Ultrastructural characterization of damage in the basement membrane of facial melasma

Espósito, Ana Cláudia Cavalcante; Brianezi, Gabrielli; Souza, Nathália Pereira de; Santos, Daniela Carvalho dos; Miot, Luciane Donida Bartoli; Miot, Hélio Amante

doi:10.1007/s00403-019-01979-w

Cited by 20 publications

(19 citation statements)

References 19 publications

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“…Mast cells also secret paracrine mediators factors that induce elastin production by fibroblasts 18 . In addition, mast cells produce tryptase, which participate in the damage to the extracellular matrix and basement membrane, (through matrix metallopeptidases 9-collagen IV damage), what can influence the occurrence of collagen heterogeneity and pendulum melanocytes, which were correlated with the presence of mast cells in the present study 19,20 . Our results suggest mast cells as playing a central role in the pathophysiology of melasma, and therapeutic trials with mastocyte stabilizers drugs are warranted.…”

Section: Fig 2 Melasma (A)mentioning

confidence: 54%

Exploratory Study of Epidermis, Basement Membrane Zone, Upper Dermis Alterations and Wnt Pathway Activation in Melasma Compared to Adjacent and Retroauricular Skin

et al. 2020

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Background: Melasma is a chronic acquired focal hypermelanosis which pathogenesis has not been fully elucidated. Classical pathophysiologic studies have analysed the affected and perilesional areas, but little is known about the status of sun-protected skin, which is subjected to the same endogenous and genetic factors. Objective: To assess the histological characteristics of melasma compared to adjacent and retroauricular skin. Methods: Skin samples were collected from 10 female from: melasma, perilesional area and retroauricular. The samples were stained (haematoxylin-eosin, periodic acid-Schiff, Fontana-Masson, picrosirius red, toluidine blue and Verhoeff), immunolabelled for CD34 and Wnt1. The data from the skin sites were analysed simultaneously by a multivariate model. Results: Melasma skin exhibited noteworthy stratum corneum compaction, greater collagen heterogeneity, solar elastosis, higher number of mast cells, basement membrane zone (BMZ) damage, Wnt1 expression, pendulum melanocytes, higher cellularity and vascular proliferation at the superficial dermis. Stratum cor-neum compaction, collagen heterogeneity and BMZ abnormalities were variables associated to melasma that not follow a continuum through retroauricular to adjacent skin. Mast cell count was the variable that disclosed correlation with the most other abnormalities as well as had the greater contribution in the multivariate model. Conclusion: In addition to melanocyte hyperactivity, melasma skin exhibits alterations in the epidermal barrier, upper dermis and BMZ, which differ from the adjacent sun-exposed skin and retroauricular skin, indicating a distinct phenotype, rather than a mere extension of photoageing or intrinsic ageing. Mast cells appear to play a central role in the physiopathology of melasma.

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Section: Fig 2 Melasma (A)mentioning

confidence: 54%

Exploratory Study of Epidermis, Basement Membrane Zone, Upper Dermis Alterations and Wnt Pathway Activation in Melasma Compared to Adjacent and Retroauricular Skin

et al. 2020

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“…Melasma has a complex pathogenesis that surpasses melanocyte hypertrophy, and a combination of strategies can lead to more effective results. [24][25][26][27] Specific designs for assessing the long-term efficacy of cysteamine as well as its use as a maintenance treatment after other potent depigmenting agents (e.g., triple combination), laser or oral tranexamic acid are needed in order to position it among the existing strategies for the management of melasma. 15,28…”

Section: Discussionmentioning

confidence: 99%

A comparative study of topical 5% cysteamine versus 4% hydroquinone in the treatment of facial melasma in women

