Melasma| Melasma and its Treatment| Facial Pigmentation| Post-Pregnancy Pigm...Dr. Rajat Sachdeva
Melasma, Pigmentation on facial skin, most commonly occur on the face of female and in Dark Skin Races.
Treatment for melasma, Sun protection, avoid waxing, Tretinoin, Hydroquinone, Corticosteroid, Azeloic Acid, Glycolic Acid, Chemical Peels, Microdermabrasion, Laser Intensed Pulse Light,
A concised information regarding use of photo therapy in dermatology. made by me as a part of MD dermatology residency. includes additional information about sunscreens.
Melasma| Melasma and its Treatment| Facial Pigmentation| Post-Pregnancy Pigm...Dr. Rajat Sachdeva
Melasma, Pigmentation on facial skin, most commonly occur on the face of female and in Dark Skin Races.
Treatment for melasma, Sun protection, avoid waxing, Tretinoin, Hydroquinone, Corticosteroid, Azeloic Acid, Glycolic Acid, Chemical Peels, Microdermabrasion, Laser Intensed Pulse Light,
A concised information regarding use of photo therapy in dermatology. made by me as a part of MD dermatology residency. includes additional information about sunscreens.
Dermoscopy or epiluminescence microscopy
A simple, noninvasive method to examine the subsurface features of the skin.
Structures seen
Epidermis
Dermoepidermal junction
Superficial dermis
3 types of dermoscope
1.Nonpolarized devices
2.Polarized devices
3.Hybrid devices
Dermoscopy is used in:
1.Evaluating pigmented skin lesions
2.Evaluating nonpigment skin lesions
3.Entomodermoscopy
4.Trichoscopy
5.Onychoscopy
different dermoscopic patterns are used to diagnose the dermatological diseases are
1. melanocytic patterns:
Pigmentary patterns: typical pigment pattern, atypical pigment patter, pseudonetwork
dots and globules
Blue white veil
star brust pattern
2, Non melanocytic pattern:
milia like cyst
comedo like opening
3. vascular patterns:
lacunae
arborizing vessels
comma like vessels
corkscrew vessel
red dots
glomerular vessels
linear vessels
etc
The key to effectively treating hyperpigmentation is finding the right product for your sensetive skin. Visit askderm.com to find products that will leave you feling like new!
cosderma chemical peels
we have wide range of chemical peels , glycolic, lactic, salicylic, TCA, jessner's, mandelic peel, yellow peel & many more combos are available
Hyperpigmentation on the face slide sharevanita rattan
Hyperpigmentation on the face. How to recognise the distribution of hyperpigmentation on the face and how to treat it. The classic causes of Hyperpigmentation.
Melasma, una entidad dermatológica de difícil manejo y tratamiento, muy frecuente, con una fuerte predisposición genética que aun sin ser una enfermedad que pone en peligro la vida de quien la padece, es capaz de dañarlo en forma sicológica.
The soft outer organ of a human's body, the skin, is greatly affected by harmful bacteria and viruses, in turn, is infected by them. Some skin issues also affect your appearance. It is important to know about their symptoms to save it from further damage. Learn more about the common skin infection symptoms.
Dermoscopy or epiluminescence microscopy
A simple, noninvasive method to examine the subsurface features of the skin.
Structures seen
Epidermis
Dermoepidermal junction
Superficial dermis
3 types of dermoscope
1.Nonpolarized devices
2.Polarized devices
3.Hybrid devices
Dermoscopy is used in:
1.Evaluating pigmented skin lesions
2.Evaluating nonpigment skin lesions
3.Entomodermoscopy
4.Trichoscopy
5.Onychoscopy
different dermoscopic patterns are used to diagnose the dermatological diseases are
1. melanocytic patterns:
Pigmentary patterns: typical pigment pattern, atypical pigment patter, pseudonetwork
dots and globules
Blue white veil
star brust pattern
2, Non melanocytic pattern:
milia like cyst
comedo like opening
3. vascular patterns:
lacunae
arborizing vessels
comma like vessels
corkscrew vessel
red dots
glomerular vessels
linear vessels
etc
The key to effectively treating hyperpigmentation is finding the right product for your sensetive skin. Visit askderm.com to find products that will leave you feling like new!
cosderma chemical peels
we have wide range of chemical peels , glycolic, lactic, salicylic, TCA, jessner's, mandelic peel, yellow peel & many more combos are available
Hyperpigmentation on the face slide sharevanita rattan
Hyperpigmentation on the face. How to recognise the distribution of hyperpigmentation on the face and how to treat it. The classic causes of Hyperpigmentation.
