Periorbital Melanosis Research Articles

Prospective study of using 1064-nm Q-switched Nd: YAG combined with radiofrequency-imported vitamin C on pigmented infraorbital dark circles

Infraorbital dark circles are a common manifestation of periorbital melanosis, which is aesthetically defective and bring a negative impact on life quality. However, there is no acknowledged treatment for infraorbital dark circles. The 1064-nm Q-switched Nd: YAG laser (QSNYL) is commonly utilized to treat hyperpigmentation disorders. Radiofrequency (RF) therapy can improve the transdermal absorption rate of drugs. A prospective clinical trial was conducted to investigate the clinical efficacy and safety of 1064-nm QSNYL combined with RF-imported vitamin C for the treatment of infraorbital dark circles. A questionnaire was used to explore the relevant factors affecting the severity of infraorbital dark circles. A total of 30 patients with pigmented infraorbital dark circles were enrolled in this clinical trial. Each participant received 4 treatments and was followed up for at least 12 months after the last treatment.We focused on the overall change in the appearance of the included participants before and after treatment, by using satisfaction evaluation.In order to reduce evaluation bias, the vivo reflectance confocal microscopy images were taken on days 1 and 120 to detect pigmentation. The questionnaire survey before treatment showed that high-frequency makeup was positively and statistically significant with the severity of infraorbital dark circles (p < 0.01). Both participants and independent evaluators found that the hyperpigmentation in the infraorbital region was significantly reduced after combined treatment with high treatment satisfaction. The density of melanin particles in the infraorbital dark circles region showed a decreased trend. No significant side effects were observed. The 1064-nm QSNYL combined with RF-imported vitamin C is a safe and effective treatment for pigmented infraorbital dark circles by reducing melanin particles.

Illuminating the shadows: an insight into periorbital hyperpigmentation

Periorbital hyperpigmentation (POH), also referred to as periorbital melanosis or dark eye circles, is a common dermatological concern characterized by darkening of the skin around the eyes. This review article aims to comprehensively analyze the current understanding of POH, encompassing its epidemiology, etiopathogenesis, clinical manifestations, diagnosis and available treatment modalities, and focusing on patients’ skin color. The review also consolidates a grading system for POH and emphasizes the importance of accurate diagnosis using clinical examination, assessment scores, Wood’s lamp, ultrasonography, and dermoscopy. Treatment modalities range from non-pharmacological measures to topical agents, including kojic acid, alpha-arbutin, vitamin C, vitamin E, niacinamide, retinoids, and hydrating agents. The manuscript explores the efficacy of various skin-lightening agents, such as hydroquinone, and introduces emerging treatments like caffeine, carotenoids, lactic acid, curcumin, and vitamin K. Additionally, it delves into procedural treatments like chemical peels, lasers, blepharopigmentation, mesotherapy, platelet-rich plasma therapy, fillers, autologous fat transplantation, and surgical interventions. The comprehensive approach to understanding and managing POH presented in this review aims to provide clinicians with valuable insights into the diverse therapeutic options available for this challenging cosmetic concern.

Prevalence of skin diseases among hostellers attending the tertiary care hospital

Background: Skin diseases are more common but are mostly non-fatal and chronic. Dermatological conditions account for a significant proportion of the global burden of diseases. Aims and Objectives: The study aimed to determine the prevalence of skin diseases among hostellers, determine the causative factors, and describe the prevention. Materials and Methods: This cross-sectional study was conducted for 2 months in the outpatient Department of Dermatology, Government Medical College, Pudukottai, on 507 hostellers. The study subjects were examined and diagnosed by the dermatologist. Questions such as exposure to sunlight, usage of sunscreen, frequency of head baths, and junk food consumption were asked and recorded in a case study form by the principal investigator. Results: Pityriasis capitis was the most prevalent skin disease among 507 participants, followed by acne vulgaris (54.83%) and pediculosis capitis (25.64%). Pityriasis capitis is more common in men (56.17%), with higher chances in those with head baths (&lt;3 times/week) and exposure to sunlight (28.08%). Acne vulgaris affects both males and females equally; face washing &lt;3 times daily is associated with oil and sebum retention, while lack of sunscreen and junk food intake are linked. Periorbital melanosis is more prevalent in females (54.62%) and is linked to stress (66.39%). Sleep duration is also a factor, with 69.23% of girls having a history of cosmetic usage. Conclusion: Pityriasis capitis, acne vulgaris, pediculosis capitis, dermatophytosis, and periorbital melanosis are common skin diseases caused by sharing, sleep deprivation, stress, and poor hygiene. Proper hygiene, sleep patterns, and self-care can reduce skin disease incidence.

