The authors describe a case of cutaneous metastases from a squamous cell carcinoma of the laryngeal vestibule. The skin lesions, which consisted of nodules localized to the forehead and left arm, appeared 2 years after diagnosis of the primary tumor. The skin manifestations preceded lung metastases by 5 months.
Background
Melasma treatment is difficult due to extended treatment periods, suboptimal adherence, inconsistent results, and frequent relapses. Kojic acid has been shown to be effective in reducing melasma severity and is now increasingly used in cosmetic treatments.
Aims
The purpose of the present study was to evaluate the effectiveness of a new cosmetic treatment for melasma at 45 and 90 days.
Methods
Multicenter prospective study across 20 dermatology clinics/ambulatories. One hundred patients with mild‐to‐moderate melasma were evaluated. The primary endpoints were changes in mean modified melasma area and severity index (mMASI) score and patient‐reported satisfaction at 45 and 90 days.
Results
The mean age of patients was 45.19 ± 11.5 years. Most patients were female and Caucasian. Patients presented mixed (65%), epidermal (26%), and dermal (4%) types of melasma. Triggering factors were hormonal contraception (33%), pregnancy (31%), and pharmacological treatment (11%); mean disease duration was 6.7 ± 6.8 years. Overall, a statistically significant decrease in mean mMASI scores was seen at 45 (2.19 ± 0.182 vs 3.29 ± 0.267, P < .0001) and 90 days (1.27 ± 0.128 vs 3.29 ± 0.267, P < .00001). The highest reduction in mMASI scores was observed in patients with dermal melasma. IGA scores showed a statistically significant improvement in pigmentation at 90 days (P < .00001).
Conclusion
The novel cosmetic treatment was associated with the improvement of melasma, as assessed by mMASI.
Thoracic aortic aneurysms and dissections can occur in families w~th autosomal dominant inheritance. Mutations in the fibrillin-l gene on chromosome 15 cause Marfan syndrome (MFS), a known cause of famllial aort~c aneurysms and dissections. Affected individuals have phenotypic stlgmata involving the skeletal, ophthalmologic and other systems. Mutations in the type Ill procollagen gene cause the vascular type o f Ehlers-Danlos syndrome (EDS
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