Revista de Dermatología y Enfermedades Dermatológicas

Background: Patients with oculocutaneous albinism (OCA) are prone to develop skin cancers.
Aim and Objectives: To analyze reports of skin cancers in albinos published in the English and the Japanese literature in order to prepare guidelines for the successful management of skin cancer in albinos. Methods and Materials: We searched on PubMed, Web of Knowledge for English literature, and Ichushi-Web for the Japanese literature.
Results: Between 1978 and 2013, 11 malignant melanoma, 4 basal cell carcinoma, and 6 squamous cell carcinoma cases were reported in Japan. The subtypes of the 11 malignant melanomas were nodular in 7 cases, superficial spreading in 3 cases, and metastatic lesions in 1 case. Amelanotic melanomas comprised 7 of the 11 malignant melanoma cases in Japanese patients with OCA. Twenty-five malignant melanoma, 50 basal cell carcinoma, and 151 squamous cell carcinoma cases were reported worldwide in the English literature during the period between 1952 and 2013.
Conclusion: Regular skin monitoring by board-certified dermatologists is required for adult OCA patients.

One of the major barriers to individuals with pigmentary disorders in achieving their life goals is the stigma of their disorder. This paper provides a review of the existing research regarding stigma reduction, focusing on public stigma, and looking at approaches used within the mental health and other stigmatized communities. A main focus of pigmentary disorder advocates is to eliminate this stigma to remove the barrier it has on success and self-efficacy. Approaching this task from a perspective well-informed by previous research is important to both ensure that stigma reduction resources are spent wisely, and that anti-stigma approaches are effective.

Melasma is a common pigmentary skin disorder, characterized by symmetrically-distributed hyperpigmented patches with serrated, irregular and geographic borders. It usually affects the chronically photo-exposed cutaneous areas, especially the face and neck. Its exact worldwide prevalence is unknown. The disease most commonly occurs in women of reproductive ages. The etio-pathogenesis of melasma is not completely understood. This disorder seems to be an interplay of various internal and environmental factors. Among these factors, genetic predisposition, sunexposure and hormonal factors are the most important ones. In this article, in addition to the introduction of melasma, we have tried to review the most effective medications and modalities for the treatment of this common, refractory, pigmentary disorder.

Vitiligo is a pigmentary skin disorder characterized by chronic and progressive loss of melanocytes. Although the etiology of vitiligo is still unknown, the most convincing theory is thought to an interaction between genetic and unknown environmental factors, resulting in autoimmune melanocyte destruction. Meniere's disease is characterized by recurrent vertigo, fluctuating or progressive sensorineural hearing loss and tinnitus, and it is associated with an accumulation of endolymph in the inner ear. Although its etiology is not known, genetic or epigenetic factors have a significant contribution. And recently many articles support the hypothesis that Meniere's disease is an autoimmune disorderand associated with immune-mediated disorder. Loss of otic melanocytes may occur in patients with vitiligo and, evidences of sensorineural hearing loss in vitiligo patients have been reported over the last decade. However, there have been no reports of Meniere's disease associated wth vitiligo patients. We report an interesting case of vitiligo on the face with Meniere's disease.

Pigmented Contact dermatitis is a non-eczematous variant of contact dermatitis clinically characterised by reddish-brown to slate grey pigmentation in a reticulate pattern, usually without any active or preceding clinical dermatitis. A detailed history is essential to establish the temporal correlation of exposure to a possible sensitizer, which further helps in differentiating PCD from its close mimickers such as melasma, lichen planus pigmentosus erythema dychromicum perstans, etc. Clinical variants of PCD include Riehl’s melanosis, pigmented cosmetic contact dermatitis, pigmented contact cheilitis and purpuric dermatitis. Histopathology shows pigment incontinence. Patch testing should be performed to identify the causative allergen and besides a papule or vesicle, a brown pigment may develop at the patch test site. Patients should be counselled regarding complete avoidance of the causative allergen and also the resistance of this condition to various treatment modalities.

Malignant melanoma is considered as the most lethal of all skin cancers. However, it is also one of the most immunogenic, characterized by specific antigen presentation and dense lymphocytic infiltration. Many studies concerning melanoma have reported the concurrent presence of vitiligo or Melanoma Associated Hypopigmentation (MAH). This type of vitiligo can appear before or after MM diagnosis, or in tandem with treatment with immunotherapeutic drugs and has been associated with an improved prognosis and/or better response to immunotherapy treatments. This may be attributed to the fact that activated T cells against antigens found on malignant melanocytes can also recognize normal melanocytes and destroy them. On the other side, very limited data exist on whether classic vitiligo can offer protection against or is associated with a decreased incidence of MM. However, MAH represents an example of a strong link between tumor immunity and autoimmune responses. This unique characteristic may be of use as a biomarker in melanoma patients, allowing prediction of MM prognosis or response to specific treatment regimens. Up to this point only a few studies report patient data regarding classic vitiligo and MM. In this paper, the autoimmune hypothesis in the pathogenesis of vitiligo and MAH are discussed, focusing on similarities, differences and known autoantigens. In addition, the results of studies regarding MM and vitiligo or MAH are also summarized.

Idiopathic guttate hypomelanosis is a common, acquired and benign dermatosis characterized by multiple, round or oval, hypopigmented to depigmented macules which mainly appear in upper and lower extremities. The major histopathologic findings are the reduced number of melanocytes in combination with structural (limited melanosomes and dendrites) or functional alterations (decreased tyrosinase activity). Although the underlying pathways are still being elucidated, genetic and environmental factors have been incriminated in its pathogenesis. Although accumulating number of studies supports the central role of sun exposure, a definite causal relationship cannot still be established. Despite the lack of symptoms idiopathic guttate hypomelanosis is a main aesthetic problem. Intense research has oriented towards the development of treatment modalities ranging from topical agents to invasive procedures. Until now the results are encouraging but they still need to be verified by future clinical and epidemiological studies.