How to Whiten Your Skin Naturally
An irregular hyperpigmentation of the skin that varies in shades of brown is seen. DISTRIBUTION. The lesions usually occur on the sides of the face, the forehead, and the sides of the neck. COURSE. The disorder is slowly progressive, but remissions do occur. It is more obvious in the summer. ETIOLOGY. The cause is unknown, but some cases appear during pregnancy (called mask of pregnancy ) or with chronic illness. There is an increased incidence of chloasma in women taking contraceptive, postmenopausal, or fertility hormones. To be nosologically correct, such cases should be labeled drug eruption, hyperpigmentation, due to hormones. A lay term for chloasma is liver spots, but there is no association with liver pathology. The melanocyte-stimulating hormone of the pituitary may be excessive and affect the tyrosine-tyrosinase enzyme system.
Chloasma. (Melasma) There are two variants of pigmentation of the skin hyperpigmentation and hypopigmentation. The predominant skin pigment discussed in this chapter is melanin, but other pigments can be present in the skin. A complete classification of pigmentary disorders appears at the end of this chapter. The common clinical example of abnormal hyperpigmentation is chloasma, but secondary melanoderma can result from many causes.
And result from an aggregation of neural crest-derived pigmented melanoblasts in the basal layer of the epidermis. Cafe au lait spots are present at birth and become more apparent with time. Ihe number of cafe au lait spots probably does not significantly increase after the first several years of life, although the degree of hyperpigmentation usually does. Ihe presence of six or more cafe au lait spots larger than 15 mm in greatest diameter is required for a diagnosis of Nf, a criterion that is most useful when applied to the postpubertal patient. It should be recognized, however, that about 10 percent of the general population have cafe au lait spots without other stigmata of the disease. Less frequent cutaneous changes in NF-1 include diffuse axillary or inguinal freckling and
Patients with AT also demonstrate progeric changes of the hair and skin, including early graying of the hair and atrophic, hidebound facial skin. Pigmentary changes are also frequent and consist of hyperpigmentation and hypopigmentation with cutaneous atrophy. A few patients may demonstrate partial albinism, vitiligo, and cafe au lait spots. Seborrheic dermatitis occurs in nearly all patients, and senile keratoses, atopic dermatitis, and eczema are also reported. Another prominent feature of AT is frequent sinopulmonary infections. These may range from infection of the ears, nose, and sinuses to chronic bronchitis and recurrent pneumonia. The latter two may result in bronchiectasis and pulmonary fibrosis. Chronic infections are typically due to common bacteria however, they are sometimes poorly responsive to antibiotic therapy. The predisposition to infection is associated with the presence of an abnormal thymus and a marked deficiency of IgA, which is the predominant immunoglobulin...
Hyperpigmentation or hypopigmentation of the skin can occur in the elderly from many causes. Aside from a simple change in pigmentation of the skin due to age, other pigmentary problems are uncommon. Effects of sunlight on the skin are extremely common and can result in simple hyperpigmentation and atrophy of the skin or can produce actinic keratoses (see Fig
This deficiency leads to pellagra, but other vitamins of the B group are contributory. The skin lesions are a prominent part of pellagra and include redness of the exposed areas of hands, face, neck, and feet, which can go on to a fissured, scaling, infected dermatitis. Local trauma may spread the disease to other areas of the body. The disease is worse in the summer and heals with hyperpigmentation and mild scarring. Gastrointestinal and neurologic complications are serious. Dementia, dermatitis, and diarrhea are the three Ds of pellagra.
This problem is usually seen in the beard area of African American men. Close shaving in people with kinky or curly hair may cause the newly emerging hair shaft to grow back into the skin surface or pierce the follicular wall causing inflammation and a foreign body reaction. Clinically, it presents as papulopustules, which may lead to hyperpigmentation and scarring. Hair plucking and electrolysis can induce this same problem.
Diffuse hyperpigmentation of the face and hands, again in the sun-exposed areas, becomes more definite with age. The quite common hyperpigmentation on the side of the neck, which is a combination of brown and red discoloration, seen particularly in women, is called poikiloderma of Civatte (Fig.34-3).