Melasma, una entidad dermatológica de difícil manejo y tratamiento, muy frecuente, con una fuerte predisposición genética que aun sin ser una enfermedad que pone en peligro la vida de quien la padece, es capaz de dañarlo en forma sicológica.
The soft outer organ of a human's body, the skin, is greatly affected by harmful bacteria and viruses, in turn, is infected by them. Some skin issues also affect your appearance. It is important to know about their symptoms to save it from further damage. Learn more about the common skin infection symptoms.
Biochemistry of Hair fall, A complete review of hair fall cause, Types, Current methods of treatment, Natural methods of treatment,
for more detail text see :https://iiopinion.blogspot.in/2017/01/hair-fall-scientific-way-of-treatment.html
Melasma is a common skin condition characterized by the appearance of dark, irregular patches on the face, especially the cheeks, forehead, and upper lip. Melasma treatment aims to reduce the pigmentation and even out the skin tone. There are several treatment options available, and the choice depends on the severity of the condition and the patient's preferences.
Skin Pigmentation disorders and its management .pptxJagruti Marathe
Some of the most common are pigmented birthmarks, macular stains, hemangiomas, port wine stains, while disorders include albinism, melasma, vitiligo and pigmentation loss due to skin damage. Birthmarks and other skin pigmentation (coloration) disorders affect many people.
Skin pigmentation disorders are conditions that affect the color of the skin. Some common types of skin pigmentation disorders include:
Pigmented birthmarks
Macular stains
Hemangiomas
Port wine stains
Albinism
Melasma
Vitiligo
Skin pigment loss due to sun damage
Other factors that can affect skin pigmentation include: Pregnancy, Addison's disease, Sun exposure.
Some treatments for skin pigmentation disorders include:
Over-the-counter or prescription creams
Topical pimecrolimus or tacrolimus
Light therapy
Melanocytes in the basal epidermis control skin pigmentation through synthesis of melanin, a complex process thought to be primarily regulated by alpha-melanocyte stimulating hormone (αMSH)
Light therapy exposes your skin to a type of ultraviolet (UV) light that can restore your natural skin color. If a large area of your body needs treatment, your dermatologist may prescribe a type of light therapy called phototherapy. During phototherapy, you expose your skin to UV light for a specific amount of time.
Archer USMLE step 3 dermatology lecture notes. These lecture notes are samples and are intended for use with Archer video lectures. For video lectures, please log in at http://www.ccsworkshop.com/Pay_Per_View.html
Hyperpigmentation refers to the darkening or discoloration of patches of skin due to the overproduction or accumulation of melanin, the pigment responsible for skin color. It is a common dermatological condition that can affect people of all skin types and tones. Hyperpigmentation can be caused by various factors, including sun exposure, hormonal changes, aging, inflammation, and certain medical conditions. These darkened patches can appear on different areas of the body, such as the face, hands, arms, or legs, and can vary in size and intensity. While hyperpigmentation is generally harmless, it can be a source of cosmetic concern for many individuals, prompting them to seek treatment options for a more even and uniform skin tone.
Sạm da là gì và nguyên nhân gây sạm da | Venus GlobalVENUS
Sạm da luôn là nỗi ám ảnh của mọi chị em phụ nữ vì khiến phái đẹp trông kém xinh. Đồng thời mất đi sự tự tin vốn có với vẻ bề ngoài không hoàn hảo của mình. Vậy nguyên nhân hình thành nên sạm da là gì, cách điều trị ra sao? Bài viết dưới đây sẽ bật mí cho các bạn những cách chữa sạm da hiệu quả, đơn giản ngay tại nhà. Cùng theo dõi để nhanh chóng lấy lại làn da trắng hồng tự nhiên nhé!