CLINICO-EPIDEMOLOGICAL STUDY OF FACIAL MELANOSIS

Introduction: Melanosis affecting face and neck occur from a myriad of conditions. The similar overlapping clinical, histological and dermoscopic features posses an intricate diagnostic problem for the clinician. Attempts to classify them have been partially successful. Methods: This was a prospective hospital based study conducted in a tertiary hospital over a period of one year involving 120 patients of facial melanosis. Relevant investigations including skin biopsy and patch testing were done wherever required. Results: Study sample ranged from nine to 60 years with maximum number of patients in 21-40 years of age. Females predominated in the study. Most common diagnosis was melasma followed by pigmented contact dermatitis, periorbital melanosis, lichen planus pigmentosus, erythema dyschromicum perstans, poikiloderma of civatte and eythromelanosis follicularis. Conclusion: There was considerable clinical, histological overlap between these clinical entities. UV exposure in melasma and lichen planus pigmentosus, exposure to allergens in pigmented contact dermatitis were the main etiological factors implicated. Key words: facial melanosis, melasma, pigmented contact dermatitis, lichen planus pigmentosus.

CLINICO DERMOSCOPIC STUDY OF PATTERNS OF PERIORBITAL HYPERMELANOSIS

Background:Periorbital hyperpigmentation (POH) is a routinely encountered condition in dermatology practice. Studying the clinical features and its correlation with dermoscopy will help in better understanding of patterns of periorbital pigmentation and its evolution. 2POH is a condition characterised by bilateral homogenous, hyperchromicmacules and patches, primarily involving the upper and the lower eyelids. 3It is a common problem with multifactorial etiology, is evident on the face and can affect patients quality of life (QoL). 7 Aim: To study dermoscopic patterns of periorbital hyper melanosis in patients presenting to dermatology, venereology,leprosy OPD in Bhaskar General Hospital from January 2022 to June 2022. Methods: 50 patients with periorbitalhypermelanosiswere included in the study.Dermilite 4 Dermoscope (10X magnification) with polarised light was employed in the study. Results:Out of 50 patientsondermoscopy mixed type was 76.4%, pigmented 11%, vascular 10.6%, structural 2%. Conclusion:Periorbital melanosis presents as multifactorial entity with constitutional type being the most common. The most common pattern seen on dermoscopy is mixed.It is essentially a clinical diagnosis, but dermoscopy might aid in further classification of the disease. Also, it might give us a clue regarding the etiology and help in the treatment, as different types of POH respond to varying treatments.7

Do we need to worry for metabolic syndrome in patients of periorbital melanosis? A case report of a middle-aged female

Background: In today's world, periorbital melanosis (PM), frequently referred to as dark circles, is of great cosmetic importance. This condition not only has a huge psychological impact but, it could also possibly be an indication of acanthosis nigricans (AN). Recently, it has been recognized as a distinct manifestation of metabolic syndrome. Methods: We studied one case of a middle aged female who came with a complaint of periorbital darkening. Relevant clinical and laboratory investigations were carried out. Results: Along with periorbital hyperpigmentation, she was also found to have axillary darkening consistent with AN. Further evaluation revealed abnormal electrocardiogram findings and she fulfilled the criteria of metabolic syndrome. Conclusion: We emphasize the need for evaluating such patients of PM for underlying metabolic syndrome.

Dermoscopy as an efficient aid to diagnose pigmentary and vascular component of periorbital melanosis: A cross-sectional study.

