Changes In Skin Pigmentation Research Articles

709 Malassezin: A preclinical assessment of a novel microbiome-based skin lightener

The Malassezia species are commensal to the skin microbiome and implicated in skin and scalp diseases, including tinea versicolor and seborrheic dermatitis. In cases of tinea versicolor, Malassezia overgrowth often results in skin pigmentation changes (including both hypo- and hyper-pigmentation). The purpose of this study was to link the benign pigmentation change to malassezin, an indole metabolite secreted by Malassezia furfur, and demonstrate the safety and ability of malassezin to decrease melanin in in-vitro models. Malassezin, was chemically synthesized and tested negative in the Computational Genotoxicity Assessment (Leadscope, Columbus, OH) and confirmed by Mini-Ames Test in Salmonella typhimurium and Escherichia coli (Pharmaron, Beijing, PRC). Phototoxicity assessment using an in vitro 3D skin tissue (EpidermTM, MatTek Corpotation) was negative. Studies of malassezin in Melanoderm models (Institute for In Vitro Sciences) demonstrated melanin reduction and compared favorably to Kojic Acid. Ex vivo studies (Laboratoire BIO-EC, Longjumeau, France) using differential gene expression (Affymetrix Human Clariom S chip, ThermoFisher Scientific, Waltham, MA; Genemarkers, LLC, Kalamazoo, MI) did not show changes expected from typical pigmentation modifying mechanisms. In addition, malassezin was not found to be a tyrosinase inhibitor (Sunny BioDiscovery, Santa Paula, CA). Malassezin, an indole metabolite of M. furfur, has been shown to be a safe and effective pigment lightening agent in-vitro, with a potentially new mechanism of action.

Topical Hydroquinone use leading to Endogenous Ochronosis: A Case Report

Ochronosis is a rare disease characterized by skin pigment changes and degenerative arthritis caused by deposition of homogentisic acid in joint cartilage. There are exogenous and endogenous forms of the disease with the endogenous form typically caused by alkaptonuria, or a defect in homogentisic acid oxidase enzyme. In this report we present a previously undocumented case of endogenous ochronosis caused by topical hydroquinone use in a 69-year-old Caucasian male without alkaptonuria.

Hypotonic infant with Pallister–Killian syndrome diagnosed by cytogenetic microarray, without pigmentary skin changes and malformations

Pallister-Killian syndrome (PKS) is a rare genetic developmental disorder characterized, by intellectual disability, seizures, streaks of hypo- or hyperpigmentation and characteristic dysmorphic features. PKS is characterized by the presence of cytogenetic abnormality in form of a supernumerary isochromosome 12p, in a tissue limited mosaicism. The isochromosome 12p is usually not detected in karyotype done from peripheral blood. Presence of patchy pigmentary skin lesions suggest the possibility of mosaicism and karyotype from skin is done which clinches the diagnosis. We describe an infant with severe hypotonia in whom trisomy 12p was detected bychromosomal microarray performed on peripheral blood. The karyotype from blood was normal and combining this information with three copies of 12p in microarray suggests the possibility of tetrasomy12p in mosaic form. The infant did not have any skin patchy pigmentary changes and malformations and hence, the diagnosis of PKS was not clinically suspected. Cytogenetic microarray is the first test for evaluation of cases with developmental delay and intellectual disability, PKS diagnosis may come as a surprise in unsuspected caseswithout characteristic skin pigmentary abnormality and malformations.

The Effect of Auricular Graft Donor Site on Morbidity and Cosmetic Appearance in Cartilage Tympanoplasties.

The aim of the present study was to compare the postoperative morbidity and cosmetic results between the use of the scapha and the use of the tragus as the auricular cartilage graft donor site in patients who had undergone cartilage tympanoplasty. The fascia graft was used as the control. The patient's visual symmetry, cosmetic satisfaction, and anthropometric measurements were studied to objectively evaluate the cosmetic condition. The formation of skin scar changes, pigmentation changes, and sensory changes as clinical criteria were compared. A total of 234 patients and their 257 operated ears were included in the study. Forty prospectively operated ears with preoperative findings were also included. All patients (100%) felt that their results were good, as indicated by the visual analog scale, and the anthropometric ear measurements used to reinforce the data showed no significant differences between the groups. A significant difference with respect to clinical sensory changes was found between the groups only in patients undergoing unilateral surgery via the retro auricular approach (p<0.05). There was no difference between the scapha and tragus groups with respect to scar formation or skin pigmentation change. Neither scapha nor tragus use for graft retrieval led to dissatisfaction or cosmetic problems in the postoperative period. Sensory changes in the skin on clinical evaluation were less common in patients in whom the scapha donor site was preferred than in cases in which the tragus was used.

