinolone acetonide 0.01% + tretinoin 0.05%) and broad-spectrum sunscreen SPF 70 were introduced for daily use. After 30 days, a significant improvement was observed in the clinical outcome (Figure 1) and the quality of life of the patient. These parameters were measured using Melasma Area and Severity Index (MASI) scale, with an 82.5% decrease, and Melasma Quality of Life Scale - Brazilian Population (MELASQoL-BP), with a 60% decrease. Dermatoscopic analysis (polarized videodermatoscopy x20) of the glabellar region revealed lighting of the pseudoreticular pigment network, diffuse light to dark brown background, and reduction in vascularity and telangiectasias (Figure 2). At the 5-month follow-up, there had been no relapse. The patient continued to use a broad-spectrum sunscreen along with the topical regiment.
Subject(s)
Cosmetic Techniques , Dermatologic Agents/administration & dosage , Hydroquinones/administration & dosage , Melanosis/therapy , Adult , Combined Modality Therapy , Drug Delivery Systems , Female , Fluocinolone Acetonide/administration & dosage , Fluocinolone Acetonide/analogs & derivatives , Follow-Up Studies , Humans , Needles , Quality of Life , Sunscreening Agents/administration & dosage , Treatment Outcome , Tretinoin/administration & dosageABSTRACT
Sarcoidosis is a multisystemic granulomatous disease of unknown causes, and cutaneous sarcoidosis (CS) is an early manifestation of the disease. Dermoscopy has gained increasing interest in the past few years as an aid in the clinical diagnosis of inflammatory and infectious skin manifestations. We present a case report about a single, erythematous, and asymptomatic plaque on the face with unexpected dermoscopy characteristics of CS. Learning points: CS on the face of a therapy-resistant actinic keratosis should be considered a differential diagnosis.Dermoscopy can change the diagnosis and lead to the correct management.
ABSTRACT
Vulvar melanoma is a rare and deadly cancer in women, and the prognosis is often poor. There are limited studies on the dermoscopic features of vulvar melanoma. Described criteria include the presence of blue, gray, or white colors. Herein we present the clinical and dermoscopic characteristics of a hypopigmented and heavily pigmented nodule in a 92-year-old and an 80-year-old woman. Dermoscopy in the former revealed structureless milky-red to white areas, remnants of brown pigmentation at the base and polymorphic vessels, while the latter displayed structureless blue-gray areas with black dots and peripheral lines at the base. In both cases, histopathology revealed a stage III melanoma. Our two cases along with a review of the literature suggest that the dermoscopic features described for diagnosing cutaneous nodular melanoma, apply also for vulvar melanoma. Clinicians should always raise the suspicion if observing plaques or nodules with a dermoscopic polymorphic vascular pattern and blue-black color on the genitals of postmenopausal women.
