Post-inflammatory hyperpigmentation

炎症后色素沉着
  • 文章类型: Journal Article
    背景:本研究的目的是评估15%壬二酸(AzA)凝胶治疗痤疮诱发的炎症后红斑(PIE)和炎症后色素沉着过度(PIH)的疗效和安全性。15%AzA凝胶对痤疮的影响,皮肤屏障功能,和生活质量也进行了评估。
    方法:共纳入72例轻度至中度痤疮患者,双盲,安慰剂对照试验。患者分为两组:AzA组患者每天两次使用15%AzA凝胶,持续12周,安慰剂组应用无AzA凝胶。使用非侵入性皮肤检测技术进行临床评估,包括VISIA皮肤分析,皮肤镜,和皮肤生理功能测试,在0、4、8和12周进行。主要结局指标包括痤疮后色素沉着指数(PAHPI),黑色素,血红蛋白,个体类型学角度,含水量,经皮水分流失,还有皮脂.研究者全球评估)和皮肤病生活质量指数(DLQI)评估在第0周和第12周进行。记录不良反应。
    结果:在研究开始的72名患者中,60人完成了审判。在8周和12周,与基线和接受安慰剂的患者相比,AzA组患者PIE病变的PAHPI显著降低(P<0.05).两组患者在第8周和第12周表现出减少的PIH病变,与基线有显著差异(P<0.05)。在第12周,与安慰剂治疗的PIE病变相比,AzA治疗的PIE病变的血红蛋白含量显着降低(P<0.05)。在12周时,AzA治疗的PIH病变中黑色素含量显着降低(P<0.05)。AzA组的DLQI改善明显(P<0.05),与安慰剂相比,总体满意度更高(P<0.05)。
    结论:结果表明,15%AzA凝胶可有效改善痤疮引起的PIE和PIH,不良反应最小,使其成为一个可行的临床应用。在研究人群中,对皮肤屏障功能无不良影响,对痤疮改善和患者生活质量有积极作用.
    背景:本研究已在中国临床试验注册中心(ChiCTR.org。cn)在标识符ChiCTR2300076959下。注册日期为2023年10月25日,追溯注册。
    BACKGROUND: The aim of this study was to assess the efficacy and safety of 15% azelaic acid (AzA) gel in treating acne-induced post-inflammatory erythema (PIE) and post-inflammatory hyperpigmentation (PIH). The effects of 15% AzA gel on acne, skin barrier function, and quality of life were also evaluated.
    METHODS: A total of 72 patients with mild to moderate acne were enrolled in a randomized, double-blind, placebo-controlled trial. Patients were divided into two groups: patients in the AzA group applied 15% AzA gel twice daily for 12 weeks, and those in the placebo group applied AzA-free gel. Clinical evaluations using non-invasive skin detection technologies, including VISIA skin analysis, dermoscopy, and skin physiological function tests, were performed at 0, 4, 8, and 12 weeks. Main outcome measures included the post-acne hyperpigmentation index (PAHPI), melanin, hemoglobin, individual typology angle, water content, transepidermal water loss, and sebum. Investigator Global Assessment) and Dermatology Life Quality Index (DLQI) assessments were conducted at weeks 0 and 12. Adverse reactions were recorded.
    RESULTS: Of the 72 patients at study initiation, 60 completed the trial. At 8 and 12 weeks, patients in the AzA group showed significantly reduced PAHPI for PIE lesions compared to baseline and patients receiving placebo (P < 0.05). Patients in both groups exhibited reduced PIH lesions at weeks 8 and 12 that differed significantly from baseline (P < 0.05). Hemoglobin content decreased significantly in AzA-treated PIE lesions compared to those treated with placebo at week 12 (P < 0.05). Melanin content decreased significantly in AzA-treated PIH lesions at week 12 (P < 0.05). The AzA group showed higher improvement in DLQI (P < 0.05), and greater overall satisfaction (P < 0.05) compared to placebo.
