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BACKGROUND: Post-inflammatory hyperpigmentation (PIH) is a common complication after laser surgeries. Recent studies applied epidermal growth factor (EGF) on the lasered area after laser surgery to decrease the incidence of PIH with controversial results. Therefore, a comprehensive literature review of randomized controlled trials (RCTs) was conducted to investigate the issue.
METHODS: Two reviewers independently searched the literatures, extracted, and analyzed the data. A total of seven RCTs involving 169 patients were included to evaluate the efficacy of EGF on recovery and PIH prevention after laser surgery.
RESULTS: The results show that the incidence of PIH in the EGF group was relatively lower than that in the control group, although the difference was not statistically significant (OR 0.64, 95% CI 0.33 ~ 1.25, p = 0.19). However, the EGF groups had a significant decrease in melanin index (MI) scores at the 1st month after the laser surgery when compared to the control groups (SMD -1.57, 95% CI -2.83 ~ -0.31, p = 0.01). In addition, the patients on the EGF side rated significantly higher satisfactory scores (SMD 0.49, 95% CI 0.22 ~ 0.76, p = 0.0004). There was no significant difference as regard to changes in MI at the 2nd week and 2nd month, erythema index (EI), and trans-epidermal water loss (TEWL) at days 3 and 7 after laser therapy, respectively.
CONCLUSIONS: The current meta-analysis found a limited temporary inhibitory effect of EGF-containing topical products on PIH with no significant effect on reducing post-laser erythema or promoting epidermal barrier repair. More studies are needed in the future due to the small sample size and marked intergroup heterogeneities.

UNASSIGNED: Post-inflammatory hyperpigmentation (PIH) is skin hyperpigmentation that occurs due to any inflammatory condition. Triggering the melanocytes by inflammation leads to melanin overproduction and deposition. Tranexamic acid (TXA) is an antifibrinolytic medication prescribed to treat bleeding. Recently, there are some studies about the use of TXA in the treatment of PIH.
UNASSIGNED: The aim of this study is to identify the efficacy and the best mode of delivery for tranexamic acid in the treatment of PIH.
UNASSIGNED: This systematic review is reported in accordance with PRISMA guidance. We included all relevant English-language studies that were published up to September 2022 in the following electronic databases: Cochrane Library, PubMed, Embase, and Google Scholar. The initial search yielded 61 articles, 9 of which were included after applying inclusion and exclusion criteria.
UNASSIGNED: The systematic review included a total of 196 patients who were over the age of 16 years old. Tranexamic acid was delivered orally in 4 studies, topically in 2 studies, and both simultaneously in 1 study. In addition, intradermal injection was used in 2 other studies. Almost all studies advocated the use of all routes for accelerating the clearance of hyperpigmentation with more favor towards topical and intradermal routes due to their mild reported side effects when compared to oral routes.
UNASSIGNED: Intradermal TXA is considered the best route, which exhibits fewer side effects with less cost and excellent outcomes, while oral TXA is found to be less preferable than other routes due to the incidence of undesirable adverse events.

Photoprotection is a critical health prevention strategy to reduce the deleterious effects of ultraviolet radiation (UVR) and visible light (VL). Methods of photoprotection are reviewed in this paper, with an emphasis on sunscreen. The most appropriate sunscreen formulation for personal use depends on several factors. Active sunscreen ingredients vary in their protective effect over the UVR and VL spectrum. There are dermatologic diseases that cause photosensitivity or that are aggravated by a particular action spectrum. In these situations, sunscreen suggestions can address the specific concern. Sunscreen does not represent a single entity. Appropriate personalized sunscreen selection is critical to improve compliance and clinical outcomes. Health care providers can facilitate informed product selection with awareness of evolving sunscreen formulations and counseling patients on appropriate use. This review aims to summarize different forms of photoprotection, discuss absorption of sunscreen ingredients, possible adverse effects, and disease-specific preferences for chemical, physical or oral agents that may decrease UVR and VL harmful effects.

Post-inflammatory hyperpigmentation (PIH) is one of the most common disorders of acquired hyperpigmentation. It often develops following cutaneous inflammation and is triggered by various stimuli, from inflammatory and autoimmune conditions to iatrogenic causes and mechanical injuries. While it is well established that an increase in melanin production and distribution within the epidermis and dermis is a hallmark feature of this condition, the exact mechanisms underlying PIH are not completely understood. This article aims to review the current evidence on the pathophysiology of PIH as the cellular and molecular mechanism of PIH represents a promising avenue for the development of novel, targeted therapies.

