Index

Pigmentary Disorders: A Comprehensive Compendium Rashmi Sarkar, Koushik Lahiri, Manas Chatterjee

1:History and Evolution of Pigmentary Disorders in Human
- INTRODUCTION
- HISTORY AND EVOLUTION OF PIGMENTARY DISORDERS IN MODERN DERMATOLOGY
- CONCLUSION
2:Evolution of Skin Color in Human: An Anthropological Overview
- INTRODUCTION
- EVOLUTIONARY TIMELINE OF HUMAN BEING
- EVOLUTION OF VARIOUS COLORS: VARIOUS OPINIONS, VARIOUS THEORIES
- EFFECT OF CLIMATE AND CHANGE OF LIFESTYLE
- PIGMENT AND FOLATE METABOLISM
- PIGMENT AND VITAMIN D
- FAIR SEX, FAIR COLOR AND SEXUAL SELECTION
- SKIN, GENE AND COLOR
- INFLUENCE OF CULTURE ON PIGMENTATION
- CONCLUSION
3:Melanocyte
- INTRODUCTION
- DEVELOPMENT OF MELANOCYTES
- MELANOCYTE SIGNALING PATHWAYS
- FORMATION OF MELANOSOMES
- MELANIN-PRODUCING ENZYMES
- MELANIN SYNTHESIS
  - Eumelanin
  - Pheomelanin
- EPIDERMAL MELANIN UNIT
- MELANOSOME TRANSFER FROM MELANOCYTE TO KERATINOCYTE
- MELANOCYTE FUNCTIONS
- EXTRACUTANEOUS MELANOCYTES
4:Systemic Disorders with Cutaneous Pigmentary Alterations
- PIGMENTARY DERANGEMENTS IN ENDOCRINE DISORDERS
- PIGMENTARY DERANGEMENTS IN METABOLIC DISORDERS
- PIGMENTARY DERANGEMENTS IN NUTRITIONAL DISORDERS
  - Protein-energy Malnutrition
  - Vitamin Deficiency
- PIGMENTARY DERANGEMENTS IN GASTROINTESTINAL DISORDERS
  - Malabsorption
  - Intestinal Polyposis Syndromes
- PIGMENTARY DERANGEMENTS IN HEPATOBILIARY DISORDERS
- PIGMENTARY DERANGEMENTS IN PANCREATIC DISORDERS
  - Acute Pancreatitis
  - Necrolytic Migratory Erythema
- PIGMENTARY DERANGEMENTS IN RENAL DISORDERS
  - Nephrocutaneous Syndromes
  - Cutaneous Pigmentary Changes Seen in Chronic Renal Failure and Dialysis
- PIGMENTARY DERANGEMENTS IN CARDIAC DISORDERS
- PIGMENTARY DERANGEMENTS IN DISORDERS OF THE RESPIRATORY SYSTEM
5:Developmental, Nevoid, Genetically Determined and Neurocutaneous Pigmentary Disorders
- INTRODUCTION
  - Hypopigmented Disorders
  - Hyperpigmented Disorders
- HYPOPIGMENTED DISORDERS
- HYPERPIGMENTED DISORDERS
6:Metabolic Disorders of Pigmentation
- INTRODUCTION
- HYPOPIGMENTATION
- HYPERPIGMENTATION
7:Endocrinal Pigmentary Disorders
- INTRODUCTION
- ROLE OF MELANOCORTINS, ACTH, AND MELANOCORTIN RECEPTORS IN MELANOGENESIS
- ADDISON'S DISEASE
- ACROMEGALY
  - Clinical Features (Table 4)
  - Treatment
- HYPERTHYROIDISM
- PHEOCHROMOCYTOMA
- DIABETES MELLITUS
- CARCINOID SYNDROME
- PIGMENTARY CHANGES IN PREGNANCY
8:Chemical, Occupational and Drug-induced Pigmentary Disorders
