Clinical Approach to Linear Hyperpigmentation: A Review Article

Alkhowailed, Mohammad S.; Otayf, Mojahed; Albasseet, Abdulrahman; Almousa, Abdullah; Alajlan, Ziyad; Altalhab, Saad

doi:10.2147/ccid.s280819

Cited by 6 publications

(3 citation statements)

References 72 publications

(14 reference statements)

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“…Genetic analysis was not performed, histology images were not provided. In our view, this was a typical case of blaschkoid lichen planus pigmentosus, but not IP [19].…”

Section: Discussionmentioning

confidence: 51%

Dermatoscopy in the Diagnostics of Incontinentia Pigmenti Skin Lesions

Minić

Dobrosavljevic

Lalošević

et al. 2022

Dermatol Pract Concept

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Introduction: Incontinentia pigmenti (IP) is a rare X-linked geno-dermatosis characterized by numerous findings. Skin biopsy and histopathological analysis are considered as minor criteria for the diagnosis of IP. We assume that dermoscopy can assist the earlier diagnosis of IP. Objectives: To gain experience in earlier diagnosis of IP by observing dermoscopic findings of cutaneous changes. Methods: We revised confirmed cases of IP and examined them using dermoscopy, comparing histopathological and dermoscopic results. Results: Stage I presented solitary and grouped vesicles in linear arrangement on erythematous skin. Early stage II presented star-shaped verrucous lesions on erythematous or pigmented skin. In well-developed lesions, dotted vessels surround keratotic part, some with thrombosed capillaries, resembling a viral wart. Stage III presented linear brown dots on the pigmented areas. Dermoscopic image was uniform in all the examined pigmented Blaschko linear changes. Stage IV presented numerous dotted vessels on the hypopigmented skin. Terminal hair was scarce or absent in all four stages. The surrounding normal skin had perifollicular depigmentations in stages III and IV. Conclusions: Dermoscopy of all four stages is very specific compared to the dermoscopy of inflammatory dermatoses and pigmentations. Stage III has very close clinical, histological and dermoscopic mimickers and needs to be carefully examined with obligatory genetic testing. Dermoscopy of the stage IV closely corresponds to histopathological findings and may be crucial as a quick tool in revealing potential IP gene carriers. Dermoscopy should be used in addition to clinical examination since the two methods are complementary.

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“…Genetic analysis was not performed, histology images were not provided. In our view, this was a typical case of blaschkoid lichen planus pigmentosus, but not IP [19].…”

Section: Discussionmentioning

confidence: 51%

Dermatoscopy in the Diagnostics of Incontinentia Pigmenti Skin Lesions

Minić

Dobrosavljevic

Lalošević

et al. 2022

Dermatol Pract Concept

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“…Linear hyperpigmentation is a unique anatomical configuration that can be associated with benign and malignant conditions. Linea nigra is a presentation of linear hyperpigmentation that is most frequently observed in pregnant women [3,[5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Linea Nigra: Case Report of a Woman With a Pregnancy-Associated Linear Streak of Cutaneous Hyperpigmentation on Her Abdomen From the Umbilicus to the Pubic Symphysis

Cohen

2023

Cureus

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Linea nigra is a distinctive presentation of asymptomatic cutaneous hyperpigmentation on the abdomen that usually extends from the umbilicus to the pubic symphysis. It is frequently observed as a physiologic change associated with pregnancy. A primigravida 19-year-old woman began to develop skin darkening during week 24 of gestation. She delivered a healthy infant. Three months postpartum, the hyperpigmentation had not resolved. After the benign characteristics of her cutaneous hyperpigmentation were explained, the patient decided to clinically monitor the dark linear streak. Similar to this patient, clinical studies of pregnant women have observed the incidence of pregnancy-associated linea nigra to range from 32% to 92%; in contrast to this woman, partial or complete spontaneous resolution of the skin darkening commonly occurs after delivery of the newborn. During gestation, the development of linea nigra has been postulated to be caused by elevated estrogen, progesterone, and/or melanocyte-stimulating hormone levels. Linea nigra is not restricted to gestational females; it has also been noted in newborns and children. In addition, it has also been observed in men who had either benign prostate hyperplasia or prostate cancer. In summary, linea nigra is often an acquired longitudinal streak of benign cutaneous hyperpigmentation on the abdomen; when linea nigra is pregnancy-associated, the skin darkening often partially or completely resolves, spontaneously after delivery.

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“…Clinically, it is classified into diffuse, circumscribed, linear, or reticulated variants. Notably, hyperpigmentation of skin can almost immediately manifest through causes including inflammation (caused by acne, eczema, and contact dermatitis), cutaneous injury and UVB irradiation (Alkhowailed et al., 2021 ). Its pathogenesis results from melanocytes being exposed to paracrine melanogenic factors which can upregulate melanogenesis-associated enzymes (such as tyrosinase), resulting in the production of melanosomes (Peters, 2005 ).…”

Section: Introductionmentioning

confidence: 99%

Targeting delivery and minimizing epidermal diffusion of tranexamic acid by hyaluronic acid-coated liposome nanogels for topical hyperpigmentation treatment

et al. 2021

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Hyperpigmentation is a common complaint and distressing problem in dermatology, and tranexamic acid (TA) is an effective treatment agent but limited by the delivery to melanocytes in the epidermis. Herein, a novel TA naogels (named HA/TA-LP), combining the advantages of liposomes and hyaluronic acid (HA), are prepared and assessed for topical hyperpigmentation treatment with targeting delivery and minimizing epidermal diffusion. Morphological characteristics indicate numerous TA-loaded liposomes packed in HA gels. In vitr o cell studies using human A375 melanoma cells show that HA/TA-LP can promote the uptake of TA by targeting delivery with resulting inhibition of tyrosinase activity and melanin production. Guinea pigs are used to construct hyperpigmentation models and investigate the topical delivery and treatment efficacy of HA/TA-LP. In vivo topical delivery studies indicate HA/TA-LP realize the effective delivery into melanocytes with an ideal balance of effective permeability and minimizing epidermal diffusion. Subsequently, hyperpigmentation treatment assessments reveal that HA/TA-LP inhibit tyrosinase activity and melanin production under the radiation of UVB. Our study identifies favorable properties of HA/TA-LP for treating hyperpigmentation, and provides an experimental basis for further clinical application.

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Clinical Approach to Linear Hyperpigmentation: A Review Article

Cited by 6 publications

References 72 publications

Dermatoscopy in the Diagnostics of Incontinentia Pigmenti Skin Lesions

Dermatoscopy in the Diagnostics of Incontinentia Pigmenti Skin Lesions

Linea Nigra: Case Report of a Woman With a Pregnancy-Associated Linear Streak of Cutaneous Hyperpigmentation on Her Abdomen From the Umbilicus to the Pubic Symphysis

Targeting delivery and minimizing epidermal diffusion of tranexamic acid by hyaluronic acid-coated liposome nanogels for topical hyperpigmentation treatment

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