Photosensitivity dermatoses. Porphyria cutanea tarda with blisters and hyperpigmentation. ( Texas Pharmaceutical) LESIONS. Cutaneous lesions are prominent in porphyria cutanea tarda and include facial plethora, hyperpigmentation of exposed areas, hypertrichosis (this may be the presenting complaint in women, who sometimes are then treated with estrogen ), blisters, erosions mainly over the dorsal hands (secondary to very fragile skin), milia, and localized areas of scleroderma (later may occur in nonexposed areas). Acute abdominal crises or other neurologic attacks do not occur in PCT, even after drugs such as barbiturates and sulfonamides. Such crises may occur, however, in the less common inherited disorder, variegate porphyria. The skin lesions in variegate porphyria are very similar to those-in PCT.
Drugs reported to cause pigment changes are shown in Table 16.3. While some, including doxoru-bicin, have been postulated to have a direct effect on melanocytes 13 ,the mechanism essentially remains undefined. Generalized hyperpigmentation from bleomycin therapy is probably the most common of these abnormalities, but other drugs such as busulfan, cyclophosphamide, dactinomycin, 5-Fluo-rouracil, hydroxyurea, and methotrexate can also do this on occasion 13 . This generalized hyperpigmen-tation usually resolves slowly with time, but it can be permanent. Antimitotic agents can also cause banding of the nails, either vertical or horizontal, as well as black pigmentation. The latter occurs first at the base of the nails, and then moves distally 43,67 . Although usually these changes reverse when the drug is withdrawn, nail hyperpigmentation can be permanent 67 .
In contrast, if told the native has dark skin, they are more likely to generalize to all natives because skin color tends to be more uniform within a race. However, sensitivity to variability does not imply that people consider the variability of predicates in the same deliberative manner that a scientist should. This phenomenon could be explained by a sensitivity to centrality (Sloman, Love, & Ahn, 1998). Given two properties A and B, such that B depends on A but A does not depend on B, people are more willing to project property A than property B because A is more causally central than B, even if A and B are equated for variability (Hadjichristidis, Sloman, Stevenson, & Over, 2004). More central properties tend to be less variable. Having a heart is more central and less variable among animals than having hair. Cen-trality and variability are almost two sides of the same coin (the inside and outside views, respectively). In Nisbett et al.'s case,...
Dermatitis herpetiformis is a rare, chronic, markedly pruritic, papular, vesicular, and bullous skin disease of unknown etiology. It is probably an autoimmune disease and activated via the alternate complement pathway. The patient describes the itching of a new blister as a burning itch that disappears when the blister top is scratched off. The severe scratching results in the formation of excoriations and papular hives, which may be the only visible pathology of the disease. Individual lesions heal, leaving an area of hyperpigmentation that is very characteristic. The typical distribution of the blisters or excoriations is on the scalp, sacral area, scapular area, forearms, elbows, and thighs. In severe cases, the resulting bullae may be indistinguishable from pemphigus or bullous pemphigoid.
Acremonium and Gliomastix (Hyphomycetes). Conidia are usually single-celled, (they rarely have more than one cell) and may be colorless (Acremo-nium) or have dark pigmentation (Gliomastix). Their sizes and shapes vary from spherical, ovoidal, tear-shaped, subspherical, falciform, reniform, ellipsoidal, to cylindrical their surfaces range from smooth to rough they are usually thin-walled, developing mostly in a slimy mass, occasionally in dry conidial chains. Phialides range from being colorless to darkly pigmen-ted, are erect, and occur mostly singly from hyphae with inconspicuous col-lorettes.1,2 These two genera are morphologically very similar, and some mycologists, in fact, treat them under the genus Acremonium. The primary differences separating the two genera are pigmentation and roughness of tips of phialides. Acremonium is moniliaceous with smooth tips of phialides, while Gliomastix is dematiaceous with rough tips. Acremonium strictum (Fig. A.1) is a common indoor species,...