- CHEMICAL INDUCED HYPOPIGMENTATION
- OCCUPATIONAL HYPERPIGMENTATION
- COSMETIC INDUCED HYPERPIGMENTATION
- DRUG-INDUCED HYPERPIGMENTATION
9:Infective and Post-inflammatory Pigmentary Disorders
- INTRODUCTION
- INFECTIVE
- PITYRIASIS VERSICOLOR
  - Mechanism of Pigmentary Changes
- TINEA NIGRA
- LEPROSY
- POST-KALA-AZAR DERMAL LEISHMANIASIS
- TREPONEMATOSES: SYPHILIS AND PINTA
- ONCHOCERCIASIS
- POST-INFLAMMATORY
  - Mechanism of Post-inflammatory Pigmentary Changes
  - Individual Chromatic Tendency
- POST-INFLAMMATORY HYPERPIGMENTATION
  - Management of Post-inflammatory Hyperpigmentation
- POST-INFLAMMATORY HYPOPIGMENTATION
10:Neoplasms with Pigmentary Changes or Discoloration
- INTRODUCTION
- HYPERCHROMIC NEOPLASTIC CONDITIONS
- HYPOCHROMIC NEOPLASTIC CONDITIONS
- MIMICS OF NEOPLASTIC DYSCHROMIC LESIONS
- DIAGNOSIS AND MANAGEMENT
- MALIGNANT MELANOMA1–37
- PIGMENTED BASAL CELL CARCINOMA38–44
- MYCOSIS FUNGOIDES45–68
- SOME COMMON BENIGN NEOPLASTIC CONDITIONS WITH PIGMENTARY CHANGES69–78
- CONCLUSION
11:Nutritional Pigmentary Disorders
- INTRODUCTION
- VITAMIN DEFICIENCIES ASSOCIATED WITH PIGMENTARY CHANGES
- TRACE ELEMENTS AND SKIN PIGMENTATION
- PIGMENTARY CHANGES SECONDARY TO PROTEIN ENERGY MALNUTRITION
- VITILIGO AND NUTRIENTS
- PIGMENTATION DISORDERS DUE TO NUTRITION EXCESS
- WORK-UP OF A PATIENT WITH NUTRITIONAL PIGMENTARY DISORDER
12:Morphological Types of Pigmentation
- INTRODUCTION
- TYPES OF MORPHOLOGICAL PIGMENTATION
- CONCLUSION
13:Pigmented Variants of Skin Disorders
- INTRODUCTION
- HYPERPIGMENTED VARIANTS
- HYPOPIGMENTED VARIANTS HYPOPIGMENTED MYCOSIS FUNGOIDES
  - Hypopigmented Sarcoidosis
  - Leukoderma Syphiliticum
- OTHER PIGMENTARY VARIANTS
  - Poikilodermic Mycosis Fungoides
  - Nonpigmenting Fixed Drug Eruption
- CONCLUSION
14:Vitiligo and Melanocyte Reservoir
- INTRODUCTION
- HISTORICAL HIGHLIGHTS ON SKIN PIGMENTATION
- CONCEPT OF A MELANOCYTE RESERVOIR
- HAIR FOLLICLE AND THE MELANOCYTE RESERVOIR
- MELANOCYTE RESERVOIR UNRELATED TO HAIR FOLLICLES
- LEUKOTRICHIA A DEPLETED MELANOCYTE RESERVOIR
- CONCLUSION
15:Clinical, Biochemical and Immunological Aspects of Vitiligo
- INTRODUCTION
- CLINICAL ASPECTS OF VITILIGO
- PATHOGENESIS OF VITILIGO
- BIOCHEMICAL THEORY OF VITILIGO
- IMMUNOLOGICAL ASPECTS OF VITILIGO: ROLE OF AUTOIMMUNITY
- CONCLUSION
16:Measuring Disease Severity in Vitiligo
- INTRODUCTION
- MEASURES OF EXTENT OF SKIN INVOLVEMENT AND INTENSITY OF DEPIGMENTATION