Periorbital melanosis (POM) has a significant impact on quality of life. There is a dearth of literature regarding POM, especially in Asian population. Accurate classification of POM is contributory to the choice of therapy. The aim of this study was to assess the role of dermoscopy in etiologic classification of POM. Two hundred and fifty adult patients (age > 18 years) of POM were enrolled over a period of 2 years. POM was classified clinically and re-evaluated based on their dermoscopic findings (pattern of pigmentary and vascular involvement, surface changes). Pigmented, vascular, structural, and mixed types of POM represented 6.4%, 4.8%, 0.4%, and 88.4%, respectively. Dermoscopy was found to be statistically more accurate in classifying pigmentary and vascular types of POM as compared to clinical examination with the naked eyes (p- value <0.05). Patchy or post-inflammatory pigmentation was the most common pigmentary pattern on dermoscopy (53.8%) followed by pseudoreticular (37.1%) and mixed pattern (9.1%). 80.4% patients had vascular involvement of which the most common vascular pattern was telangiectasia (58.8%). Wrinkling or increased skin laxity as a cause of shadow effect was found in 52% patients. Diffuse erythema and scaling suggestive of subtle inflammation was detected in 47.6% patients on dermoscopy. Dermoscopy as a diagnostic modality is more accurate in detecting pigmentary and vascular causes of POM and subtle signs of active inflammation in the form of erythema and scaling which is difficult to detect clinically. The major limitations of this study were lack of correlation of dermoscopic findings with the histological findings and the absence of any control group for comparison.

Evaluation of Efficacy and Safety of Low-Fluence Q-Switched 1064-nm Laser in Infra-orbital Hyperpigmentation Based on Biometric Parameters.

Introduction: Dark circles and wrinkles under the eyes are common cosmetic problems, caused by various conditions, especially aging and overproduction of melanin in the epidermis or dermis of the skin. Iin addition to the application of topical lightening agents, different types of lasers, especially the Q-Switched ND:YAG laser, have been used for the treatment of cutaneous hyperpigmentation. Because of a high prevalence of idiopathic eye dark circles (EDCs) or periorbital melanosis and a poor response to available therapies, we decided to evaluate the efficacy and safety of the Fractional QS 1064 nm ND:YAG Laser through a before-after trial. Methods: 18-65-year-old patients with skin Fitzpatrick phototype of I-V and without any usage of a topical or systemic therapeutic regimen (2-4 weeks before the trial) were enrolled in the study. Each patient was treated with 6 sessions of the Fractional QS 1064 nm ND:YAG Laser at 2-week intervals and assessed for response and possible side effects or recurrences through 4 outcome measures, including Visoface-based color and erythema, melanin index and lightness (Before the fourth and sixth sessions of the therapy; also 1 week and 3 months after finishing the trial). Results: The changes of Visoface-based color and erythema, the melanin pigment amount by the Mexameter (melanin index) and the degree of lightness by the Colorimeter of patients after 6 months of intervention were statistically significant (P < 0.001). Conclusion: The fractional QS 1,064 nm ND:YAG Laser is an effective and safe therapy in EDCs since objective outcomes like the reduction of the melanin index and improving lightness and subjective ones like the reduction of darkness and erythema were confirmed.

Clinical and Dermoscopic Evaluation of Periorbital Melanosis.

Background:Periorbital melanosis (POM) describes the light-to-dark-colored, brownish-black pigmentation surrounding the eyelids. It can affect an individual’s quality of life. Dermoscopic features of POM are not frequently reported in the literature.Materials and Methods:This study comprised 100 patients aged above 16 years, who attended our outpatient department (OPD) from November 2018 to October 2019. A detailed history, clinical features, and the dermoscopic study of color, pattern of pigment, and pattern of the blood vessel were recorded with the Dermlite-3N dermoscope (3Gen, San Juan Capistrano, California). On the basis of the eyelids’ pigmentation and involvement, patients were clinically graded as Grade 0 to 4, with 4 being deep dark color extending beyond the infraorbital fold. The clinical patterns and the dermoscopic features were correlated.Results:Most patients were women (76) and the common age group was 16–25 years. Most of the patients had both the eyelids involved (58%), followed by lower eyelids (28%). The majority of the patients were having POM of grade 2 (47%). Seventeen patients (17%) had a positive family history of POM. The most common clinical form of POM observed was constitutional type (77) followed by postinflammatory type (12). Of 100 patients, 52 had pigmentary, 15 had vascular, and 33 had mixed pigmentary-vascular pattern. Cell phone usage (>4 h) and refractory errors (38% each) were the common risk factors observed. Stress and respiratory allergy were significantly associated. In the pigmentation patterns, epidermal (54%), dermal (14%), and mixed (17%) subsets were observed. The reticular pattern was the most common vascular pattern (65%).Conclusion:POM is a multifactorial entity. Multiple risk factors play a role in the pathogenesis and aggravation. Clinical forms did not show any specific dermoscopic patterns. Dermoscopy of POM helps to know the underlying pathology, which in turn paves the way to the effective treatment.