CDKN2A testing and genetic counseling promote reductions in objectively measured sun exposure one year later

PurposeThis study investigated whether genetic counseling and test reporting for the highly penetrant CDKN2A melanoma predisposition gene promoted decreases in sun exposure. MethodsA prospective, nonequivalent control group design compared unaffected participants (N = 128, Mage = 35.24, 52% men) from (1) families known to carry a CDKN2A pathogenic variant, who received counseling about management recommendations and a positive or negative genetic test result and (2) no-test control families known not to carry a CDKN2A pathogenic variant, who received equivalent counseling based on their comparable family history. Changes in daily ultraviolet radiation (UVR) exposure (J/m2), skin pigmentation (melanin index), and sunburns between baseline and one year following counseling were compared among carriers (n = 32), noncarriers (n = 46), and no-test control participants (n = 50). ResultsBoth carriers and no-test control participants exhibited a decrease one year later in daily UVR dose (B = −0.52, −0.33, p < 0.01). Only carriers exhibited a significant decrease in skin pigmentation at the wrist one year later (B = −0.11, p < 0.001), and both carriers and no-test control participants reported fewer sunburns than noncarriers (p < 0.05). Facial pigmentation did not change for any group. Noncarriers did not change on any measure of UVR exposure. ConclusionsThese findings support the clinical utility of disclosing CDKN2A test results and providing risk management education to high-risk individuals.

A 19 Month Old Male Child with Xeroderma Pigmentosum-A Case Report

Background: Xeroderma Pigmentosum (XP) is a rare autosomal recessive genodermatosis characterized by pigmentary abnormalities, solar skin damage and cutaneous malignancies on sun exposed area of skin and eyes. XP occurs in subjects with molecular defects in the genes involved in nucleotide excision repair (NER) of ultraviolet-induced DNA lesions leading to premature skin and ocular ageing consequent upon cellular apoptosis and other UV-induced degenerative changes. If sufficient DNA damage occurs, there will be cellular transformation and the development of malignancies. Both genetic, as well as environmental factor, play an important role in XP. XP has a >1000-fold increased risk of a cutaneous basal cell or squamous cell carcinoma or malignant melanoma. Case history: In this case report, we mentioned about a 19 month old boy who was diagnosed clinically as a case of Xeroderma Pigmentosum and presented with pigmentary skin changes (generalized hypo and hyper pigmented macule), eye problems, developmental delay, acute respiratory infection and failure to thrive. A multidisciplinary team involving the Pediatrician, Dermatologist and Ophthalmologist evaluated, diagnosed and treated the patient. In this case, XP was diagnosed clinically due to lack of all investigation facilities. This genetic premalignant condition is rarely diagnosed at the district level hospitals in Bangladesh. We report this case to upgrade the knowledge of pediatricians working in the rural areas (primary and secondary level health care facilities) regarding the diagnosis, counseling, treatment modalities and appropriate referral for Xeroderma Pigmentosum. Recommended management should be focused on educating the patient and the parents about effective sun protection and early recognition of cancers. Genetic counseling should be offered for families at risk

Balneotherapy for chronic venous insufficiency.

Balneotherapy for chronic venous insufficiency.

SAT-468 Conversion of a Non-Secreting to a Growth Hormone-Secreting Pituitary Adenoma: A Case of Rapid Development of Acromegaly