- MEASURES OF DISEASE ACTIVITY/PROGRESSION OF DISEASE/DISEASE STABILITY
- MEASURES OF THE POTENTIAL FOR REPIGMENTATION
- DISFIGUREMENT
- PSYCHOSOCIAL IMPACT OF VITILIGO
- GENERIC QUALITY OF LIFE INSTRUMENTS
- DERMATOLOGY QUALITY OF LIFE INSTRUMENTS
  - Dermatology Life Quality Index
  - Skindex
- VITILIGO SPECIFIC QUALITY OF LIFE INSTRUMENTS
- CONCLUSION
- ACKNOWLEDGMENT
17:Epidemiology of Vitiligo
- INTRODUCTION
- ASSOCIATIONS OF VITILIGO
  - Morbidity and Mortality Associated with Vitiligo
- CONCLUSION
18:Classification of Vitiligo
- INTRODUCTION
- DEFINITIONS
- CONCLUSION
19:Segmental Vitiligo
- INTRODUCTION
- EPIDEMIOLOGY
  - In World
  - In India
- PATHOGENESIS
- CLINICAL FEATURES
- DIFFERENCES BETWEEN SEGMENTAL AND NON-SEGMENTAL VITILIGO
- DIAGNOSIS
  - Development of Criteria for Diagnosis of Segmental Vitiligo
    - Essential Criteria (Major)
    - Additional Criteria (Minor)
- DIFFERENTIAL DIAGNOSIS
- MANAGEMENT
- CONCLUSION
- ACKNOWLEDGMENT
20:Vitiligo in Children
- INTRODUCTION
- ETIOPATHOGENESIS
- CLASSIFICATION
- CLINICAL MANIFESTATIONS
- ASSOCIATED CONDITIONS
- PROGNOSIS AND OUTCOME
- MANAGEMENT
  - Medical Treatment2,3,6
    - Topical Therapy
    - Systemic Therapy
  - Surgical Treatment6,7
- CONCLUSION
21:Concept of Stability of Vitiligo
- INTRODUCTION
- PERIOD OF STABILITY
- AREA BASED VARIABLE STATUS OF STABILITY
- ASSESSMENT OF STABILITY
- HOW STABLE IS STABILITY?
- UNDERSTANDING STABILITY FROM WITHIN
- CONCLUSION
- ACKNOWLEDGMENTS
22:Phototherapy in Vitiligo
- INTRODUCTION
- PSORALEN PLUS ULTRAVIOLET A THERAPY
- NARROWBAND ULTRAVIOLET B
- TARGETED PHOTOTHERAPY
- ADJUVANT THERAPY WITH PHOTOTHERAPY
  - Khellin Plus UVA
  - L-Phenylalanine Plus UVA
- PHOTOTHERAPY IN CHILDREN
- CONCLUSION
23:Medical Management of Vitiligo
- INTRODUCTION
- CLASSIFICATION OF VITILIGO
- CLINICAL MANAGEMENT
- THERAPEUTICAL MANAGEMENT
- MEDICAL TREATMENT
- MANAGEMENT ALGORITHM
- CONCLUSION
24:Oral and Systemic Corticosteroids in Management of Vitiligo
- INTRODUCTION
- HISTORY
- STRUCTURE AND CLASSIFICATION OF SYSTEMIC CORTICOSTEROIDS
- MECHANISM OF ACTION OF CORTICOSTEROIDS IN VITILIGO
- EFFICACY OF CORTICOSTEROIDS IN VITILIGO
- CONCLUSION
- ACKNOWLEDGMENTS
25:Topical Treatment of Vitiligo: New Insights, New Trends
- INTRODUCTION
- TOPICAL TREATMENT OF VITILIGO
- CONCLUSION
26:Alternative Treatment for Vitiligo
- INTRODUCTION
- ANTIOXIDANT
- L-PHENYLALANINE
- KHELLIN
- HOMEOPATHY AND AYURVEDIC MEDICINE
- PSYCHOTHERAPY