The diffuse atrophy of the skin that occurs in the aged person is partially responsible for the dryness that results in senile pruritus and winter itch. Other changes include excessive wrinkling and hyperpigmentation of the skin. Specific dermatoses noted with increased frequency are seborrheic and actinic keratoses, basal cell and squamous cell carcinomas, senile purpura, pedunculated fibromas, and capillary senile hemangiomas.
Infants born to mothers who had rubella in the first trimester of pregnancy can have multiple system abnormalities. The skin lesions include thrombocytopenic purpura hyperpigmentation of the navel, forehead, and cheeks acne seborrhea and reticulated erythema of the face and extremities.
The symptoms of central adrenal insufficiency can be subtle. They include poor weight gain, anorexia, easy fatigability, and poor stamina. In patients who have ACTH deficiency, as opposed to primary adrenal insufficiency, symptoms of salt craving, electrolyte imbalance, vitiligo, and hyperpigmentation usually are not observed. More overt manifestations of complete ACTH deficiency include weight loss and shak-iness that is relieved by eating (hypoglycemia). Signs of adrenal crisis at times of medical stress include weakness, abdominal pain, hypotension, and shock.
VP is particularly found in southern Africa. It mimics AIP and CHP clinically, and photosensitivity is common. y In addition, a variety of skin lesions, including hyperpigmentation, hypertrichosis, vesicles, and bullae, are seen in patients with VP. Excretion patterns are similar to those of HCP, except the excreted amount of porphobilinogen exceeds coproporphyrin in VP whereas they are approximately equal in HCP. Treatment is the same as for AIP and HCP.
Three types of information about technosemen are highlighted by semen banks phenotypic characteristics (including race or ethnicity, hair color, skin tone, eye color, height, and weight), biological characteristics (including blood type, RH factor, and bone size), and social characteristics (including years of education, occupation, and hobbies and interests). These divisions serve as ways to easily segment the market, but they also do much more. Semen banks prioritize differences that they believe are important to the client through the ordering of the characteristics of men.
Some adaptations for life in Africa, such as dark skin color, were lost by groups moving to Asia and northern Europe. There is a definite correlation between the amount of sunlight to which people are exposed and their skin color. Several theories have been advanced to account for it. One has to do with vitamin D The vitamin is needed for calcium use and bone growth (as discussed in Chapter 4), but too much of it can lead to calcification of the arterial walls and kidney disease. Overproduction of vitamin D doesn't occur in dark-skinned people living near the equator, as the pigment in their skin absorbs sunlight, but there may have been selection against light-skinned people who produced too much vitamin D. Other explanations include protection against sunburn and skin cancer for tropical inhabitants, protection of the internal organs against overheating, protection against sudden drops in temperature in the tropics, protective coloration, and protection against frostbite by pale...
Acquired hypertrichosis may be generalized or localized also. Acquired hypertrichosis lanuginosa ( malignant down ) is a rare but striking cutaneous manifestation of internal malignancy. Fairly generalized hypertrichosis may occur in patients with diverse diseases such as porphyrias, dermatomyositis, anorexia nervosa, mercury intoxication, insulin-resistant diabetes, Cushing's disease, hypothyroidism, postencephalitis, multiple sclerosis, head injuries, and POEMS syndrome polyneuropathy (sensorimotor), organomegaly (heart, spleen, kidneys), endocrinopathy, skin changes (hyperpigmentation, hypertrichosis, hyperhidrosis, thick skin, clubbed nails, leukorychia, angiomas) . Drugs can induce hypertrichosis (see T.a.bie 2Z-1). Localized acquired hypertrichosis may occur over areas of inflammatory dermatoses such as venous stasis or areas occluded by a plaster cast or may be a feature of a benign nevus. Acquired hypertrichosis of ears and eyebrows as well as long eyelashes may be seen in...
