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   Table of Contents - Current issue
Coverpage
July-December 2019
Volume 6 | Issue 2
Page Nos. 57-116

Online since Thursday, December 19, 2019

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EDITORIAL  

Postinflammatory hyperpigmentation: what we should know Highly accessed article p. 57
Rashmi Sarkar, Anupam Das
DOI:10.4103/Pigmentinternational.Pigmentinternational_56_19  
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REVIEW ARTICLE Top

Role of chemical peels in postinflammatory hyperpigmentation: a comprehensive review p. 59
Surabhi Dayal, Priyadarshini Sahu, Bhavya Sangal, Shruti Sharma
DOI:10.4103/Pigmentinternational.Pigmentinternational_22_19  
Postinflammatory hyperpigmentation (PIH) is an acquired hypermelanosis arising after inflammation or injury to the skin and can develop in all skin types especially in Fitzpatrick skin phototypes III to VI. In higher skin phototypes, chances of PIH following procedures using laser and other light sources are high. Therefore, it is becoming increasingly important to manage this unforeseen condition. Wide variety of treatment options are available for PIH, but there is limited literature regarding efficacy and safety of chemical peels in PIH. Hence, a thorough systematic review was performed by searching Pubmed, Scopus, Medline, and Cochrane databases in English language involving studies on PIH. Thus, this article is an attempt to bring together all the possible ways of using chemical peels (alone, in combination with other peels or topical agents) for the management of PIH.
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Reticulate Pigmentary Disorders: a review p. 67
Surabhi Sinha, Anita Kulhari
DOI:10.4103/Pigmentinternational.Pigmentinternational_50_19  
Reticulate pigmentary disorders include presentations with “net-like,” “sieve-like,” or “chicken wire” configuration of the skin lesions. Various congenital and acquired dermatoses, as well as few systemic diseases, are present with this pattern of skin lesions. However, there is a lack of consensus on the exact scope of the term “reticulate” pigmentary disorders. True reticulate disorders include mostly genetic disorders including dyskeratosis congenita, Dowling Degos, acropigmentation of Kitamura, Naegeli Franceschetti Jadassohn (NFJ) syndrome, X-linked reticulate pigmentary disorder, dyschromatosis symmetrica hereditaria (DSH), and dyschromatosis universalis hereditaria (DUH). We review the “true” genetic reticulate pigmentary disorders here.
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ORIGINAL ARTICLE Top

