Hyperpigmentation monitoring

Flaking should not be helped along under any circumstances. Peeling off any bits of skin can result in uneven skin tone, infection, hyperpigmentation, scars or localized achromia. It is also essential to take preventive measures against infection after a papillary TCA-SAS peel, as the latter destroys most of the skin s defenses. An antibiotic cream is applied during the first week after the peel. The skin should be cleaned before each application of cream, and any occurrence of contact allergies, which can sometimes be confused with secondary infections, should be monitored. 

Post-inflammatory hyperpigmentation (PIH) is rare after an AHA peel. It may result from an error in assessment, indication or monitoring, but sometimes it can occur suddenly when a peel has been performed and neutralized correctly. PIH can be treated for more details, see Chapter 37. 

Complete sun avoidance and effective sun protection is a must for 2 or even 3 months (see Chapters 2 and 3). Post-inflammatory hyperpigmentation (PIH) is not at all uncommon, even after a phenol peel. After the immediate post-peel period, which requires close and almost daily monitoring, it is advisable to see patients again after 15 days, 30 days and 2 months and to warn them of the need to treat any early signs of hyperpigmentation immediately. It should be noted that PIH frequently resolves itself without treatment after a phenol peel. 

The most frequent and serions side effect of bnsnlfan is bone marrow failure. Therefore, the hemoglobin, hematocrit, white blood cells, platelets, and differential counts should be monitored weekly. A rare complication of busulfan therapy is the development of bronchopnlmo-nary dysplasia with pulmonary fibrosis. Bnsnlfan is known to have caused cataract, hyperpigmentation of skin, adrenal... 

The adequacy of corticosteroid replacement therapy is judged by clinical criteria and biochemical measurements. The subjective well-being of the patient is an important clinical parameter in primary and secondary disease. In primary adrenal insufficiency, the disappearance of hyperpigmentation and the resolution of electrolyte abnormalities are valuable indicators of adequate replacement. Overtreatment may cause manifestations of Cushing s syndrome in children, linear growth may be decreased. Plasma ACTH levels may be used to monitor therapy in patients with primary adrenal insufficiency the early-morning ACTH level should not be suppressed, but should be less than 100 pg/mL (20 pmol/L). 

A single-centre study monitored the efficacy and safety of intralesional cidofovir administered for recalcitrant cutaneous viral warts [7 ]. Two hxmdred and eighty patients were treated with intralesional cidofovir (15mg/mL once per month). Local adverse reactions were frequent all patients reported pain and burning sensations during the injection. In 51/280 patients, local pruritus and erythema occxured after treatment. Post-inflammatory hyperpigmentation of the hands occurred in 20/280 patients. Renal function was monitored, and there were no alterations at the end of treatment, nor any systemic side effects reported. In this small, uncontrolled study, all local side effects resolved spontaneously and did not require medical intervention. 

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