Nguồn: http://venusglobal.com.vn/cach-chua-sam-da/
#cách_chữa_sạm_da
#cách_chữa_da_bị_sạm_nắng
#cách_chữa_da_bị_sạm_đen
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Acne is the result of overactive sebaceous glands and excessive keratin production, leading to excessively oily skin that is prone to blackheads and pimples. You cannot change your skin type you cannot stop this process permanently. However, you can control this process and minimise your acne breakout reoccurrence by....
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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3. Case Hx
A 25-year-old woman with Fitzpatrick type IV skin complains of a
darkening of the skin on her cheeks, nose, upper lip and forehead that
began 7 months ago during her first pregnancy.
The lesions are asymptomatic “ not pruritic nor painful “, and they’re
exacerbated by sun exposure.
No history of atopy or other skin diseases.
There’s no history of new cosmetics usage
4. Physical examination
- Well-demarcated, hyperpigmented macules are seen on the cheek,
nose, and upper lip.
- Bilateral, symmetrical, with
irregular shapes smooth surface
and variable pigment intensity.
- Size 4-6 cm
6. Melasma (black spot)
• Acquired light- or dark-brown hyperpigmentation that occurs in the
exposed areas.
• Often affect face
• Aetiology: Sunlight – Hormonal – Genetic predisposition.
• Commonly among :
1- Constitutive brown skin.
2- Whose taking contraceptive pills.
3- Living in sunny climates.
90% are women
9. Pathophysiology
1- Sun exposure
Ultraviolet (UV) light from the sun stimulates the melanocytes production.
In fact, just a small amount of sun exposure can make melasma return after
fading.
This is why melasma often is worse in summer. It also is the main reason why
many people with melasma get it again and again.
2- A change in hormones
When melasma appears in pregnant women, it is called chloasma, or the
mask of pregnancy.
Birth control pills and hormone replacement medicine also can trigger
melasma.
11. Classification
Epidermal Dermal Mixed Indetermined
Comments melanin is
increased in the
epidermis, with
only a few
melanocytes in
the upper
dermis
many
melanophages
throughout the
entire dermis
melanin is
increased in the
epidermis,
many
melanophages
throughout the
dermis
Seen with
people with
Fitzpatrick type
V or VI skin
Wood lamp
examination
Enhanced does not
enhance
spotty
enhancement
Not helpful
12. Clinical manifestation
(It causes brown to gray-brown patches), sharply marginated, roughly
symmetric patches of hyperpigmentation on the face.
(usually on the forehead, malar and mandibular).
Some people get patches on their forearms or neck. This is less common.
13.
14. Melasma risk factors
Pregnant women
Women taking any contraceptives. But commonly oral (estrogen)
Skin type III, IV.
Sun exposure.
Family Hx of melisma
furosemide, ACE-inhibitors, beta-blockers, hydrochlorothiazide, and
anti-seizure medications,
16. Management
Education:
1- Use sun protection daily and compliant to treatment
2- stop OCPs and facia cosmetics
Goals of treatment: curative and prophylactic
A- Hydroquinone ( 1st line)
B- Tretinoin and corticosteroids
C- azelaic acid
D- Kligman formulation (BEST)
Combination of fluocinolone 0.01%, hydroquinone 4%, and tretinoin 0.05%.
17. Hydroquinone:
This medicine is a common first treatment for melasma.
It is applied to the skin and works by lightening the skin. It’s came as a
cream, lotion, gel, or liquid.
Applied every night
18. Tretinoin and corticosteroids:
To enhance skin lightening, dermatologist may prescribe a second
medicine.
This medicine may be tretinoin or a corticosteroid.
Sometimes a medicine contains 3 medicines (hydroquinone,
tretinoin, and a corticosteroid) in 1 cream. This is often called a
triple cream.
19.