    CONCLUSIONS: The results indicate that 15% AzA gel effectively improved acne-induced PIE and PIH with minimal adverse reactions, making it a viable clinical application. In the study population, it had no adverse effects on skin barrier function and contributed positively to acne improvement and patient quality of life.
    BACKGROUND: This study was registered with the Chinese Clinical Trial Registry (ChiCTR.org.cn) under the identifier ChiCTR2300076959. The registration date was 25 October 2023, retrospectively registered.
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  • 文章类型: Meta-Analysis
    背景:炎症后色素沉着过度(PIH)是激光手术后常见的并发症。最近的研究将表皮生长因子(EGF)应用于激光手术后的激光区域,以降低PIH的发生率,但结果存在争议。因此,我们对随机对照试验(RCTs)进行了全面的文献综述,以调查该问题.
    方法:两位审稿人独立检索了文献,提取,并分析了数据。共纳入7项RCT,涉及169例患者,以评估EGF对激光手术后恢复和预防PIH的疗效。
    结果:结果表明,EGF组的PIH发生率相对低于对照组,虽然差异无统计学意义(OR0.64,95%CI0.33~1.25,p=0.19)。然而,与对照组相比,在激光手术后第1个月,EGF组的黑色素指数(MI)评分显著下降(SMD-1.57,95%CI-2.83~-0.31,p=0.01).此外,EGF侧患者的满意评分明显较高(SMD0.49,95%CI0.22〜0.76,p=0.0004)。在第2周和第2个月,MI的变化没有显着差异,红斑指数(EI),激光治疗后第3天和第7天经表皮失水(TEWL),分别。
    结论:目前的荟萃分析发现,含EGF的局部产品对PIH的暂时抑制作用有限,对减少激光后红斑或促进表皮屏障修复没有显著作用。由于样本量小和明显的组间异质性,未来需要更多的研究。
    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.
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  • 文章类型: Journal Article
    炎症后色素沉着过度(PIH)和阳光下的色斑是由于损伤或紫外线暴露导致的过度黑色素产生的皮肤黑斑。这项为期12周的单中心研究评估了新型靶向色素矫正斑点治疗凝胶悬浮乳膏(暗斑治疗)的疗效和耐受性,用于改善轻度至中度PIH或太阳腹胀。
    年龄在25-65岁的女性参与者(N=41),患有轻度至中度面部黑斑,每天进行黑斑治疗,持续12周。调查人员评估了总体色素沉着过度,肤色均匀度,和暗点强度,对比,和大小在第2、4、8和12周。参与者的自我评估发生在第1、2、4、8和12周。通过临床分级和参与者报告评估耐受性。
    黑斑治疗改善了整体色素沉着过度,肤色均匀度,以及在第2周至第12周的暗斑强度和对比度,以及在第4周至第12周的暗斑大小(与基线相比,所有p<0.001)。参与者的自我评估显示出很高的总体满意度。黑斑治疗耐受性良好。
    新型颜料校正暗斑治疗显着改善了PIH和太阳扁豆的外观,参与者满意度高,并被很好地容忍。
    UNASSIGNED: Post-inflammatory hyperpigmentation (PIH) and solar lentigines are dark spots of skin from excessive melanin production due to injury or UV exposure. This 12-week single-center study assessed the efficacy and tolerability of a novel targeted pigment-correcting spot treatment gel suspension cream (Dark Spot Treatment) for improving mild-to-moderate PIH or solar lentigines.
    UNASSIGNED: Female participants (N = 41) aged 25-65 with mild-to-moderate facial dark spots applied Dark Spot Treatment daily for 12 weeks. Investigators assessed overall hyperpigmentation, skin tone evenness, and dark spot intensity, contrast, and size at Weeks 2, 4, 8, and 12. Participant self-assessments occurred at Weeks 1, 2, 4, 8, and 12. Tolerability was assessed by clinical grading and participant reporting.
    UNASSIGNED: Dark Spot Treatment improved overall hyperpigmentation, skin tone evenness, and dark spot intensity and contrast at Weeks 2 through 12, and dark spot size at Weeks 4 through 12 (all p < 0.001 compared to baseline). Participant self-assessments showed high overall satisfaction. Dark Spot Treatment was well tolerated.