Comparative study of noncultured epidermal cell suspension and postage stamp skin grafting in stable vitiligo p. 77
Ashwant Kaur, Suresh K Malhotra, Tejinder Kaur
DOI:10.4103/Pigmentinternational.Pigmentinternational_16_19  
Background: Vitiligo is an acquired primary depigmentary disorder, with a worldwide prevalence of 1%. Up to 80% of patients respond to medical treatment but for the rest of the patients, surgical methods are the treatment options. There is a scarcity of comparative studies of different surgical techniques in vitiligo. Aims: This article compares the efficacy of noncultured epidermal cell suspension (NCES) and postage stamp skin grafting in stable vitiligo. Methods: It was an experimental analytical study conducted over a period of 2 years. Two lesions in each patient were selected and those two lesions in each individual were randomized between Group A (NCES) and Group B (postage stamp grafting technique). Forty lesions in the 20 patients were divided into two groups − Groups A and B comprising of 20 lesions in each were taken up for surgery with two different procedures, that is, NCES and postage stamp grafting, respectively. Digital photographs were taken at every sitting. An analysis was performed using the Wilcoxon signed-rank test and Mann–Whitney tests and grading was done for response in the form of repigmentation as excellent (>75%), good (50%–75%), fair (25%–50%), and poor (<25%). Results: The patients included in the study belonged to different strata of society. Postage stamp split skin grafting being a simple and cost-effective technique showed excellent repigmentation in 19/20 (95%) of lesions as compared to NCES in which it was only seen in 13/20 (65%) lesions at the end of study over the period of 12 weeks. Conclusion: Postage stamp skin grafting is easy to perform, relatively inexpensive, and shows early and better results with minimum complications than NCES.
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Comparative study of efficacy of intradermal tranexamic acid versus topical tranexamic acid versus triple combination in melasma p. 84
Shruti S Patil, Ashish R Deshmukh
DOI:10.4103/Pigmentinternational.Pigmentinternational_19_19  
Background: Melasma, a hypermelanotic disorder, is challenging to treat as it needs long-term management. Intradermal tranexamic acid (TA), a plasmin inhibitor, has been tried for melasma in Korean and Iranian patients but not studied in skin type of Indian patients. TA cream topically as well as fluocinolone-based triple combination along with intradermal TA have not been studied in the literature so far in melasma. Objective: This study is designed to study the efficacy of intradermal TA vs topical TA vs triple combination (hydroquinone 2%, tretinoin 0.025%, fluocinolone acetonide 0.01%) for the treatment of melasma. Materials and Methods: A total of205 patients of melasma attending Dermatology OPD were enrolled in the study and randomly assigned into three groups. Groups A, B, and C were given intradermal TA, topical 3% TA, and triple combination, respectively, from November 2016 to May 2018 and asked to follow-up every month for 6 months. Total 180 patients completed the study and clinical evaluation was done using melasma area severity index (MASI) score. The results were analyzed using SPSS-22 and comparison of three groups were assessed by applying analysis of variance. Results: The MASI score at baseline and at 6 months for Groups A, B, and C was 15.4 and 2.2, 15.4 and 6.4, and 15.3 and 5.4, respectively. MASI score decreased in all three groups but it was statistically significant in Group A (TA group) that had the least MASI score followed by triple combination therapy. Conclusion: On the basis of these results, TA can be used as potentially a new, effective, safe, and promising therapeutic agent in melasma.
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A clinico-epidemiological study of facial melanosis at a tertiary care center in Gujarat p. 96
Pooja Agarwal, Krishna Gajjar, Amit Mistry
DOI:10.4103/Pigmentinternational.Pigmentinternational_30_18  
Background: A group of heterogenous entities having the common clinical feature of altered facial pigmentation have been informally called as facial melanoses. Since, the cosmetic disfigurement is easily visible, it has a lot of impact on the psychological well being of the person. Aim: To assess the patients of facial hyper pigmentary disorders for demographic , etiological and clinical profile. Methods: A prospective clinical study was conducted in a tertiary care center in Gujarat over period of 6 months. 107 patients with facial hyper pigmentary disorders were assessed by detailed history and clinical examination. Results: In our study, most common age group which sought treatment was 30-50 years. Female were predominantly affected (2.5: 1). Six different facial melanosis were observed which included melasma, postinflammatory hyperpigmentation , nevus of ota, exogenous ochronosis, Addison’s disease, and Riehl’s melanosis. Melasma was the most common disorder reported by 94 patients out of 107. Limitations: Dermoscopy could not be done to resource constraint. Conclusion: Increase in awareness and concern with appearance has led to an increase in reported incidence of facial melanosis in both sexes. Prior application of over the counter products poses difficulty in correct evaluation and treatment. Psychological evaluation forms an integral part of the treatment of these patients.
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CASE REPORT Top

Griscelli syndrome 3: a rare and mild variant p. 102
Mudita Gupta, Reena K Sharma, Sandhya Kumari, Saru Thakur
DOI:10.4103/Pigmentinternational.Pigmentinternational_29_18  
Griscelli syndrome is a multisystemic disorder. It is of three types with a common feature of pigmentary dilution. The clinical types depend on the gene involved leading to a varied presentation ranging from only pigmentary dilution and excellent prognosis in type 3 to a severe disease with multisystem involvement in type 2. Type 3 is the least reported variant. We describe a 23-year-old male with sporadic presence of light-colored skin and silver gray hair.
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Nivolumab induced vitiligo-like depigmentation in metastatic acral lentiginous melanoma p. 105
Disha Dabbas, Shekhar Neema, Niloy Pathak
DOI:10.4103/Pigmentinternational.Pigmentinternational_38_19  
Melanoma is an uncommon malignancy in Indian subcontinent. Dermoscopy of cutaneous metastases of malignant melanoma has been rarely reported. Immune checkpoint inhibitors are increasingly being used for management of metastatic melanoma. They are associated with frequent cutaneous adverse events. Few of the cutaneous adverse events are associated with better prognosis for melanoma. We report a rare case of metastatic acral lentiginous melanoma for rarity of dermoscopic findings of cutaneous metastases and adverse effect due to immune checkpoint inhibitor.
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SHORT COMMUNICATION Top

Dermoscopy of acral lentiginous melanoma in an Indian patient p. 109
Vrutika H Shah, Kinjal D Rambhia, Jayesh I Mukhi, Rajesh P Singh
DOI:10.4103/Pigmentinternational.Pigmentinternational_26_19  
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THE CLINICAL PICTURE Top

Giant congenital melanocytic nevus with neurofibroma-like papules p. 113
Dwarika Prasad Shrestha, M. M Aarif Syed
DOI:10.4103/Pigmentinternational.Pigmentinternational_25_18  
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Koebnerization and lichen planus pigmentosus: Is it a reality? p. 115
Seema Manjunath, Divya Kamat, Muthu Sendhil Kumaran
DOI:10.4103/Pigmentinternational.Pigmentinternational_48_19  
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