Madhulika A Mhatre; Shashikant Malkud; Venkataram Mysore
Abstract
Background: The Q-switched neodymium: yttrium aluminum garnet laser (QS-Nd:YAG) is effective in the treatment of tattoos and different pigmentary conditions; however, little has been published regarding the removal of facial cutaneous pigmented lesions. The aim of this study was to determine the effectiveness ...
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Background: The Q-switched neodymium: yttrium aluminum garnet laser (QS-Nd:YAG) is effective in the treatment of tattoos and different pigmentary conditions; however, little has been published regarding the removal of facial cutaneous pigmented lesions. The aim of this study was to determine the effectiveness and safety of QS-Nd:YAG laser in the treatment of facial pigmentary lesions in Indian patients. Methods: Data of 100 patients with pigmented facial lesions treated with QS-Nd:YAG laser were analyzed. Clinical improvement of skin lesions was assessed by the physician’s global assessment of two blinded observers. This was done based on photographs taken at the baseline and after the last treatment session. Side effects were recorded if present, and patient satisfaction was evaluated after each treatment session. Results: The majority of the patients had post-inflammatory hyperpigmentation (n=41), followed by melasma (n=19), photomelanosis (n=15), nevus of Ota (n=5), periorbital melanosis (n=5), nevus spilus (n=3), Riehl melanosis (n=3), Café-au-lait macules (n=2), freckles (n=2), lichen planus pigmentosus (n=2), compound nevus (n=1), Hori’s nevus (n=1), and pigmentary demarcation lines (n=1). 10% of patients showed more than 50% improvement in pigmentation from the baseline level; no response was seen in 22% of patients, while 7% experienced worsened pigmentation. Conclusion: The degree of improvement and efficacy in clearing pigmentation is partial, variable, and inconsistent. Worsening of pigmentation may be seen and needs to be discussed with the patient prior to treatment
Sonal Agarwala; Shashikant Malkud
Abstract
Background: Vitiligo is an acquired condition resulting from the progressive loss of melanocytes. It may be associated with disorders of pigmented tissues of the eyes and ears, and withdisorders of the endocrine organs. Aim: To study the clinico-demographic profile of vitiligo patientsand ...
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Background: Vitiligo is an acquired condition resulting from the progressive loss of melanocytes. It may be associated with disorders of pigmented tissues of the eyes and ears, and withdisorders of the endocrine organs. Aim: To study the clinico-demographic profile of vitiligo patientsand its association with endocrine disorders and audiological and ocular abnormalities. Materials and Methods: This was a case-control study conducted at a tertiary care hospital; 261 vitiligo patients were enrolled together with 100 age- and gender-matched healthy individuals without vitiligo as the controls. A detailed history and clinical examination, including audiological and ocular examination, was undertaken; blood investigations like random blood sugar, thyroid function tests, and serum cortisol levels were requested for all subjects. Results: Vitiligo vulgaris was the most common type of disease detected in 146 (55.93%) patients, followed by focal vitiligo in59 (22.60%), mucosal vitiligo in 31 (11.87%), acrofacial vitiligo in 16 (6.13%), segmental vitiligo in 8 (3.06%), and universal vitiligo in one (0.38%) patient. Endocrine disorders were noted in 40 (15.32%) patients, which included hypothyroidism in 27, hyperthyroidism in 5, and diabetes in 8 patients. Sensorineural hypoacusis andocular abnormalities were noted in 56 (21.45%) and 49 (18.77%) vitiligo patients respectively. The association of hypothyroidism, sensorineural hypoacusis, and ocular abnormalities with vitiligowas statistically significant. Conclusion: Vitiligo is not limited to cutaneous melanocytes; it also affects pigment cells throughout the body. Patients with increased age, prolonged duration of disease, and greater bodysurface area involvement are at increased risk for systemic associations. A thorough clinical evaluation seems necessary for all vitiligo patients.