Introduction: Acromegaly is known to have a slow and insidious course. As a result, the diagnosis is made very late, and at the time of diagnosis most patients have macroadenomas. The average interval from onset of symptoms of acromegaly and diagnosis is approximately 12 years. In addition, conversion of a non-functioning to a functioning pituitary adenoma is very rare. We report a case of a documented non-secreting pituitary macroadenoma turning into a growth hormone secreting one resulting in symptomatic acromegaly in less than 4 years. Clinical Case: A 28 year old African American female presented for evaluation of headaches in 2014. Her past medical history is significant for headaches and childhood epilepsy since age 9. During her workup she was found to have a 1.2 cm pituitary macroadenoma on MRI. Her review of systems showed no evidence of vision changes, galactorrhea, hand enlargement, weakness, changes in body weight or skin pigmentation. Her exam was unremarkable, in particular she did not have any acromegaloid or cushingoid features. Her pituitary hormone work-up was unremarkable, showing no evidence of hormone excess or deficiency. Her IGF-1 was found to be 251 ng/dL (Normal: 78-270). She was evaluated by neurosurgery at that time, who recommended conservative approach with serial follow-up imaging. About 3 years and 8 months later, she was admitted to the hospital for her worsening symptoms of headaches, which were noted approximately 3 times weekly. On further questioning, examination and comparison with old pictures, she was noted to have coarsening of her facial features as well as increase in her ring size. Laboratory tests showed elevated IGF-1 levels on 2 separate occasions at 570 and 551 ng/dL. On repeat imaging, the pituitary macroadenoma was noted to be increased in size to 1.8 cm with increasing suprasellar extension and abutting the anterior aspect of the optic chiasm. She underwent endoscopic excision of pituitary adenoma and reconstruction of sellar floor. The pathology came back positive for human growth hormone staining. IGF-1 level decreased to 244 ng/mL in less than 4 months after surgery. Conclusion: Conversion of non-secreting pituitary adenoma to a growth hormone secreting one can happen over a relatively short time span, resulting in symptomatic acromegaly. We had a unique opportunity to observe this since the patient had previous imaging and biochemical work-up which we could use for comparison. This is contrary to the classic description of acromegaly where the clinical picture develops very slowly over many years or even decades.

Ethanol induces skin hyperpigmentation in mice with aldehyde dehydrogenase 2 deficiency

Alcohol induces various cutaneous changes, such as palmar erythema and jaundice. However, alcohol-induced skin hyperpigmentation due to melanin deposition has not been reported. Aldehyde dehydrogenase 2 (ALDH2), one of 19 human ALDH isozymes, metabolizes endogenous and exogenous aldehydes to their respective carboxylic acids. Reduced ALDH2 greatly affects acetaldehyde metabolism, leading to its accumulation in the body after the consumption of alcohol and the consequent development of a wide range of phenotypes. In the present study, we report a novel phenotype manifesting in a mouse model with the altered expression of ALDH2. Aldh2 knockout (Aldh2+/− and Aldh2−/−) and wild-type (Aldh2+/+) mice were fed a standard solid rodent chow and a bottle of ethanol solution at concentrations of 0%, 3%, 10%, or 20% (v/v) for more than 10 weeks. The intensity of their skin pigmentation was evaluated by macroscopic observation. Ethanol-exposed Aldh2+/− and Aldh2−/− mice exhibited dose-dependent skin pigmentation in areas of hairless skin, including the soles of the paws and tail; no such changes were observed in wild-type mice. The intensity of skin pigmentation correlated with the number of Aldh2 alleles that were altered in the mice (i.e., 0, 1 and 2 for Aldh2+/+, Aldh2+/−, Aldh2−/−, respectively). Interestingly, the skin pigmentation changes reversed upon the discontinuation of ethanol. The histological examination of the pigmented skin demonstrated the presence of melanin-like deposits, mainly in the epidermis. In conclusion, we report a novel finding that the intake of ethanol induces skin hyperpigmentation in an ALDH2 activity-dependent manner.

Syringomas

Syringomas are benign tumors of cutaneous appendages of eccrine or apocrine origin affecting approximately 1% of the population. They mainly occur in women and they commonly manifest as soft skin-colored or slightly yellowish papules on the lower eyelid and the upper part of the cheeks. More rarely, syringomas can even occur on the neck, the armpits, the breasts, the lower portion of the abdomen, the thighs and the groin. Clinically, they can be distinguished from xanthelasmas, warts or cancers because they are monomorphic and have a regular distribution. In doubtful cases, the diagnosis is confirmed by biopsy. Syringomas can be easily detected on histological examination due to the presence of comma-shaped sweat ducts in the dermis. Even though syringomas are benign tumors, their appearance can be embarrassing to the patients. Therapeutic options, mainly supported by small case series and case reports, include surgical excision, electrodessication, curettage, chemical exfoliation, cryosurgery and laser treatment. However, as these tumors lie deep in the dermis, all treatments are associated with a substantial risk of recurrence and can cause scars and skin pigment changes. We here report the case of a 40-year old woman with no previous history, presenting with skin-colored periorbital papules whose histological examination showed syringomas.