Lima¹,

Dias²,

Cassiano

et al. 2020

Int J Dermatology

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Objective To assess the efficacy and safety of topical 5% cysteamine versus 4% hydroquinone in the treatment of facial melasma in women. Topical 5% cysteamine is an antioxidant and tyrosinase inhibitor that has been shown to be effective in the treatment of melasma. However, to date, no study has compared the performance of topical cysteamine to hydroquinone for facial melasma. Methods A quasi-randomized, multicenter, evaluator-blinded clinical trial was conducted on 40 women with facial melasma who were submitted to the nightly application of 5% cysteamine (CYS) or 4% hydroquinone (HQ) on hyperpigmented areas for 120 days. Both groups were required to use tinted sunscreen (SPF 50; PPD 19). Subjects were assessed at the inclusion and after 60 and 120 days of treatment for mMASI, MELASQoL, and the difference in colorimetric luminosity between melasma and the adjacent unaffected skin. The Global Aesthetic Improvement Scale was used to assess the difference in the appearance of the skin through standardized photographs. Results The mean reduction of the mMASI scores was 24% for CYS and 41% for HQ (P = 0.015) at 60 days, and 38% for CYS and 53% for HQ (P = 0.017) at 120 days. The photographic evaluation revealed up to 74% improvement for both groups, without statistically significant difference between them (P = 0.087). The MELASQoL score showed a progressive decrease for both groups over time, despite the greater reduction for HQ after 120 days (P = 0.018). Colorimetric assessment disclosed progressive depigmenting in both groups, without statistically significant difference between them (P > 0.160). No severe adverse effects were identified in either group. Erythema and burning were the most important local adverse effects with cysteamine, although their frequency did not differ between groups (P > 0.170). Conclusion Cysteamine proved to be safe, well-tolerated, and effective, despite its inferior performance to hydroquinone in decreasing mMASI and MELASQoL in the treatment of melasma.

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“…V.13, N. 48 p. 435-443, Dezembro/2019 -ISSN 1981 88,88% das volutárias relataram ja terem feito algum tratamento e a avaliação na qualidade de vida foi de 44,44% de baixa autoestima. Apesar dos tratamentos disponíveis, recidivas são frequentes, o que causa impacto negativo na qualidade de vida da populaçao com melasma (ESPÓSITO, 2019;LIMA,2017).…”

Section: Resultsunclassified

Impacto do Melasma na Autoestima de Mulheres / Impact of Melasma on Women's Self-Estems

Oliveira¹,

Gonçalves²,

Santos³

et al. 2019

IDonline

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Resumo: O presente estudo tem por objetivo determinar os fatores associados ao melasma em mulheres atendidas em uma clínica de estética de uma faculdade do interior da Bahia. Trata-se de um estudo descritivo com abordagem quali-quantitativa, realizado em uma faculdade Privada com 14 cursos e aproximadamente 3500 alunos. Para alcançar o objetivo proposto, foi desenvolvido um questionário autoaplicável contendo as principais causas associadas ao surgimento do melasma em mulheres como por exemplo o uso de anticoncepcional. A presente pesquisa foi composta por 30 voluntárias do sexo feminino com melasma facial, apresentaram a média de idade de 25,80 (± 8,69) anos. 24 das voluntárias do presente estudo 80% das mulheres não tiveram filhos. Dentre as participantes, 80% relataram fazer uso de anticoncepcional. Com isso, visto que as dermatoses podem afetar a autoestima e contribuem para causar sentimentos que pode se manifestar como ansiedade, tristeza ou até depressão.Abstract: The present study aims to determine the factors associated with melasma in women treated at an aesthetic clinic of a college in the interior of Bahia. This is a descriptive study with a qualitative and quantitative approach, conducted in a private college with 14 courses and approximately 3500 students. To achieve the proposed objective, a self-administered questionnaire was developed containing the main causes associated with the onset of melasma in women, such as contraceptive use. The present study consisted of 30 female volunteers with facial melasma, with a mean age of 25.80 (± 8.69) years. 24 of the volunteers in the present study 80% of women had no children. Among the participants, 80% reported using contraception. Thus, since dermatoses can affect self-esteem and contribute to feelings that can manifest as anxiety, sadness or even depression.

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Ultrastructural characterization of damage in the basement membrane of facial melasma

Cited by 20 publications

References 19 publications

Exploratory Study of Epidermis, Basement Membrane Zone, Upper Dermis Alterations and Wnt Pathway Activation in Melasma Compared to Adjacent and Retroauricular Skin

Exploratory Study of Epidermis, Basement Membrane Zone, Upper Dermis Alterations and Wnt Pathway Activation in Melasma Compared to Adjacent and Retroauricular Skin

A comparative study of topical 5% cysteamine versus 4% hydroquinone in the treatment of facial melasma in women

Impacto do Melasma na Autoestima de Mulheres / Impact of Melasma on Women's Self-Estems

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