- CLIMATOLOGICAL AND BALNEOLOGICAL THERAPIES
- CONCLUSION
27:Surgical Management of Vitiligo
- INTRODUCTION
- HISTORY
- PRINCIPLE OF SURGICAL TREATMENTS
- INDICATIONS FOR SURGERY AND PATIENT SELECTION
- CONTRAINDICATIONS
- PREOPERATIVE COUNSELING
- METHODS OF SURGERY
  - Tissue Grafts
    - Suction Blister Epidermal Grafting
    - Split-thickness Skin Grafting
  - Cellular Grafting Techniques
- APPROACH TO SURGICAL MANAGEMENT OF VITILIGO
- CONCLUSION
- ACKNOWLEDGMENT
28:Autologous Mini Punch Grafting in Vitiligo
- HISTORICAL PERSPECTIVE
- PUNCH INSTRUMENT
- EVOLUTION OF MINI PUNCH GRAFTING
- TEST GRAFTING
- PROCEDURE OF MINIGRAFTING 13,40–42 (FIG. 4)
- FOLLOW-UP AND COURSE OF EVENTS
- COMPLICATIONS22,40–42
- ANALYSIS OF SPECIAL FEATURES
- CONCLUSION
- ACKNOWLEDGMENTS
29:Meshed Split Skin Graft for Extensive Vitiligo
- INTRODUCTION
- TECHNIQUE
- PROCEDURE
- CONCLUSION
30:Therapeutic Guidelines in Vitiligo
- INTRODUCTION
- TOPICAL THERAPY
  - Topical Corticosteroids
    - Recommendations19
  - Topical Calcineurin Inhibitors
- SYSTEMIC THERAPY
  - Oral Steroids
  - Other Immunosuppressants
- PHOTOTHERAPY
- SURGERY
- MISCELLANEOUS THERAPY
- OTHER INTERVENTIONS
- CONCLUSION
31:Pigmentary Changes in Pregnancy
- INTRODUCTION
- PATHOGENESIS
- MELASMA
- CONCLUSION
32:Quality of Life in Pigmentary Disorders
- INTRODUCTION
- QUALITY OF LIFE IN DISORDERS OF HYPERPIGMENTATION
- OTHER RELATED QoL INDICES
- QUALITY OF LIFE IN DISORDERS OF DEPIGMENTATION
- STIGMATIZATION IN VITILIGO24,26,27
- PSYCHOLOGICAL AND PSYCHIATRIC CO-MORBIDITY28–31
- STRESS PRECIPITATING VITILIGO
- PSYCHOSOCIAL ASSESSMENT SCALES
- VITILIGO SPECIFIC SCALES
- PREDICTORS OF INCREASED SEVERITY IN VARIOUS SCALES
- QUALITY OF LIFE IN CHILDREN AND ADOLESCENTS WITH VITILIGO
- EFFECTIVENESS OF THERAPEUTIC INTERVENTIONS IN QoL IN VITILIGO PATIENTS66
- ROUTINE PSYCHOLOGICAL ASSESSMENT IN VITILIGO
- OVERCOMING QUALITY OF LIFE ISSUES IN VITILIGO37
- LIMITATIONS OF QoL STUDIES
- CONCLUSION
33:Epidemiology of Melasma
- INTRODUCTION
34:Etiopathogenesis of Melasma
- INTRODUCTION
- SUN EXPOSURE AND MELASMA
- ROLE OF DERMAL FACTORS IN THE DEVELOPMENT OF MELASMA
  - Role of Fibroblasts
  - Role of Blood Vessels
- BASEMENT MEMBRANE PERSPECTIVE
- TRANSCRIPTOMICS OF MELASMA
- CONCLUSION
35:Histopathological Evaluation of Melasma and Other Facial Hyperchromias
- DEFINITION OF TERMS
- HYPERCHROMIA AND HYPERPIGMENTATION
  - Melanosis
  - Melanocytosis
- FACIAL HYPERCHROMIA
- MELASMA
  - Histopathology