    UNASSIGNED: The novel pigment-correcting Dark Spot Treatment significantly improved the appearance of PIH and solar lentigines, had high participant satisfaction, and was well tolerated.
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  • 文章类型: Journal Article
    痤疮是影响大多数青少年的常见皮肤病。在有纹理头发的彩色青少年中,最重要的是要考虑头发护理习惯如何影响痤疮的分布和治疗。皮肤科医生在治疗该人群时应该熟悉头发护理文化规范。
    Acne is a common dermatologic condition that affects most adolescents. In adolescents of color with textured hair, it is paramount to consider how hair care practices may affect acne distribution and treatment. Dermatologists should be familiar with hair care cultural norms when treating this population.
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  • 文章类型: Case Reports
    我们介绍了一个32岁的非洲裔美国女性,其已知的原发性干燥综合征病史,多种维生素缺乏,和先前的面部蜂窝织炎,在机动车事故后出现弥漫性面部炎症后色素沉着过度。糖皮质激素治疗后,仅选择与炎症相关的色素沉着过度区域,感染,或者创伤得到改善,从而对改善患者的外观和状况提出了临床挑战。这样的结果可能需要考虑辅助局部疗法以减轻色素沉着过度的剩余区域。
    We present the case of a 32-year-old African American female with a known history of primary Sjogren\'s syndrome, multiple vitamin deficiencies, and prior facial cellulitis who presented with diffuse facial post-inflammatory hyperpigmentation following a motor vehicle accident. Following glucocorticoid treatment, only select hyperpigmented areas associated with inflammation, infection, or trauma improved, which thereby posed a clinical challenge to improve the patient\'s appearance and condition. Such results may warrant the consideration of adjunctive topical therapies to lighten the remaining areas of hyperpigmentation.
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  • 文章类型: Journal Article
    背景:痤疮病理生理学包括炎症介质之间的复杂相互作用,脂溢过多,痤疮丙酸杆菌改变角质化和卵泡定植。
    目的:描述曝光对痤疮的影响以及光保护如何改善结果。
    方法:对文献进行了叙述性回顾;从1992年1月至2022年11月,使用GoogleScholar和Pubmed进行了搜索。使用的关键词是“痤疮,\"\"防晒霜,\"\"光保护,\“\”化妆品,\"\"药妆,“”发病机理,“病因学”,\"\"暴露,\"\"阳光,\"\"压力,\"\"睡眠不足,\"\"饮食,炎症后色素沉着,\"\"污染,\"\"暴露,紫外线辐射,\"和\"可见光。\"
    结果:环境因素,如太阳辐射,空气污染,烟草消费,心理压力,不同的微生物,营养,其中,可以触发或恶化痤疮。太阳辐射可以暂时改善病变。然而,它可以诱导促炎和促纤维化反应,并产生炎症后色素沉着过度和/或炎症后红斑。虽然光保护被广泛推荐给痤疮患者,只有四项相关研究被发现。防晒霜可以显着改善症状或增强治疗,并可以防止炎症后色素沉着过度。此外,他们可以提供伪装和提高生活质量。基于痤疮的发病机制,最佳防晒霜应该有润肤剂,抗氧化剂和皮脂控制特性。
    结论:暴露和太阳辐射可以引发或加重痤疮。紫外线可以诱导炎症后色素沉着/红斑,可以发射耀斑。使用专门配制的防晒剂可以增强对局部或全身治疗的依从性,伪装损伤(有色防晒霜),减少炎症,并降低炎症后色素沉着/红斑的发生率。
    BACKGROUND: Acne pathophysiology includes a complex interaction among inflammatory mediators, hyperseborrhea, alteration of keratinization and follicular colonization by Propionibacterium acnes.
    OBJECTIVE: To describe the impact of the exposome on acne and how photoprotection can improve outcomes.
