Propionibacterium acnes and the Pathogenesis of Progressive Macular Hypomelanosis

Westerhof, W.; Relyveld, Germaine N.; Kingswijk, Melanie M.; Man, Peter de; Menke, Henk E.

doi:10.1001/archderm.140.2.210

Cited by 92 publications

(106 citation statements)

References 9 publications

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“…Westerhof i wsp. [8] potwierdzili zależność pomiędzy obecnością P. acnes i hipopigmentacją zmian w PMH. Ponadto Cavalcanti i wsp.…”

Section: Przypadekunclassified

Progressive macular hypomelanosis: a common disorder rarely diagnosed in clinical practice

Pelc¹,

Reszke²,

Szepietowski³

2016

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Przegląd Dermatologiczny 2016/5 StreSzczenieWprowadzenie. Progressive macular hypomelanosis (PMH) jest zaburzeniem barwnikowym skóry wynikającym z niedoboru melaniny, cechującym się rozsianymi odbarwionymi plamami. W rozpoznaniu różnico-wym PMH bierze się pod uwagę: łupież biały, odbarwienia pozapalne (atopowe zapalenie skóry, łuszczyca), infekcje bakteryjne i grzybicze, schorzenia nowotworowe, bielactwo nabyte, bielactwo ograniczone, znamię anemiczne oraz idiopatyczną hipomelanozę kropelkową. Dotychczas nie ma powszechnie akceptowanych rekomendacji terapeutycznych dotyczących tej dermatozy. W piśmiennictwie opisywano skuteczność antybiotyków miejscowych, fototerapii oraz izotretynoiny stosowanej doustnie. Cel pracy. Przedstawienie przypadków własnych PMH, dermatozy, która pomimo stosunkowo częstego występowania w populacji nadal jest zbyt rzadko rozpoznawana w praktyce klinicznej. Opis przypadku. Opisujemy dwa przypadki: 33-letniej kobiety oraz 38-letniego mężczyzny, u których na podstawie badania klinicznego i wykluczenia innych przyczyn ustalono rozpoznanie PMH. W leczeniu zastosowano doustną izotretynoinę. Wnioski. Dermatolodzy powinni znać tę jednostkę chorobową, gdyż pomimo stosunkowo łagodnego obrazu klinicznego może stanowić ona poważny problem dla dotkniętych nią pacjentów. AbStrActIntroduction. Progressive macular hypomelanosis (PMH) is a cutaneous pigmentary disorder resulting from a deficit of melanin and manifesting with disseminated hypopigmented macules. Pityriasis alba, post-inflammatory hypopigmentation (atopic dermatitis, psoriasis), bacterial and fungal infections, neoplasms, vitiligo, piebaldism, nevus anemicus and idiopathic guttate hypomelanosis are included in the differential diagnosis. No commonly accepted therapeutic recommendations have been published so far; topical antibiotics, phototherapy and oral isotretinoin have been described in the literature. Objective. To present our own cases of PMH -a dermatosis which is somewhat common in the general population but is still diagnosed infrequently in clinical practice.Progressive macular hypomelanosis: częste schorzenie rzadko rozpoznawane w praktyce klinicznej Progressive macular hypomelanosis: a common disorder rarely diagnosed in clinical practice

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“…Westerhof i wsp. [8] potwierdzili zależność pomiędzy obecnością P. acnes i hipopigmentacją zmian w PMH. Ponadto Cavalcanti i wsp.…”

Section: Przypadekunclassified

Progressive macular hypomelanosis: a common disorder rarely diagnosed in clinical practice

Pelc¹,

Reszke²,

Szepietowski³

2016

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“…1 During the 1980s, the disease began to be reported in other countries; however, there was no association with mixed race and different nomenclatures such as progressive macular confluent hypomelanosis, cutis trunci variata and nummular and confluent hypomelanosis of the trunk were used to describe the condition. 1,2 It is a common dermatosis in different continents such as Africa, Europe, Asia and the Americas. In Brazil, there are no epidemiological data on this dermatosis.…”

Section: Introductionmentioning

confidence: 99%

“…Studies published in the literature describe a higher prevalence of the condition in females (7:1), and in adolescents and young adults with Fitzpatrick skin type II-IV. 1,2 The condition is clinically classified by poorlydefined, hypopigmented, confluent, nummular macules, located symmetrically in seborrheic areas, generally on the posterior and anterior trunk and, less commonly, on the neck and areas close to the extremities. The lesions are asymptomatic and there have been no precedents of inflammatory lesions.…”

Section: Introductionmentioning

confidence: 99%

“…The lesions are asymptomatic and there have been no precedents of inflammatory lesions. [1][2][3][4][5] Its pathogenesis remains unclear. Some authors have suggested the effect of a subspecies of Propionibacterium acnes in the physiopathology of the condition.…”

Section: Introductionmentioning

confidence: 99%

“…Some authors have suggested the effect of a subspecies of Propionibacterium acnes in the physiopathology of the condition. 2,4 The treatment options that have been described in the literature include phototherapy (PUVA, UVA or narrow band UVB) and topical benzoyl peroxide 5% and clindamycin 1%. One report described treatment with oral doxycycline.…”

Section: Introductionmentioning

confidence: 99%

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Hipomelanose macular progressiva: estudo epidemiológico e resposta terapêutica à fototerapia

Duarte

Nina

Gordiano

et al. 2010

An. Bras. Dermatol.