Use of Hyaluronic acid fillers in treatment of periorbital melanosis induced by tear trough deformity: Anatomical considerations, patient satisfaction, and management of complications.

Periocular melanosis (POM) due to shadow effect of tear trough deformity (TT) does not respond to the conventional treatment modalities. Hyaluronic acid (HA) fillers are a favurable treatment modality. This area is a high risk for injectables due to its unique anatomy. To find role of HA fillers in treatment POM due to TT deformity with special emphasis on practical anatomy, patient satisfaction rate, and management of complications. A correlation of the grade of TT, age of the patient, and patient satisfaction was done. A follow-up at 1year was done to assess longevity of results. Retrospective study of 60 cases of clinically diagnosed POM (120 TT) due to TT deformity was performed. Each patient was injected with 1ml, cross-linked HA 22.5mg/ml in under-eye area using 30 G needle or a 25 G cannula. Follow-up was done at 2weeks, 4weeks, and 1year. Mean age of patients was 36.4years. Majority of patients, that is, 31 (52%) were in the age group of 30-40. As per Hirmand's classification, 46.6% (28/60) had grade 2 TT which was most common. We graded results in the form of VAS and 80% patients had VAS>7. There were no major side effects. Hyaluronic acid fillers are promising treatment modality without any major side effects. Both needle and cannula can be used effectively. Patient satisfaction is higher in younger patients with low grade of TT and results persisted in all cases for a minimum of 1year.

Efficacy and safety of Q-switched Nd:YAG laser in the treatment of facial pigmentary lesions: A retrospective observational study

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), Cafe-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

A cross-sectional study on clinico-dermoscopic features of periorbital melanosis in a tertiary care hospital.

Periorbital melanosis (POM) is an esthetic facial concern on increasing trend and has a severe emotional impact on patients. We aimed to study the clinical and dermoscopic patterns of periorbital melanosis to aid in the classification and strategize therapy. A cross-sectional, observational study was conducted on one hundred patients with POM in a tertiary care center in India from January 2020-March 2020. Dermoscopic assessment of POM was done using video dermatoscope- FotoFinder Medicam 1000s (magnification up to 140x). The mean age of participants was 32.8±9years. It was more prevalent among females (78%). The constitutional type (43%) of POM was the most common followed by shadow-effect type (32%). The various dermoscopic pigmentary patterns seen were scattered pigmented dots (56%), exaggerated pigment network (31%), globules (30%), and blotches (27%). Dilated veins and telangiectasia were seen in 50% and 32% of subjects, respectively. Exaggerated skin markings were seen in 43% of participants. Scattered pigmented dots were most commonly seen in constitutional, vascular, and shadow types but were significantly associated with vascular type. Exaggerated pigment network was the most frequent pigmentary pattern in post-inflammatory type of POM. Globules were significantly associated with constitutional as well as shadow type of POM and blotches with shadow type of POM. Periorbital melanosis presents as multifactorial entity with constitutional type being the most common. The dermoscopic patterns of POM may provide a clue to the underlying etiology, thereby helping to plan appropriate treatment.

Assessment of Patients with Periorbital Melanosis for Hyperinsulinemia and Insulin Resistance.

Background:Periorbital melanosis (PM) is one of the most common dermatological condition seen in routine practice. Several cutaneous markers such as acanthosis nigricans have been associated with insulin resistance (IR). However, the association of PM with IR needs to be substantiated.Objective:The objective of the study is to evaluate the association of circulating adipokines and IR with PM.Materials and Methods:In this cross-sectional study, we recruited 100 patients with PM and 100 age- and gender-matched healthy controls. The serum levels of leptin, adiponectin, fasting glucose, fasting insulin, insulin-like growth factor-1 (IGF-1), homeostatic model assessment of insulin resistance (HOMA-IR), and leptin: adiponectin ratio (L/A ratio) were assayed.Results:The serum levels of leptin, fasting glucose, fasting insulin, HOMA-IR, L/A ratio were significantly higher in patients with PM as compared to controls. The serum levels of adiponectin were significantly lower in cases as compared to controls. On multivariate regression analysis, leptin, adiponectin, and HOMA-IR were found to be significant, even after adjusting for BMI, blood pressure and LDL and HDL cholesterol.Conclusion:Our findings suggest that patients with PM have hyperinsulinemia, IR, and elevated L/A ratio. PM as a marker of IR in adults may help in identifying patients early and thus aid in the early prevention and management of the disease.