    METHODS: A narrative review of the literature was carried out; searches with Google Scholar and Pubmed from January 1992 to November 2022 were performed. The keywords used were \"acne,\" \"sunscreens,\" \"photoprotection,\" \"cosmetics,\" \"cosmeceuticals,\" \"pathogenesis,\" \"etiology,\" \"exposome,\" \"sunlight,\" \"stress,\" \"lack of sleep,\" \"diet,\" \"postinflammatory hyperpigmentation,\" \"pollution,\" \"exposome,\" \"ultraviolet radiation,\" and \"visible light.\"
    RESULTS: Environmental factors such as solar radiation, air pollution, tobacco consumption, psychological stress, diverse microorganisms, nutrition, among others, can trigger or worsen acne. Solar radiation can temporarily improve lesions. However, it can induce proinflammatory and profibrotic responses, and produce post-inflammatory hyperpigmentation and/or post-inflammatory erythema. While photoprotection is widely recommended to acne patients, only four relevant studies were found. Sunscreens can significantly improve symptomatology or enhance treatment and can prevent post-inflammatory hyperpigmentation. Furthermore, they can provide camouflage and improve quality of life. Based on acne pathogenesis, optimal sunscreens should have emollient, antioxidant and sebum controlling properties.
    CONCLUSIONS: The exposome and solar radiation can trigger or worsen acne. UV light can induce post-inflammatory hyperpigmentation/erythema, and can initiate flares. The use of specifically formulated sunscreens could enhance adherence to topical or systemic therapy, camouflage lesions (tinted sunscreens), decrease inflammation, and reduce the incidence of post-inflammatory hyperpigmentation/erythema.
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  • 文章类型: Journal Article
    由于引入了选择性光热解,Q开关纳秒激光器已用于治疗皮肤色素沉着病变。在过去的几年里,皮秒激光器已被引入化妆品界。我们最近进行了一项研究,比较550皮秒755nm激光与50ns755nm激光,目的是评估每种激光治疗太田痣的临床疗效和并发症。10名患有太田痣的亚洲患者被纳入研究。每个病灶分成两部分,患者接受755nm皮秒激光(PSL)和755nm纳秒激光(NSL)治疗。注量选择的临床终点是治疗区域的立即增白(PSL:2.33~3.36J/cm2,NSL:5.5~7J/cm2)。脉冲持续时间固定在550皮秒(PSL)和50ns(NSL)。每个激光器的光斑尺寸为2.5-3mm。进行激光治疗直至观察到良好的临床改善。第一次治疗后1周检查患者,在每次后续访问中,最后一次激光治疗后6个月。实现优异的临床改善的治疗疗程的平均数目是使用PSL的4.2治疗和使用NSL的5.4治疗。在NSL治疗组中观察到1例色素沉着过度和1例色素沉着不足。PSL治疗组无并发症发生。在Ota痣的治疗中,755nm550皮秒激光明显比755nm50ns激光更有效。PSL治疗组的副作用也最小。
    Since the introduction of selective photothermolysis, Q-switched nanosecond lasers have been used for the treatment of dermal pigmented lesions. Over the past several years, picosecond lasers have been introduced to the cosmetic community. We recently performed a study comparing a 550 picosecond 755 nm laser versus a 50 ns 755 nm laser, with the purpose of evaluating the clinical efficacy and complications of each laser when treating nevus of Ota. Ten Asian patients with nevus of Ota were enrolled in the study. Each lesion was split into 2 parts, and patients were treated with a 755 nm picosecond laser (PSL) and a 755 nm nanosecond laser (NSL). The clinical endpoint for fluence choice was immediate whitening (PSL: 2.33 ~ 3.36 J/cm2, NSL: 5.5 ~ 7 J/cm2) of the treated area. The pulse duration was fixed at 550 picoseconds (PSL) and 50 ns (NSL). The spot size of each laser was 2.5-3 mm. Laser treatments were performed until excellent clinical improvement was observed. Patients were examined 1 week after the first treatment, at each follow-up visit, and 6 months after the last laser treatment. The average number of treatment sessions to achieve excellent clinical improvement was 4.2 treatments using PSL and 5.4 treatments using NSL. One case of hyperpigmentation and one case of hypopigmentation were observed in the NSL treatment group. There were no complications in the PSL treatment group. The 755 nm 550 picosecond laser is significantly more effective than the 755 nm 50 ns laser in the treatment of nevus of Ota. The PSL treatment group also had minimum side effects.