VCD were skin necrosis and urethral bleeding 27 . Sometimes, continuous use of VCD may result in hyperpigmentation of the penile skin due to repeated skin bruising, with subsequent hemosiderin deposition. It is important to advise patients to use only prescription devices. Others devices have no pressure control or safety valves to release the pressure, which can increase the rate and severity of complications 25 .
Factors that make one more suspicious of an underlying subungual melanoma when evaluating a longitudinal hyperpigmented band in the nail are involvement of one nail rather than multiple nails, appearance in the sixth decade of life or later, abrupt onset, enlarging size, irregular border, leaching of pigment from the nail to the nail folds (Hutchinson's sign), and accompanying nail dystrophy such as partial nail destruction. Although traumatic friction can cause linear hyperpigmentation too, it is important to remember that in many cases of subungual melanoma, previous trauma has been reported to occur. The thumbnail, great toenail, and index fingernail are most likely to be involved in subungual melanoma. Melanoma in African-Americans occurs subungually in 25 of cases. Many drugs, especially the chemotherapeutic agents, can cause longitudinal nail hyperpigmentation. Sometimes systemic diseases such as pernicious anemia, Addison's disease, or AIDS may be responsible.
Before its molecular structure and its multiple roles were deciphered, melatonin (MLT) was merely a mysterious substance produced by the pineal gland (PG). It became an object of interest because of its control of skin coloration on amphibians. In 1917, McCord and Allen, applying extract of bovine PG to frog skin, produced a skin lightening (38). This extract was later (1958) identified to be N-acetyl-5-meth-oxytryptamine, and named by their discoverers Lerner et al. as MLT because of its effect on amphibian skin (39). A few years before, Bargman had suggested that the secretion of this substance was regulated by the light (40). Simultaneously, Kitay and Altschule demonstrated the influence of MLT in regulating the animal seasonal reproductive function (41,42). Implications of MLT in circadian and seasonal reproduction control, and stimulation on amphibian's skin melanophores, represent the main roles of this hormone, whereas its involvement in regulation of immune system, gut,...
Clinical Features and Associated Disorders. The clinical features of adrenal insufficiency are influenced by the site of dysfunction, because PAI affects all of the adrenocortical hormones, whereas SAI only affects glucocorticoids. Thus, hyperpigmentation, salt craving, and hyperkalemia are unique to patients with PAI. Patients with adrenal insufficiency may present acutely or as a chronic condition. Acute adrenal insufficiency is a medical emergency (so-called addisonian crisis) characterized by mental status changes, fever, hypotension, volume depletion, arthralgias, myalgias, and abdominal pain that may mimic an acute abdomen. 101. Chronic adrenal insufficiency may present more insidiously with fatigue, weakness, GI symptoms, amenorrhea, decreased libido, salt craving, arthralgias, and hypoglycemic symptoms. Neurological manifestations can include confusion, apathy, depression, psychosis, paranoia, and myalgias, as well as hypoglycemic symptoms. 102 In addition, a past medical...
Hypomelanosis of Ito is the term given to the presence of hypopigmentation or hyperpigmentation distributed along the lines of Blaschko (see Fig 31-4.B.). The biologic basis for this phenomenon is not understood. Individuals with these skin changes often have structural malformations and mental retardation. Almost two thirds of patients are mosaic for detectable chromosomal aneuploidy. Mosaicism for X chromosome alterations, tetrasomy 12p, triploidy, trisomy 18, and chimerism are the more common abnormalities reported. It appears that it is the presence of two chromosomally distinct lines, rather than specific cytogenetic alterations, that confers this striking pigment anomaly. Individuals with hypopigmentation due to any cause need to be protected from excessive sun exposure. Hyperpigmentation Newborns present with blistering distributed along the lines of Blaschko. Over weeks to months, these areas become hyperkeratotic and warty in appearance. This gradually subsides and...
Acute radiodermatitis is divided into three degrees of severity, similar to the reactions from thermal burns. The first degree is manifested by the slow development of erythema, hyperpigmentation, and usually hair loss. A single dose of x-rays necessary to produce these changes is called an erythema dose. All of the changes in the first degree are reversible.
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