- DIFFERENTIAL DIAGNOSIS OF MELASMA
- PRACTICAL APPROACH IN DIAGNOSING FACIAL HYPERCHROMIA
36:Update Scoring Methods and Non-invasive Measurement Methods in Melasma (Reliability Assessment and Validation of the Melasma Area and Severity Index and a New Modified MASI Scoring Method)
- MELASMA AREA AND SEVERITY INDEX
- MEASURING THE IMPACT OF MELASMA
- REFLECTANCE CONFOCAL MICROSCOPY FOR PIGMENTARY DISORDERS
- VISUALIZATION OF MELANIN AND MELANOCYTES BY REFLECTANCE CONFOCAL MICROSCOPY
- IN VIVO REFLECTANCE CONFOCAL MICROSCOPY DETECTS PIGMENTARY CHANGES IN MELASMA AT A CELLULAR LEVEL RESOLUTION
- HISTOLOGICAL CLASSIFICATION OF MELASMA WITH REFLECTANCE CONFOCAL MICROSCOPY: A PILOT STUDY IN CHINESE PATIENTS
37:Cutaneous Biophysical Characteristics of Melasma
- DEFECTIVE BARRIER FUNCTION IN MELASMA SKIN
- MATERIAL AND METHODS
- MELANIN INDEX AND ERYTHEMA INDEX
- BASAL STRATUM CORNEUM PROPERTIES
- SEBUM CONTENT
- SEBUM CONTENT THICKNESS AND EXPRESSION OF PPAR-α AND ALOX15B
- DISCUSSION
38:Importance of Pendulous Melanocytes in Melasma
- DOES ALTERED BASEMENT MEMBRANE OF MELASMA LESIONS AFFECTS TREATMENT OUTCOME IN THE SKIN?
  - Does Altered Basement of Melasma Lesion Affects Treatment in Asian Skin?
- PENDULOUS MELANOCYTES: A CHARACTERISTIC FEATURE OF MELASMA AND HOW IT OCCURRED
39:Classification and Clinical Features of Melasma
- INTRODUCTION
- CLINICAL FEATURES
- CLASSIFICATION
- CONCLUSION
40:Medical Management of Melasma
- INTRODUCTION
- HYDROQUINONE
- RETINOIDS
- TOPICAL STEROIDS
- TRIPLE COMBINATION THERAPY
- OTHER RETINOIDS
- KOJIC ACID
- AZELAIC ACID
- GLYCOLIC ACID
- ARBUTIN
- OTHER AGENTS
- CONCLUSION
41:Photoprotection for Melasma
- INTRODUCTION
- ELECTROMAGNETIC RADIATION
  - Effects of Ultraviolet Radiation on the Skin
  - Pigmentation Following Ultraviolet Exposure
- PHOTOPROTECTION
  - General Measures
- SUNSCREENS
- PROTECTIVE CLOTHING
- CONCLUSION
42:Chemical Peeling for Melasma
- INTRODUCTION
- CHEMICAL PEELS
- TECHNIQUE
- POST-PEEL INSTRUCTIONS
- CONCLUSION
43:Cosmetics, Cosmeceuticals and Camouflage for the Treatment of Melasma
- INTRODUCTION
- NON-HYDROQUINONE PRESCRIPTION AGENTS
- COSMECEUTICAL AGENTS
- ENERGY BASED DEVICES
- CHEMICAL PEELING
- COMBINATION TREATMENTS
- CAMOUFLAGE TREATMENTS
- CONCLUSION
44:Recent Trends and Future Treatment Paradigms of Melasma Based on Current Understanding of Pathophysiology
- INTRODUCTION
- THE OLD CLASSIFICATION SCHEME IS NOT VALID
- IS THERE A TRUE DERMAL MELASMA?