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  • 文章类型: Journal Article
    未经证实:炎症后色素沉着过度(PIH)是由于任何炎症而发生的皮肤色素沉着过度。通过炎症触发黑素细胞导致黑色素过度产生和沉积。氨甲环酸(TXA)是一种用于治疗出血的抗纤维蛋白溶解药物。最近,有一些关于TXA治疗PIH的研究。
    UNASSIGNED:本研究的目的是确定氨甲环酸治疗PIH的疗效和最佳给药方式。
    UNASSIGNED:本系统评价是根据PRISMA指南报告的。我们将截至2022年9月发表的所有相关英语研究纳入以下电子数据库:Cochrane图书馆,PubMed,Embase,谷歌学者。最初的搜索产生了61篇文章,其中9例在应用纳入和排除标准后纳入。
    UNASSIGNED:系统评价共纳入196名16岁以上的患者。在4项研究中口服氨甲环酸,在2项研究中,同时在1项研究中。此外,皮内注射用于其他2项研究。几乎所有研究都主张使用所有途径来加速色素沉着的清除,与口服途径相比,由于其轻微的副作用,因此更倾向于局部和皮内途径。
    UNASSIGNED:体内TXA被认为是最佳途径,副作用少,成本低,结果好,而由于不良事件的发生率,发现口服TXA不如其他途径优选。
    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.
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  • 文章类型: Journal Article
    人类皮肤的特点是颜色和色调的显著多样性,这取决于表皮中黑色素的数量和分布。黑色素吸收和反射紫外线辐射(UVR),防止表皮中基因组DNA的损伤和真皮中胶原蛋白的降解;因此,由于黑色素含量高,深色皮肤类型被认为可以很好地保护免受光损伤。然而,黑色素含量的增加与引起炎症的外在应激因素,如过量的UVR,过敏反应,或伤害也经常导致美容问题,导致变色和疤痕。这篇综述总结了组织病理学的最新知识和最常见问题之一的可能分子特征,炎症后色素沉着过度(PIH)。到目前为止提出的机制随后在表征深色皮肤类型的其他因素的背景下进行讨论。这包括常见的蜂窝特征,上皮层的组织,和主要的生物标志物,特别强调全身和局部炎症的倾向增加。增强或延长的炎症反应不仅可以影响黑素生成的过程,而且还与损伤相关的皮肤病理和老化有关。最后,我们总结了PIH的主要美容治疗方法及其已知的抗炎靶点,这对于较深的肤色是有益的,并与针对UVR的广谱滤镜相结合。
    Human skin is characterized by significant diversity in color and tone, which are determined by the quantity and distribution of melanin pigment in the epidermis. Melanin absorbs and reflects ultraviolet radiation (UVR), preventing the damage to genomic DNA in the epidermis and degradation of collagen in the dermis; therefore, darker skin types are thought to be well protected from the photodamage because of the high melanin content. However, increased content of melanin in combination with the extrinsic stress factors causing inflammation such as excess UVR, allergic reactions, or injury can also frequently lead to cosmetic problems resulting in discoloration and scarring. This review summarizes current knowledge on histopathology and likely molecular signatures of one of the most common problems, post-inflammatory hyperpigmentation (PIH). The mechanisms proposed so far are subsequently discussed in the context of other factors characterizing darker skin types. This includes the common cellular features, organization of upper skin layers, and major biomarkers, with particular emphasis on increased propensities to systemic and localized inflammation. Enhanced or prolonged inflammatory responses can not only affect the process of melanogenesis but also have been implicated in injury-related skin pathologies and aging. Finally, we summarize the major cosmetic treatments for PIH and their known anti-inflammatory targets, which can be beneficial for darker skin tones and combined with broad-spectrum filters against UVR.
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