Postinflammatory hyperpigmentation in an Asian patient: a dramatic response to oral isotretinoin (13-cis-retinoic acid)

Winhoven, S. M.; Ahmed, I. Ben; Owen, Caroline M.; Lear, John T.

doi:10.1111/j.1365-2133.2005.06286.x

Cited by 11 publications

(6 citation statements)

References 8 publications

(16 reference statements)

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“…To date, most of the literature supporting the use of isotretinoin for treatment of hyperpigmentation consists of case reports for various hyperpigmentation disorders including: prurigo pigmentosa, erythema dyschromicum persistans, post-inflammatory hyperpigmentation from acne vulgaris, malignant acanthosis nigricans, Kyrle’s disease, and minocycline-induced hyperpigmentation. 35 -40…”

Section: Resultsmentioning

confidence: 99%

A Review of Oral Therapies for the Treatment of Skin Hyperpigmentation

et al. 2021

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This review article examines evidence supporting the use of oral therapies in treating idiopathic, actinic, and metabolically induced skin hyperpigmentation. A thorough review of the literature regarding oral treatments for hyperpigmentation was systematically conducted through PubMed. Keywords used in the primary search include “Hyperpigmentation,” “Melanosis” or “Melasma,” “Lightening,” “Oral,” and “Therapeutics.” The search was limited to the English language, and no timeframe restrictions were implemented. Numerous orally administered therapies have been proposed for the treatment of skin hyperpigmentation. There is an abundant body of literature demonstrating the efficacy of orally administered tranexamic acid, glutathione, isotretinoin, and proanthocyanidin. It is reasonable to expect that the most effective oral therapies will address known underlying causes of hyperpigmentation such as thyroid disease, diabetes, and hormonal imbalance. Improvement due to oral therapy of otherwise unresponsive skin hyperpigmentation or hyperpigmentation of unknown cause is less predictable. This review is limited by the strength of evidence contained within the available studies. Clinical studies investigating the treatments discussed within this article are limited in number, at times lack blinding in the study design, and are based on small sample sizes. Based on existing research, the most promising oral remedies for hyperpigmentation appear to be tranexamic acid, glutathione, isotretinoin, and proanthocyanidin. Additional studies to better establish safety and efficacy are necessary.

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Section: Resultsmentioning

confidence: 99%

A Review of Oral Therapies for the Treatment of Skin Hyperpigmentation

et al. 2021

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“…The mode of action of isotretinoin in PP is unknown; however, retinoids are thought to have immunological and anti-inflammatory effects [19]. Additionally, the use of isotretinoin has also been reported to resolve postinflammatory hyperpigmentation of acne vulgaris in an Asian patient [20]. …”

Section: Discussionmentioning

confidence: 99%

Prurigo Pigmentosa Successfully Treated with Low-Dose Isotretinoin

Akoğlu

Boztepe

Karaduman³

2006

Dermatology

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Background/Aims: Prurigo pigmentosa (PP) is an uncommon inflammatory disease with pruritic reddish papules, papulovesicules or vesicules that are symmetrically localized on the trunk and nape, accompanied by reticular hyperpigmentation. Currently available therapeutic options seem somewhat unsatisfying. Herein, we report an 18-year-old female with PP successfully treated with low-dose isotretinoin. Methods: The patient presented with a symmetrical pruritic eruption on the lateral sides of her trunk with erythematous papules on a hyperpigmented background. Based on the typical clinical and associated histological findings, the patient was diagnosed as PP and a treatment with low-dose isotretinoin 0.3 mg/kg/day (20 mg/day) was started. Results: After a total of 3 months of 20 mg/day isotretinoin therapy, all erythematous macules and papules resolved and the residual pigmentation had almost disappeared. Conclusion: Low-dose isotretinoin is not only adequate for the improvement of erythematous lesions, it also helps resolve the reticular hyperpigmentation of PP. Further studies are needed to observe the efficacy of isotretinoin in the treatment of PP.

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“…[35][36][37] Along with the above treatment options, oral isotretinoin has also been used to reduce the inflammation associated with acne as well as PIH. [38]…”

Section: Systemic Agentsmentioning

confidence: 99%

Tips for managing post-inflammatory hyperpigmentation of acne

Garg¹,

Tuknayat²

2021

CSDM

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Post-inflammatory hyperpigmentation (PIH) is a reactive hypermelanosis, profoundly common in the Asian skin. The post-acne sequelae may have profound effects on the patients’ mental status, sometimes even more than the acne itself, as they are long lasting and sometimes treatment refractory. PIH occurs secondary to release of inflammatory mediators such as prostaglandins and interleukins in acne which stimulate melanogenesis. There are a multitude of therapeutic modalities available for the treatment of PIH associated with acne. Treating acne and PIH simultaneously would be a logical approach. Epidermal PIH usually responds to topical skin lightening agents which are the first line in these cases. Patients refractory to topical and oral treatment modalities usually have dermal PIH and may be offered interventional therapies. These therapies can be utilized simultaneously along with conventional therapies to hasten up the results, as combination treatment works synergistically by multipronged action at different pathways of etiopathogenesis. The patients with dermal PIH refractory to standard treatment may require other adjunctive therapies such as chemical peels, PRP, and lasers. This review provides an insight into rational and holistic approach to the management of the underlying acne, early customized treatment along with correction of underlying nutritional deficiencies, and lifestyle modifications in effective treatment of PIH.

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Postinflammatory hyperpigmentation in an Asian patient: a dramatic response to oral isotretinoin (13-cis-retinoic acid)

Cited by 11 publications

References 8 publications

A Review of Oral Therapies for the Treatment of Skin Hyperpigmentation

A Review of Oral Therapies for the Treatment of Skin Hyperpigmentation

Prurigo Pigmentosa Successfully Treated with Low-Dose Isotretinoin

Tips for managing post-inflammatory hyperpigmentation of acne

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