Revista de Dermatología y Enfermedades Dermatológicas

Background: Keloid scar patients are known to present with a combination of symptoms including pain, physical deformity and psychological distress. These three facets that characterise the full extent of the keloid disease (KD) have not been validated in a clinical setting before as a whole and thus the disease is usually approached and managed incompletely. Assessment measures need to accurately quantify the disease’s impact on the patients’ distress in terms of physical symptoms, life quality and psychosocial status. Method: 46 keloid scar patients seen at clinic were asked to fill out the MSF-PQ, DLQI and DAS-24 questionnaires. The results were analysed for internal consistency (IC) and convergent validity (CV). Each of the three questionnaires was then further analysed to identify factors which affect patients with the disease. Results: There was convergent validity between DAS-24 and DLQI scores (0.54, p<0.01). The questionnaires showed excellent IC (α-range 0.86-0.9). Female gender and the presence of scars hidden under the clothesline significantly increased patients’ pain (MSF-PQ) and QoL impact scores (DLQI). All questionnaires showed good validity in assessing the aspects of concern for keloid scar patients, severity of physical symptoms and capturing patient’s subjective feelings and avoidance behaviours. Conclusion: KD extends beyond being a hyper-proliferative disease of scars. The resulting lesions can produce disabling symptoms, deforming growths and a level of appearance anxiety whether visible or not. Assessing the extent of the disease and its effects on the patient, by the proposed, validated assessment tools, highlights the need for a more complete management of the disease.

Xeroderma pigmentosum is a rare genodermatosis, autosomal recessive in nature in which excessive ultraviolet radiation causes skin, ocular, neurological, and oral lesions along with development of cutaneous and internal malignancies at an early age. There is no definitive cure for the disease. Avoidance of ultraviolet radiation, use of protective clothing, sunscreens, oral retinoids, 5-fluorouracil and regular consultations with dermatologists, ophthalmologists, neurologists and dentists forms an important part of the treatment protocol. This paper aims to throw light on the etiopathogenesis, clinical features and treatment modalities of this life threatening disease. There is also a special mention on the oral manifestations and dental health considerations of the rare disorder.

Retinal pigment epithelium (RPE) is a single layer of hexagonal pigmented cells located in the outmost part of the neurosensory retina. RPE cells are vital for the health of retina. Dysfunction of RPE resulted from consistent exposures to oxidative stress has been reportedly to cause retinal degenerations, such as age-related macular degeneration (AMD). RPE cells exert different types autophagy to maintain retina hemostasis. This review summarizes molecular and cellular autophagic mechanisms that are revealed in RPE to respond to stress. The evidence in support of autophagy dysfunction or aging that result in diseases is also discussed.

Vitiligo is a dermatologic pigmentary disorder triggered by melanocytes’ loss and sustained by a deep immune imbalance which induce chronic inflammation and excessive oxidative stress phenomena at skin level. Current therapies are mainly symptomatic and designed in order to inhibit the inflammatory mediators at vitiligo patches level. To restore the correct immune balance between Th1/Th17 and Th2/Treg response and concomitantly rebalancing the inflammatory response represents an innovative and effective approach for Vitiligo treatment; Low Dose Medicine theories and the availability of specific low dose SKA interleukins, antibodies and growth factors allows researchers and clinicians to act simultaneously against all the main etiologic causes of vitiligo and makes possible to design new therapeutic approaches for vitiligo.

Melasma is a localized, chronic acquired hypermelanosis of the skin. Despite several treatments available, melasma can often be refractory to treatment. Also recurrences are common. Tranexamic acid is a new addition in treatment of melasma and is effective in dosage of 250 mg BD for atleast 4 to 8 weeks. Tranexamic acid acts mainly via the plasminogen activator-plasmin system to prevent UV radiation induced pigmentation in melasma. This article reviews the mechanism of action of tranexamic acid in melasma and current evidence in literature for use of tranexamic acid in melasma.