Fox-Fordyce disease on the peristernal region: a rare and atypical case

Syringomas are benign tumors of cutaneous appendages of eccrine or apocrine origin affecting approximately 1% of the population. They mainly occur in women and they commonly manifest as soft skin-colored or slightly yellowish papules on the lower eyelid and the upper part of the cheeks. More rarely, syringomas can even occur on the neck, the armpits, the breasts, the lower portion of the abdomen, the thighs and the groin. Clinically, they can be distinguished from xanthelasmas, warts or cancers because they are monomorphic and have a regular distribution. In doubtful cases, the diagnosis is confirmed by biopsy. Syringomas can be easily detected on histological examination due to the presence of comma-shaped sweat ducts in the dermis. Even though syringomas are benign tumors, their appearance can be embarrassing to the patients. Therapeutic options, mainly supported by small case series and case reports, include surgical excision, electrodessication, curettage, chemical exfoliation, cryosurgery and laser treatment. However, as these tumors lie deep in the dermis, all treatments are associated with a substantial risk of recurrence and can cause scars and skin pigment changes. We here report the case of a 40-year old woman with no previous history, presenting with skin-colored periorbital papules whose histological examination showed syringomas.

Characterizing the Effects of Radiation Dermatitis on Quality of Life

Radiation dermatitis (RD) is a common adverse event of radiation therapy (RT). Clinically, patients may experience skin changes, including erythema, edema, pigment changes, and dry or moist desquamation. However, little is known about how this radiation-induced skin toxicity can affect patients’ quality of life (QOL). This study aimed to 1) assess the impact of RD on QOL in patients undergoing RT, focusing on 3 domains: emotions, symptoms, and functioning, and 2) evaluate the change in QOL during RT and its association with the severity of RD. We are presenting preliminary results from a prospective trial during which patients undergoing RT for treatment of cancers of the breast, head and neck, and anus completed the Skindex-16, a survey to measure the effects of their skin disease on QOL. Responses were recorded during initiation and upon completion of RT. Pre- and post-treatment Skindex-16 responses were compared using the sign test. Spearman rank correlation was used to assess associations between changes in Skindex scores and dermatitis grade, scored using CTCAE version 4.0. Forty-seven subjects with cancers of the breast (49%), head and neck (43%), and anus (8%) have completed RT to date and were included in the study. 60% developed grade 1 dermatitis, 32% developed grade 2 dermatitis, and 8% developed grade 3 dermatitis. Patients reported significantly higher Skindex scores for all 16 questions after completing RT (p<0.002). Dermatitis grade was significantly (p<0.05) associated with change in Skindex score for 7 out of 16 elements. These associations were most common for questions assessing the functional domain (4/5 elements) and less common for questions addressing symptomatic (1/4) and emotional (2/7) domains. Patients can perceive a broad range of adverse dermatologic events during RT. Standard dermatitis grading assesses physical changes, but may not adequately capture changes in all domains. Evaluation using the Skindex-16 revealed that the severity of RD is significantly associated with impact on QOL, especially in the functional domain. Supportive interventions need to address the emotional, functional, and symptomatic domains in patients undergoing RT, with an increased focus on the functional domain.

Dermatologic findings of vitamin B12 deficiency in infants.

Vitamin B12 deficiency in infants is uncommonly reported from developed countries and generally lacks dermatologic manifestations. On the contrary, infantile vitamin B12 deficiency is common in India and cutaneous manifestations are a constant feature, although often overshadowed by neurologic and hematological manifestations. The aim of this study was to describe the skin changes of vitamin B12 deficiency in infants. A retrospective chart review of vitamin B12 deficient infants for clinical and laboratory parameters was performed and data analyzed. Forty-three infants, 30 boys and 13 girls, aged 4 to 27months, with vitamin B12 deficiency were identified. Skin hyperpigmentation was present in 41 infants; it was localized to the dorsa of hands and feet in 26. Fifteen infants had generalized hyperpigmentation; 10 had a reticulate pattern, and 5 had a homogeneous pattern. Brown and sparse scalp hair were present in all. Glossitis was seen in 5 infants and cheilitis in 3. Of the 32 infants who underwent laboratory investigations, 28 had anemia and 21 macrocytosis. Serum vitamin B12 was measured in 30 infants; it was low in 19. Of the 11 with normal serum vitamin B12 , 9 had received vitamin B12 before referral but had macrocytosis and low maternal serum vitamin B12 . The infants were treated with vitamin B12 . Skin pigmentation and mucosal changes resolved completely by 3-4weeks, but hair changes were slower to reverse. Cutaneous findings are a common feature of vitamin B12 deficiency in Indian infants and resolve with treatment.

Treatment of post-burn and post-traumatic atrophic scars with fractional CO2 laser: experience at a tertiary care centre.