20. Other topical (applied to the
skin) medicines:
Dermatologist may prescribe azelaic acid lighten melasma. (Used in
pregnancy)
21. Sun protectors
Agents that protect against UVA include:
oxybenzone, avobenzone, and terephthalylidene dicamphor sulfonic
acid.
Agents that protect against UVB include:
octocrylene, padimate O, octinoxate, and ensulizole.
Follow up: after 3 months.
23. Notes
Epidermal melasma- best therapeutic results.
Dermal melasma – disappointing
Relapse on stopping treatment is common
Maintainance therapy adviced
24. Reference
http://www.dermatology.ca
Ball Arefiev KL, Hantash BM. Advances in the treatment of melasma: a review of
the recent literature. Dermatol Surg. 2012;38:971-984.
Lakhdar H, Zouhair K, Khadir K, et al. Evaluation of the effectiveness of a broad-
spectrum sunscreen in the prevention of chloasma in pregnant women. J Eur
Acad Dermatol Venereol. 2007;21:738-742.
Guinot C, Cheffai S, Latreille J, et al. Aggravating factors for melasma: a
prospective study in 197 Tunisian patients. J Eur Acad Dermatol Venereol.
2010;24:1060-1069.
http://bestpractice.bmj.com/best-practice/monograph/627/follow-
up/prognosis.html
Fitzpatricks Color Atlas and Synopsis of Clinical Dermatology 7th ED
centrofacial, malar, mandibular.
Can affect different areas, such as the forearms and neck.
Solar elastosis, also known as actinic elastosis, is a disorder in which the skin appears yellow and thickened as a result of sun damage
Epidermal most common
Pregnancy melisma increase at third trimester due to increased levels of melanin-stimulating hormone (MSH), post-inflammatory phenomenon, and UV light exposure in pregnant women
Post-inflammatory hyperpigmentation Hyperpigmentation of skin that was previously inflamed due to dermatitis.
Diagnosis is typically made on history of erythema, pruritus, and dermatitis preceding the hyperpigmentation.
Phototoxic reaction Seen in patients exposed to systemic or topical medicines or cosmetics, and then UV radiation.
Disease usually begins abruptly, in contrast to melasma, which develops gradually.
Exogenous ochronosis Skin hyperpigmentation associated with use of the bleaching agent hydroquinone. It is caused by the deposition of polymerised homogentisic acid in the skin.
Historically, this condition follows use of hydroquinone products, and distribution correlates with areas of medicine application.
Most commonly seen in people with Fitzpatrick type V or VI skin who have used hydroquinone-containing preparations of >3% concentration for months to years, and who have had significant UV light exposure without the use of photoprotection. Biopsy reveal golden-yellow to brown deposition of pigment in the dermis.
Erythema dyschromicum perstans Also called ashy dermatosis. Most frequently seen in Hispanic people and can be seen at any age.
Clinically, it presents as multiple blue-grey macules on the neck, chest, and sometimes the face.
The colour and distribution, as well as the lack of association with UV light exposure, help to differentiate it from melisma. Biopsy reveal non-specific, but can show some cell death at the dermal-epidermal junction, as well as pigment incontinence.
hydroquinone 3% solution and 4% cream; azelaic acid 20% cream; and a combination of fluocinolone 0.01%, hydroquinone 4%, and tretinoin 0.05%. Hydroquinone 4% cream can be compounded with 0.05% tretinoin cream or glycolic acid.
Hydroquinone inhibits the activity of the enzyme homogentisic acid oxidase and can cause polymerisation of homogentisic acid, which is then deposited in the skin. The result is a blue-black discoloration of the skin in areas treated with hydroquinone.
This condition is seen primarily in darker-skinned people who use hydroquinone-containing preparations (usually ≥3%) for a period of months to years, and is thought to occur more commonly in those who do not use adequate photoprotection.
This complication is seen most commonly in African countries, where high-concentration hydroquinone-containing products are readily available. If the treating physician encounters this reaction, hydroquinone-containing medicines should be discontinued immediately.
This condition can slowly fade, but is permanent in some cases