Post-inflammatory hyperpigmentation (PIH) is a common cosmetic complaint affecting patient quality of life. PIH has been proven to disproportionately affect skin of color. While several treatment options exist, special consideration must be given when managing PIH in patients of color, as topical treatments and aesthetic procedures, such as chemical peels and lasers, may either exacerbate or prove ineffective against PIH.

BACKGROUND: Polypodium leucotomos (PL) is a natural extract from tropical fern leaves with antioxidant and anti-inflammatory properties. It has been implicated as a potential treatment agent in multiple dermatologic conditions. OBJECTIVE: Here, we review the mechanism of action and current dermatologic applications of PL and extrapolate potential future dermatologic applications of PL. DESIGN: An extensive literature review on Pubmed was conducted in search of relevant background information and human studies utilizing PL for the treatment of dermatologic conditions. METHODS: Using the PubMed database, a literature search was conducted to identify relevant publications. \"Polypodium leucotomos\" was input as the key search criterion. The results were filtered by species (human) and language (English). Only papers with dermatologic applications were selected. Additionally, relevant publications found in the reference sections of selected articles were manually searched and selected. Included articles explore the origin, basic science mechanism, and various dermatologic applications of PL studied in humans. Each article was thoroughly studied by all authors and applicable data from each was used for the compilation of this review article. RESULTS: See Table 1 for a summary of dermatologic applications of PL based on available human clinical studies. LIMITATIONS: There was a limited number of human studies concerning the use of PL for treatment of dermatologic conditions and, of the available studies, many were of a small sample size. CONCLUSION: PL has a clinically significant role for the treatment and prevention of certain dermatologic conditions including: photoprotection, photocarcinogenesis, photoaging, vitiligo, melasma, and polymorphic light eruption. There is supporting evidence for its use in malignant melanoma high-risk patients, for enhanced actinic keratosis clearance following photodynamic therapy, and for symptomatic relief in atopic dermatitis. Potential clinical uses that require additional human clinical studies include solar urticaria, post-inflammatory hyperpigmentation, cutaneous lupus erythematosus, and other photosensitive cutaneous disorders.

Post inflammatory hyperpigmentation (PIH) can be difficult to treat especially in patients with darker skin types as darker skin carries increased epidermal melanin content. Various treatments available to improve the appearance of PIH may incite further pigmentation thus making treatment extremely difficult and frustrating. The purpose of this study was to perform a retrospective chart and photographic review to evaluate the efficacy and safety profile of a low energy low density non-ablative fractional1927 nm wavelength laser treatment for PIH in patients with Fitzpatrick skin types IV-VI.
A retrospective evaluation of 61 patients with PIH treated with a 1927 nm laser was conducted at a single center. Inclusion criteria required at least 2 treatment sessions so that before and after treatment photographs would be available for comparison and study purposes. Two blinded physician-evaluators using a visual analog scale for percentage of pigmentary clearance in standard photographs assessed treatment efficacy.
The mean percent improvement after treatment, evaluated by two dermatologists was 43.24%. The correlation between raters was statistically significant (Pearson\'s correlation coefficienct of r = 0.59, p < 0.0001). No side effects were observed in the patients treated with the 1927 nm laser.
The low energy low density non-ablative fractional 1927 nm wavelength laser is a safe and effective modality for improving post inflammatory hyperpigmentation in patients with darker skin types. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

OBJECTIVE: Erythema dyschromicum perstans (EDP) can be difficult to diagnose and treat; therefore, we reviewed the literature to assess whether histology can be used to differentiate lichen planus pigmentosus (LPP) from EDP and determine which treatments are the most effective for EDP. We also present a case of a patient who was treated successfully with narrow-band ultraviolet B (NB-UVB).
METHODS: A systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was conducted up to July 2017 using four databases.
RESULTS: Histologic analyses from the literature reveal a significant percentage of melanophages, lymphocytic infiltrates, and basal vacuolar degeneration in EDP, and a significant histologic overlap with LPP. The review of the literature on treatment outcomes showed that NB-UVB and tacrolimus were effective with minimal side effects. Clofazimine was effective, but demonstrated significant-to-intolerable side effects. Griseofulvin, isotretinoin, and dapsone provided unsatisfactory results as lesions recurred after discontinuation. Lasers were largely ineffective and may cause postinflammatory hyperpigmentation and fibrosis.
CONCLUSIONS: A diagnosis of EDP should not be based on histologic findings alone. Clinical history, morphology, and distribution should be used to differentiate EDP and LPP. NB-UVB and tacrolimus are promising treatments for EDP with minimal side effects. This is the first report to our knowledge of sustained resolution of EDP after treatment with NB-UVB at long-term follow-up of 4 years. Larger studies are needed to confirm these findings.