Patients Of Skin Types Research Articles

Progressive pigmented purpuric dermatosis in skin of color: a dermoscopic and histopathological correlation

<p class="abstract"><strong>Background:</strong> Progressive pigmented purpuric dermatosis (PPPD) is a chronic cutaneous presents with petechiae, purpura on hyperpigmented yellowish-brown macules or patches. Diagnosis is straight forward, sometimes may be challenging for the diagnosis. Dermoscopy is a non-invasive tool. It gives characteristic patterns in PPPD. However, dermoscopic descriptions in skin of color are limited to case reports. Here, dermoscopic evaluation in skin of color is studied in detail. </p><p class="abstract"><strong>Methods:</strong> It was a cross sectional observation study. Ethical clearance and written consent was obtained. Patients of skin type 4 and 5, attending dermatology clinic with suspected lesions of PPPD were selected serially. Handheld dermoscope was used for examination. Site for dermoscopic examination was considered as target area. Skin biopsy was taken. Dermoscopic patterns were analysed and features were correlated with histopathological changes.<strong></strong></p><p class="abstract"><strong>Results:</strong> Totally 30 patients with 27 males and 3 females were enrolled. Schamberg’s disease was commonest type noted in 21patients. Eczematoid, lichen aureus, and lichenoid types were seen in 2 (6.7%) each. Hence, overall occurrence of Schamberg’s disease was statistically significant (p=0.028). Commonest dermoscopic findings were brown pigment network and yellowish-brown dots/globules. Least common features included linear vessels and bluish globules. Distorted pigment network noted in 29 (96.7%).</p><p class="abstract"><strong>Conclusions:</strong> Dermoscopy of PPPD shows characteristic patterns of which pigment network, red globules and yellowish-brown globules are the basic features. These features correlate well with histopathological changes. Yellowish-brown globules and background are prominently observed in skin of color. Larger studies are recommended to validate these differences.</p><p class="abstract"> </p>

Trichloroacetic Acid Paint for Boxcar and Polymorphic Acne Scars.

Scarring is a common complication of acne vulgaris with a significant impact on the psychological well-being of patients. Focal application of high concentration trichloroacetic acid (TCA) has been proven efficacious in treating ice-pick scars, but the utility in other scar types is understudied. The aim of this study is to evaluate the efficacy and safety of 90% TCA in boxcar and polymorphic acne scars using a novel brush applicator. Forty-one patients with acne scars were recruited for treatment of boxcar and polymorphic scar with 90% TCA applied with a cosmetic brush. Each patient received 3 treatment sessions spaced between 7 and 9 weeks apart. All participants had good to excellent outcomes as per Jacob and colleagues grading. Patients with skin Type 3 to 6 had more excellent outcomes (13 patient, 59%) than patients of skin type 1 to 2 (9 patients, 41%). Two participants (5%) had postprocedural complications. Five participants (14%) were on concomitant isotretinoin with no appreciable increase in reepithelialization time or rate of complications. Focal 90% TCA with a cosmetic brush applicator is safe and effective in treating boxcar and polymorphic scars. The clinical outcome is good to excellent with low rates of complication.

Effect of Subcision and Microneedling in the Treatment of Atrophic Acne Scars in Ten Patients: A Case Series

Background: Acne vulgaris is a common condition with a prevalence of over 90% among adolescents and post- acne scarring is a well known sequelae. Different types of scars (ice pick, boxcar, and rolling scars) warrant a customized approach of treatment for each type. We propose a novel treatment of atrophic acne scars using combination of subcision and microneedling. 
 Methods: Ten consecutive patients of skin types III - IV with moderate and severe facial acne scarring received three sequential subcision and microneedling treatments after informed consent over a period of three months with an interval of 4 weeks between each session. Goodman and Baron’s qualitative and quantitative acne scar grading systems along with side by side comparison of pre operative and post operative photographs were used for assessment at the end of three sessions of the combination procedure. 
 Results: Estimation of improvement with Goodman and Baron’s Global qualitative acne scarring system , we found good results in patients with Grades 3 and 4 acne scars. Out of 7 patients with grade 4 scars, 29% showed improvement by 2 grades and 71% showed improvement by 1 grade and all the 3 patients with grade 3 scars showed improvement by 1 grade. Quantitative assessment showed 30% patients had minimal improvement, 50% had moderate improvement and 20% had good improvement in scars. Adverse effects were transient pain, erythema and oedema.
 Conclusion: Subcision and microneedling are simple and inexpensive office procedures which in combination are well tolerated and are efficacious in treatment of moderate and severe acne scars.
 

Treatment of facial port-wine stains with a new intense pulsed light source in Chinese patients

Background: Intense pulsed light (IPL) systems have been used for the treatment of port-wine stains (PWS) for more than 10 years. Some of them have been reported in the treatment of laser-resistant PWS. Objective: To conduct a prospective trial to assess the efficiency and complications of a new IPL source in the treatment of PWS in Chinese patients. Methods: Thirty Chinese patients with PWS without previous treatment were recruited to receive IPL therapy for three to eight treatments at intervals of 4–5 weeks. There were 24 female and six male patients. Results: One hundred percent of patients showed more than 25% clearance, and 30% of the patients were able to achieve more than 75% clearance. About 70% of patients experienced 25–75% clearance, among them 53.33% of patients experienced 50–75% clearance. There were no long-term complications or side effects. Conclusion: The new IPL system can be safely used in treating PWS in Chinese patients of skin type IV.