Scars are abnormal wound responses in predisposed individuals. They occur after any kind of wound and skin inflammation in predisposed individuals. Despite their benign nature, they can be aesthetically disabling. Although several approaches have been tried in their management, most of them have produced poor results. This study aims to assess the efficacy and safety of fractional CO2 laser treatment in the management of post-burn and post-traumatic scars. One hundred consecutive patients (77 females and 23 males) affected by post-burn scars as well as post-traumatic atrophic scars were treated with monthly sessions of fractional CO2 laser treatment. Patient's response to treatment was assessed clinically as well as improvement of scars by comparing the photographs taken before treatment with those taken 6months after the last treatment session. Changes in skin texture, surface irregularity and pigmentation were assessed on a quartile grading scale and scored individually from 0 to 4. A mean of the three individual scores was calculated and the response was labelled as 'excellent' if the mean score achieved was > 3. A score of 2-3 was labelled as good response while a score below 1 was labelled as 'poor' response. A mean of six treatments per scar were required and all patients, followed up for 1year after the last treatment, had optimum results and no recurrence. Response to treatment was excellent in 53.75%, good in 16.25% patients, and poor in 30% patients. Fractional CO2 laser gives a very good result in the management of patients with post-burn scars as well as post-traumatic scars with minimal adverse effects.

Health Survey of Adults with Neurofibromatosis 1 Compared to Population Study Controls.

Neurofibromatosis type 1 (NF1) is a genetic, autosomal dominant multi-organ disease characterized by susceptibility to tumor formation, changes in skin pigmentation, skeletal abnormalities, and neuropsychological deficits. Clinical studies have shown impaired health-related quality of life (HQoL) in adults with NF1. However, little is known about HQoL in non-clinical NF1 samples. We conducted a cross-sectional self-report survey of 142 persons with NF1 (M age = 50.3years, SD = 12.0, range 32 to 80; 62.0% females) recruited from non-clinical settings. Several HQoL domains, including life satisfaction, mental health, sleep, pain, gastrointestinal problems, oral health, and social support, were compared between the NF1 sample and 46,293 controls from the HUNT3 population study. We also examined gender differences within the NF1 sample and predictors of HQoL. Compared to controls, the NF1 sample reported significantly poorer life satisfaction, mental health, sleep, and oral health, and more pain, gastrointestinal problems, comorbid diseases, and memory problems. Several HQoL domains were significantly correlated. Mental health was the only unique significant predictor of overall life satisfaction. Women with NF1 reported significantly more mental health, sleep, and pain problems than men with NF1. Mental health assessment and management should be integrated into clinical care of persons with NF1 to potentially improve their HQoL.

Kindler syndrome in a patient with colitis and primary sclerosing cholangitis: coincidence or association?

Kindler syndrome is a rare, autosomal recessive genodermatosis, caused by mutations in the FERMT1 gene. It is thought to be primarily a skin disease, but other organs may also be involved. We report a case of a novel mutation of FERMT1 gene in a patient with a probable new phenotype of Kindler syndrome, including colitis and primary sclerosing cholangitis. A 42-year-old man, born to first cousin parents, was referred to our outpatient dermatology clinic with an unknown dermatosis since birth. He presented with neonatal blistering and developed photosensitivity and changes in skin pigmentation during childhood. Since the age of 20, he has had regular follow-up in the gastroenterology clinic, owing to esophageal stenosis, ulcerative colitis, and primary sclerosing cholangitis. Clinical examination revealed jaundice, poikiloderma, diffuse cigarette paper-like atrophy on dorsal surfaces of the hands, and palmoplantar hyperkeratosis. Skin biopsy showed epidermal atrophy covered by orthokeratotic hyperkeratosis. DNA molecular analysis revealed FERMT1 homozygous mutation c.1179G&gt;A, p.W393X, which has not been reported before. The intestinal phenotype of Kindler syndrome has already been defined previously. However, to the best of our knowledge, no other case of primary sclerosing cholangitis in a patient with Kindler syndrome has been reported.