Clinical spectrum of facial hypermelanosis: a descriptive study from a tertiary care centre

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Facial melanosis (FM) which refers to brown, black or blue pigmentation over the face is a common cosmetic concern in Indian patients. This increased incidence could be due to remarkable diversity of Indian ethinic population. Pigmentary disorders of the face are a great cosmetic and psychological concern for the patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This is an extensive descriptive clinico epidemiological study comprising of 1024 patients, conducted at Sri Venkateshwara Medical College Hospital and Research Centre, Puducherry, for a period of one and a half years. A detailed clinical history and examination was done, and all the clinical photographs and data were recorded. Necessary investigations like skin biopsy and patch testing was done wherever required.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The maximum number of patients belong to the age group of 21-35 years with a female predominance (67.2%). Among patients of FM, post inflammatory pigmentation (35.3%) was the most common comprising of 362 patients, followed by melasma (17.2%), periorbital melanosis (15.7%), seborrheic melanosis (7.5%) followed by other causes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; FM is common in Indian skin, several of which have overlapping features, and some have defined clinical classification. Additionally, climatic conditions, cosmetic usage and social parameters predispose to the increased incidence of FM.&lt;/p&gt;

Ferulic acid 12% peel: An innovative peel for constitutional type of periorbital melanosis—Comparing clinical efficacy and safety with 20% glycolic peel and 15% lactic peel

Periorbital hyperpigmentation (POH) is a very common, yet unexplored aesthetic condition. Topical therapy is mainstay of treatment which includes chemical peels and other depigmenting agents. To compare clinical efficacy, safety, and tolerability of 20% glycolic acid peels, 15% lactic acid peels, and 12% ferulic acid peels in the treatment of constitutional type of periorbital hyperpigmentation in Indian patients. Ninety patients of constitutional POH were enrolled for 12 weeks. They were divided into three groups of 30 each. In 1st group 20% glycolic acid peeling, in 2nd group 15% lactic acid peeling and in 3rd group 12% ferulic acid peeling sessions were performed at 3 weekly intervals. Clinical improvement was assessed objectively using POH grading, physician's and patient's global assessment, and patient's global tolerance. Significant improvement in periorbital hyperpigmentation was noted in all the three groups. Physician and patient's global assessment was excellent with glycolic acid peel followed by ferulic acid peel and lactic acid peel. The incidence of side effects in the form of erythema and itching was maximum with glycolic acid followed by lactic acid and least with ferulic acid, which did not necessitate cessation of therapy. Glycolic acid produced the best results among the three peels; however, ferulic acid peel emerged as a safe and effective modality for the treatment of POH.

Single-handed vampire facial: Combining microneedling with platelet-rich plasma for single-hand use

Microneedling, or collagen induction therapy, is an extremely effective and minimally invasive modality with an ever-growing list of indications, including skin rejuvenation, acne scars, androgenetic alopecia, axillary hyperhidrosis, melasma, periorbital melanosis, and striae distensae, to name a few.1 Many of these indications have found favor in combination with platelet-rich plasma (PRP). PRP has been used both in the form of intradermal injections into the acne scars followed by microneedling and as a topical application before or after microneedling.

Clinical efficacy and safety of 20% glycolic acid versus 30% lactic acid peel in constitutional type of periorbital melanosis: a comparative study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Periorbital melanosis (POM) is a common aesthetic condition with significant impact. Chemical peeling is a frequently used treatment; yet, an ideal peeling agent is however to find. The aim of the study was to compare the clinical efficacy and safety of 20% glycolic acid (GA) and 30% lactic acid (LA) peels in POM.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; With approval and consent, the study was conducted from September 2016-August 2017. Patients aged 18-60 years of both sexes, having a constitutional POM were enrolled. Patients known to be allergic to the peeling agents were excluded. Alternate patients were enrolled into Gr-G (20% GA) and Gr-L (30% LA) and were treated every 3 weeks, for 3 sessions and evaluated till 9 weeks. Clinical improvement using POM grading, patients’ global assessment, satisfaction, and physician's global satisfaction were noted. Data are presented in number, percentages and mean±standard deviation. INSTAT software was used for statistical analysis; p&amp;lt;0.05 was considered significant.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Fifty-six (27 in Gr-G, 29 in Gr-L) were enrolled; 70.37% and 68.97% completed the study. Demographic variables, baseline POM grade, and skin types were similar. Compared to baseline, both Gr-G and Gr-L showed significant improvement (p&amp;lt;0.0001). Patient-reported significantly higher improvement in Gr-L (p=0.008) and higher satisfaction. Both the peeling agents were tolerated well with statistically indifferent adverse effects.&lt;/p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt;Both GA and LA are useful in the aesthetic treatment of the constitutional type of POM. Three sessions of 30% LA peel appears to be better than 20% GA peeling used at 3 weeks apart. &lt;p&gt; &lt;/p&gt;

