RESUMEN
Depigmented lesions may occur as postinflammatory sequelae of subacute cutaneous lupus erythematosus (SCLE), leading to great psychosocial impact. A 53-year-old male patient presented with post-SCLE depigmented facial lesions after five years of disease stability. We proposed surgical treatment with melanocyte-keratinocyte transplantation procedure (MKTP), and after five months the patient achieved 90% repigmentation, without Koebner phenomenon (KP). In theory, KP is a possible complication of MKTP procedure since the preparation of the receptor area involves the use of dermabrasion. In an attempt to avoid it, we suggest to maintain the treatment of the underlying disease and wait for a minimum period of disease stability before the procedure.
Asunto(s)
Hipopigmentación/terapia , Queratinocitos/trasplante , Lupus Eritematoso Cutáneo/complicaciones , Melanocitos/trasplante , Cara , Humanos , Hipopigmentación/etiología , Hipopigmentación/psicología , Lupus Eritematoso Cutáneo/terapia , Masculino , Persona de Mediana Edad , Fototerapia , Trasplante Autólogo , Resultado del TratamientoRESUMEN
Nevus depigmentosus (ND), also known as nevus achromicus or achromic nevus, is an uncommon congenital hypomelanosis of the skin that is often characterized as being nonprogressive and having serrated borders. It needs to be distinguished from other hypopigmented skin conditions such as nevus anemicus, hypomelanosis of Ito, Fitzpatrick patches (ash leaf spots) of tuberous sclerosis, vitiligo, indeterminate leprosy, and pigment demarcation lines. Treatment may be desired for aesthetic and possible psychosocial considerations. We review and update knowledge about ND and its simulants.
Asunto(s)
Hipopigmentación/diagnóstico , Nevo/diagnóstico , Diagnóstico Diferencial , Estética , Humanos , Hipopigmentación/epidemiología , Hipopigmentación/psicología , Hipopigmentación/terapia , Lepra/diagnóstico , Terapia por Luz de Baja Intensidad , Melanocitos/patología , Melanocitos/trasplante , Nevo/epidemiología , Nevo/psicología , Nevo/terapia , Terapia PUVA , Factores de Riesgo , Esclerosis Tuberosa/diagnósticoRESUMEN
Skin color is one of the major attributes that defines both individual distinctiveness and differences between groups. There is a preference for lighter skin world-wide, among both light- and dark-skinned individuals, further leading to skin-color bias based upon skin-color hierarchy within certain ethnoracial groups. The psychiatric and psychosocial ramifications of skin color are important in several situations, including (1) disorders of skin discoloration (eg, vitiligo), which can significantly affect the psychosocial development of the patient especially when it has its first onset during adolescence; (2) widespread use of skin-lightening products, which are used despite knowledge about serious toxicity from inorganic mercury and potent corticosteroids that are some of their main constituents; (3) indoor tanning, which is a recognized carcinogen and practiced by over 50% of university-age adults and 20% of adolescents. Educating about photocarcinogenicity does not change tanning behaviors, which is strongly driven by peer pressure; and (4) when a psychiatric disorder, such as body dysmorphic disorder or major depressive disorder, is the primary basis for skin color dissatisfaction. Despite the role of complex sociocultural and psychiatric factors in clinical manifestations involving skin color, a supportive relation with the dermatologist can significantly aid the patient in managing their disease burden.
Asunto(s)
Trastornos de la Pigmentación/psicología , Preparaciones para Aclaramiento de la Piel/uso terapéutico , Pigmentación de la Piel , Baño de Sol/psicología , Trastorno Dismórfico Corporal/psicología , Educación en Salud , Humanos , Hipopigmentación/psicología , Racismo/psicología , Preparaciones para Aclaramiento de la Piel/efectos adversos , Factores Sociológicos , Baño de Sol/educación , Vitíligo/psicologíaRESUMEN
Vitiligo is an idiopathic chronic skin disease that is notable for depigmented macules forming by destruction of melanocytes mediated by cells of the immune system. Vitiligo occurs in 1-2% of the population irrespective of race and without predilection to gender or age. The dynamics and extent of the disease vary widely, ranging from stable cases with isolated minor foci to states showing rapid progression and occupying large areas of the skin. For many patients, the disease represents a serious cosmetic defect which limits their activities in various spheres of life. There are many noninvasive methods of treatment but none of them offers a guarantee of complete therapeutic success. PUVA- and UVB-therapy are recognized as the most effective and most commonly used methods. The management of vitiligo should also include education, cosmetic correction options, and psychotherapy in some cases.