Pulsed radiofrequency for periorbital sagging: a comparative study

Introduction: Wrinkles, sagging, changes in texture and skin pigmentation in the periorbital region are common complaints in dermatologic practices. Several treatment options, including fractional radiofrequency, which has been shown safe and effective, have been described. Objective: To compare outcomes and side effects after the use of two types of electrodes coupled to a radiofrequency device, used for rejuvenating the eyelid region. Methods: A comparative, randomized and blind clinical trial was carried out with patients bearing aging in the periorbital region. The patients were treated with two different electrodes (called standard tip and Lima 8 tip), which can be coupled to the same radioelectrosurgery device. The variables investigated were sagging, wrinkles, texture and firmness of the treated skin, in addition to the presence of adverse effects. Thirty days after the last session, patients answered to a satisfaction questionnaire, having been photographed for clinical assessment. Results: The patients treated with both tips experienced considerable satisfaction with the improvement of sagging and wrinkles. The variable firmness presented worse satisfaction indices, with a disadvantage for the standard tip. Important edemas emerged after the use of both tips; nevertheless ecchymosis occurred most frequently and lasted longer with the Lima 8 tip. Hyperpigmentation was more frequent and longer lasting with the standard tip, however without statistically significant difference. Conclusions: The two tips were equally effective for the treatment of sagginess, wrinkles and skin texture in the periorbital region. The patients treated with the Lima 8 tip had higher satisfaction indices regarding the skin’s firmness, experiencing a higher incidence of ecchymosis, as well as a longer duration of that side effect.

Cosmetic Potential of a Liotropic Liquid Crystal Emulsion Containing Resveratrol

Resveratrol is a natural substance that has been the target of many researchers over the years since it presents a variety of potential applications in the areas of cosmetics and medicine as a treatment for some diseases. Due to its high antioxidant capacity but low bioavailability, we evaluated the antiaging potential of resveratrol as a liotropic liquid crystal emulsion. Initially, we performed in vitro assays to quantify both the organoleptic characteristics and stability of the emulsion. Next, an in vivo trial was performed on the faces of 30 volunteers to determine the cream’s cosmetic potential and to measure porphyrins, skin barrier function, skin pigmentation, expression lines, and porosity. The emulsion maintained its characteristics during the in vitro assays and, in the in vivo trial, it had some effect only on pore size in forehead, without any significant effects on the other parameters. We had 6 dropouts throughout the study, then the final number of volunteers was 24. Most volunteers did not show any changes in skin pigmentation throughout the study. Similarly, there was not any noticeable improvement on any other parameters evaluated. However, volunteers related a high level of satisfaction with the product.

Restoration of skin pigmentation after deep partial or full-thickness burn injury.

Significant skin pigmentation changes occur when patients suffer deep burn injuries. These pigmentation disorders may cause not only cosmetic and psychological issues, but more importantly it increases the risk of skin cancer or photoaging. Severe burns significantly effect on the process of repigmentation as the pigmentation is tightly regulated by cell proliferation and differentiation of melanocytes and melanocyte stem cells which are housing in the epidermis and hair follicles of the skin. In the present review, we discuss the possible mechanisms to replenish the melanocytes from the healthy epidermis and hair follicles surrounding burn wounds. The molecular mechanisms of skin repigmentation following healing of burn injuries includes the differentiation of melanoblasts into melanocytes, the distribution and responses of melanocytes and melanocyte stem cells after burn injury, and the regulation of melanin production. We also reviewed advanced therapeutic strategies to treat pigmentation disorders, such as convectional surgery, laser, UV treatment and emerging concepts in skin tissue-engineering.

Pigmentary changes in patients treated with targeted anticancer agents: A systematic review and meta-analysis

The discovery of signaling networks that drive oncogenic processes has led to the development of targeted anticancer agents. The burden of pigmentary adverse events from these drugs is unknown. To conduct a systematic review and meta-analysis of published clinical trials and determine the incidence and risk of development of targeted therapy-induced pigmentary changes. A comprehensive search was conducted to identify studies reporting targeted therapy-induced pigmentary changes. The incidence and relative risk were calculated. Case reports and series were reviewed to understand clinical characteristics. A total of 8052 patients from 36 clinical trials were included. The calculated overall incidences of targeted cancer therapy-induced all-grade pigmentary changes in the skin and hair were 17.7% (95% confidence interval [CI], 11.9-25.4) and 21.5% (95% CI, 14.9-30.1), respectively. The relative risk of all-grade pigmentary changes of skin and hair were 93.7 (95% CI, 5.86-1497.164) and 20.1 (95% CI, 8.35-48.248). Across 53 case reports/series (N=75 patients), epidermal growth factor receptor andbreakpoint cluster region-abelson inhibitors were the most common offending agents. Potential under-reporting and variability in oncologists reporting these events. There is a significant risk of development of pigmentary changes during treatment with targeted anticancer therapies. Appropriate counseling and management are critical to minimize psychosocial impairment and deterioration in quality of life.