By Thierry Passeron, Jean-Paul Ortonne
The dermis is coloured by means of a mix of pigments, which shape a part of a fancy and hugely regulated technique. Pigmentary defects quite often current with dyschromia and will be as a result of genetic defects, systemic ailment, inflammatory methods, metabolic defects, infections, tumors, or poisonous or iatrogenic motives. This atlas is an intensive textual content written through key opinion leaders inside dermatology, it has a entire structure that publications the reader throughout the epidemiology, pathophysiology, prognosis, therapy, and differential analysis of either universal and infrequent pigmentary problems. It illustrates the analysis and popularity of pigmentary problems with quite a lot of images.
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Localization: Only on sun-exposed area. Mucous membrane, palms and soles are spared. Sun avoidance with protective clothing and sunscreens. For cosmetic reasons topical depigmenting creams, peeling, cryotherapy and lasers (Q-switched 532 nm is preferable) can be used. Relapses are constant and strongly limit the interest of such treatments. PATHOPHYSIOLOGY HISTOPATHOLOGY Ephelides are strongly associated with the MC1-R gene. The MC1-R is the receptor of α-MSH that activates the cyclic adenosine monophosphate (cAMP) pathway, Increased pigmentation in the basal layers of the epidermis.
In developed nations, pellagra can affect individuals suffering of chronic alcoholism, malabsorption disorders, eating and psychiatric disorders, and nutrient-drug interactions. In children the first signs can be seen after breastfeeding ceases. Men and women are equally affected. PATHOPHYSIOLOGY Pellagra is caused by a deficit in niacin (vitamin B3) or its derivatives, nicotinamide. Erythematous and hyperpigmented scaly lesions of pellagra. Note that the lesions are restricted to sun-exposed areas (coll.
Hee Young Kang). Erythrose péribuccale of Brocq (coll. Hee Young Kang). Brown hyperpigmentation restricted to the peri oral area suggestive of érythrose péribuccale of brocq. SYNONYMS EXTRACUTANEOUS SIGNS KEY REFERENCES Erythrosis pigmenta faciei, erythrosis pigmentosa peribuccalis, melanosis perioralis et peribucalis. None. EPIDEMIOLOGY Increased melanin in the basal layers of the epidermis and melanophages in the dermis. Vascular dilatation and perivascular lymphohistiocytic infiltrate in the dermis.
Atlas of Pigmentary Disorders by Thierry Passeron, Jean-Paul Ortonne