- ROLE OF EPIDERMAL MELANIN IN MELASMA
- HYPERACTIVE MELANOCYTES
- PENDULOUS MELANOCYTES AND SPECTRUM OF RADIATION RESPONSIBLE IN MELASMA
- DEFECTIVE BARRIER FUNCTION IN MELASMA SKIN
- DERMAL-EPIDERMAL INTERACTION AND PARACRINE REGULATION
- ROLE OF VASCULAR ENDOTHELIUM
- ENDOCRINE CORRELATES OF MELASMA
- DEPIGMENTING AGENTS WITH NOVEL MECHANISMS OF ACTION
- CONCLUSION
45:Exogenous Ochronosis
- INTRODUCTION
  - The Term
  - Definition
- HISTORICAL ASPECTS
- EPIDEMIOLOGICAL ASPECTS
- PREDISPOSING FACTORS
- CLINICAL FEATURES AND STAGING
- DIAGNOSIS
- TREATMENT OF EXOGENOUS OCHRONOSIS
46:Periocular Pigmentation
- INTRODUCTION
- EPIDEMIOLOGY
- HISTORY
- ETIOLOGY AND DIAGNOSTIC CONSIDERATIONS
  - Pathomechanisms of Periocular Pigmentation16
  - Studies on Etiological Factors
- TREATMENT
- CONCLUSION
47:Physical Therapies for Periorbital Hyperpigmentation, Chemical Peels and Lasers
- INTRODUCTION
- PREVALENCE
- CAUSES OF PERIORBITAL MELANOSIS1,2
- CLINICAL PICTURE OF PERIORBITAL MELANOSIS
- WHAT IS OUR AIM?
- CHEMICAL PEELING FOR PERIORBITAL HYPERPIGMENTATION
- LASER TREATMENT FOR PERIORBITAL MELANOSIS
- CONCLUSION
- ACKNOWLEDGMENTS
48:Progressive Macular Hypomelanosis
- INTRODUCTION
- HISTORY
- EPIDEMIOLOGY
- CLINICAL FEATURES
- DIFFERENTIAL DIAGNOSES AND PITFALLS IN DIAGNOSIS
- RELEVANT INVESTIGATIONS
- DIAGNOSIS
- MICROSCOPY AND ELECTRON MICROSCOPY
- ETIOLOGY
- MANAGEMENT
- FUTURE DIRECTIONS
- CONCLUSION
49:Non-melasma Facial Melanoses
- INTRODUCTION
- WELL-DEFINED FACIAL MELANOSES
- ACQUIRED MELANOSES WHICH ALSO INVOLVE FACE
- MISCELLANEOUS
- MANAGEMENT OF NON-MELASMA FACIAL MELANOSIS
  - Diagnosis
  - Treatment
50:Pigmentary Abnormalities of Nail
- INTRODUCTION
- MELANONYCHIA
  - Etiology of Melanonychia
    - Melanocytic Activation
    - Melanocytic Hyperplasia
  - Approach to Evaluation of Melanonychia
- LEUKONYCHIA (WHITE NAIL)
- SPLINTER HEMORRHAGES
- YELLOW NAIL
- GREENISH-BLACK DISCOLORATION
- ABNORMALITY IN COLOR OF LUNULA
51:Macular Amyloidosis
- INTRODUCTION
- EPIDEMIOLOGY
- PATHOGENESIS
- ETIOLOGICAL FACTORS
- PATHOLOGY
- DERMOSCOPY
- CLINICAL FEATURES
- TREATMENT
- CONCLUSION
52:Lichen Planus Pigmentosus
- INTRODUCTION
- EPIDEMIOLOGY
- PATHOGENESIS
- RISK FACTORS
- CLINICAL FEATURES
- INVESTIGATIONS
- TREATMENT
- COURSE OF DISEASE
- CONCLUSION
53:Maturational Hyperpigmentation
- INTRODUCTION
- HISTORICAL ASPECTS
- INDIAN SCENARIO
- HISTOPATHOLOGY
- DIFFERENTIAL DIAGNOSIS
- CONCLUSION
- FUTURE APPROACH

INDEX

TOC
Index

Chapter Notes