Evaluation of platelet-rich plasma on infraorbital dark circles by using the FACE-Q scales

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Infraorbital dark circles, also referred to as idiopathic cutaneous hyperchromia of the orbital region, periorbital melanosis, periorbital hyperpigmentation or infraorbital pigmentation, is a common condition frequently observed in dark-skinned patients, but has little data in scientific literature. We aimed to discuss our results of PRP procedure in the treatment of infraorbital dark circles using objective scales based on patient satisfaction and the quality of life.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Between 2016 and 2017, 9 patients complaining of infraorbital darkness were included who underwent 3 sessions of platelet-rich plasma injection. The outcome was determined by the difference in pre- and post- procedure FACE-Q modules which were designed as patient-reported outcome instrument to evaluate the unique outcomes of patients undergoing facial cosmetic procedures. Surveys conducted were modules of satisfaction with facial appearance, satisfaction with skin, psychological function, social function, aging appearance appraisal and satisfaction with outcome.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; All patients were followed up a minimum of 9 months. No major complications were recorded. Only transient ecchymosis and edema were seen in all patients who were improved during follow-up. The patient-reported FACE-Q satisfaction and FACE-Q quality of life pre- and post- procedure results showed statistically significant improvement (&amp;lt;0.05). Overall satisfaction with outcome was 83.33±16.25 (range 63–100).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; PRP as a potent source of growth factors, can be seen as a safe, biocompatible, autologous and appropriate treatment modality for the dark eye circles formed in lower eye regions which can increase the quality of patients’ lives in terms of social and psychological function.&lt;/p&gt;

Periorbital Hyperpigmentation: Overcoming the Challenges in the Management

Periorbital hyperpigmentation, also referring as dark circles or periorbital melanosis, is not a medical problem but can be a significant cosmetic concern for a large number of individuals and they try to find a treatment for this condition. This condition affects individuals in a wide range of ages, both sexes and all races. The therapeutic approach must vary with cause as it is multifactorial. Possible causes include excessive pigmentation, volume loss, skin laxity, tear trough, increased prominence and density of subcutaneous vasculature and orbital structural problem. Treatment modalities include topical bleaching agents, chemical peeling, and lasers, injectable fillers, fat transfer, high intensity focused ultrasound and surgery as monotherapy or in combination therapy to target the contributing factors of periorbital hyperpigmentation.

A Study of Clinicopathological Correlation of Periorbital Hyperpigmentation.

Context:“Dark circles” are esthetic concerns that can affect individuals of any age, gender, or race. They can be familial, physiological, or associated with various medical illnesses.Aim:To study the clinicopathological correlation of periorbital hyperpigmentation.Patients and Methods:Fifty patients affected with periorbital melanosis (POM) were enrolled for the study after obtaining informed consent. Details regarding history, demographic data, and physical examination of POM were recorded, and a 2-mm punch skin biopsy was taken from the affected skin under local anesthesia and stained with hematoxylin and eosin (H and E), Fontana Masson (Melanin), Perls Prussian blue (Hemosiderin).Results:Twenty-three (46%) patients with POM had history of chronic illness before developing POM; 18% patients were atopic, 16% had jaundice, 18% had associated pigmentary demarcation lines (PDL) of type F and G, 8% had acanthosis nigricans, 22% patients had anemia, 16% patients gave positive family history of POM, and menstrual irregularity was seen in 16%. Histopathology revealed dermal melanin deposition with melanophages along with predominantly increased epidermal melanin and melanin in vellus follicular epithelium. Prussian blue for hemosiderin was negative in all cases.Conclusions:The study has elicited the multifactorial origin of POM; females are affected more than males. Dermal melanin deposition is a constant feature. Hemosiderin is not found in POM. Increased pigmentation of the vellus follicular epithelium is a feature of POM.