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BACKGROUND: Progressive macular hypomelanosis is a common dermatosis in various continents. Its cause is unknown and proposed treatments have had little effect. OBJECTIVES: To determine epidemiological aspects of progressive macular hypomelanosis in patients referred to a phototherapy clinic between 1997 and 2008 and to evaluate therapeutic response to PUVA (psoralen + UVA) photochemotherapy or narrowband UVB phototherapy. METHODS: Eighty-four patients with progressive macular hypomelanosis were evaluated. After 16 phototherapy sessions, therapeutic response was classified as: unchanged, slightly improved (<50% of repigmentation), moderately improved (50-79% of repigmentation), much improved (80-99%) or cured (100%). After a minimum of three months, patients whose response was classified as cured or much improved were contacted by telephone to evaluate the persistence of the therapeutic response. RESULTS: Most of the patients were women (79%) and white (85%). Age at onset of progressive macular hypomelanosis ranged from 13 to 36 years. PUVA was prescribed for 27 patients and narrowband UVB phototherapy for 57. No significant difference was found between the outcomes obtained with PUVA and those obtained with narrowband UVB phototherapy (Fisher's exact test; p<0.05). The majority of patients (81%) had 50% or more repigmentation, with 65% being classified as cured or much improved. Nevertheless, there was a recurrence of the lesions in 72% of patients. CONCLUSIONS: The fact that no patients were over 40 years of age suggests that progressive macular hypomelanosis is a self-limiting disease. Both PUVA and narrowband UVB are effective therapeutic options; however, they do not prevent recurrence of the disease. Keywords: Phototherapy; Pigmentation disorders; Therapeutics Resumo: FUNDAMENTOS: A hipomelanose macular progressiva é uma dermatose comum em diferentes continentes. Sua causa é desconhecida e os tratamentos propostos são pouco eficazes. OBJETIVOS: Determinar aspectos epidemiológicos da hipomelanose macular progressiva em pacientes atendidos num setor de fototerapia, no período de 1997 a 2008, e avaliar a resposta terapêutica com PUVA ou UVBNB. MÉTODOS: Foram avaliados 84 pacientes com Hipomelanose Macular Progressiva. Após 16 sessões de fototerapia, a resposta terapêutica foi definida: I=inalterado, MD=melhora discreta(< 50% de repigmentação), MM=melho-ra moderada(50-79%), MI=melhora intensa(80-99%) e C=cura(100%). Após um tempo mínimo de três meses, pacientes com cura ou MI foram contatados por telefone para avaliar a manutenção do resultado terapêutico. RESULTADOS: Predominaram mulheres (79%) e a cor branca. A idade mínima de aparecimento da Hipomelanose Macular Progressiva foi de 13 anos e a máxima de 36 anos. Fototerapia com PUVA foi indicada em 27 pacientes e UVBNB em 57. Estatisticamente, não houve diferença significante entre o tratamento com PUVA e UVBNB (teste de Fisher P>0.05). A maioria (81%) dos pacientes obteve 50% ou mais de repigmentação e 65% tiveram cura ou MI. Entretanto, 72% apres...

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The Person-Centered Dermatology Self-Care Index

Cowdell¹,

Ersser²,

Gradwell³

et al. 2012

Arch Dermatol

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Design:To date, no validated assessment measures exist to identify the education and support needs of patients living with long-term dermatological conditions and to enable them to self-manage as effectively as possible. The PeDeSI assessment tool was developed to meet this need using the self-efficacy construct and a model of concordance within prescribing practice. In total, 200 copies of the PeDeSI were distributed for validation, and 145 (72.5%) were returned completed. Data were analyzed using statistical software. Frequency distributions of all items were examined, and internal consistency was summarized using Cronbach ␣. Exploratory factor analysis was used to disclose any underlying structure among the data items.Setting: Three specialist dermatology centers in acute care hospitals.Participants: Dermatology specialist nurses treating patients with chronic dermatoses.Intervention: A PeDeSI was completed with each patient during his or her usual outpatient consultation.Main Outcome Measure: Cronbach ␣.Results: Cronbach ␣ was 0.90, indicating good internal consistency. Eliminating individual items in turn made little difference in Cronbach ␣ (range, 0.89-0.90). Item total correlations ranged from 0.44 to 0.76 (median, 0.68). Exploratory factor analysis extracted just one factor (eigenvalue, 5.37), with no other factors having eigenvalues exceeding 1.00. Factor loadings on individual items ranged from 0.47 to 0.80. Conclusion:The PeDeSI is a valid, reliable, and clinically practical tool to systematically assess the education and support needs of patients with long-term dermatological conditions and to promote treatment concordance.

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Propionibacterium acnes and the Pathogenesis of Progressive Macular Hypomelanosis

Cited by 92 publications

References 9 publications

Progressive macular hypomelanosis: a common disorder rarely diagnosed in clinical practice

Progressive macular hypomelanosis: a common disorder rarely diagnosed in clinical practice

Hipomelanose macular progressiva: estudo epidemiológico e resposta terapêutica à fototerapia

The Person-Centered Dermatology Self-Care Index

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