Pigmentary changes

Delayed hypopigmentation is a reason why some doctors dislike the long-term results of deep peels. Hypopigmentation after phenol peels is proportional to the depth of the peel, amount of the solution used, inherent skin color, and post-peel sun-related behavior. Complete avoidance of any sun exposure years after the peel creates ivory skin color. 

Demarcation line due to wrong positioning of the lower margin of the treatment area 

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Clinically, photodamaged skin is characterized by coarse and fine wrinkling, mottled pigmentary changes, sallowness, textural rough-... 

Kim NY, Pandya AG (1998) Pigmentary diseases. Med Clin North Am 82 1185-1207 Pierard GE, Pierard-Franchimont C, Laso Dosal F et al (1991) Pigmentary changes in skin senescence. J Appl Cosmetol 9 63-67... 

Persistent Pigmentary changes Scarring Persistent erythema Sensitive skin Textural changes Skin thinning Milia ... 

Burning at site of application, pain, inflammation Erythema, irritation, ulceration, pain, burning, edema, pigmentary changes Local irritation, erythema, burning, soreness at application site possibly oncogenic Local irritation and pain, minimal systemic effects... 

Deposits in the lens or cornea probably result from melanin-drug complex deposition and are best detected by slit-lamp examination. These deposits are probably dose-and time-related, since they generally occur only after years of treatment. Fortunately, they are in large part reversible, but if undetected they may progress to interfere with vision. They are most often reported with chlor-promazine or thioridazine and can occur in association with pigmentary changes in the skin. 

The authors thought that the pigmentary changes were probably due to thioridazine, as adverse effects on the retina are rare with chlorpromazine. 

An increase in pigmentation of eyelid skin is also possible. This increased skin pigmentation can occur several months after latanoprost therapy is begun. Once the drug is discontinued, the drug-induced pigmentary changes usually subside. 

Corneal pigmentary changes almost inrariably occur only in patients who have concomitant lens opacities in the higher grades (Table 35-4).There is often little or no comeal involvement with mild lens changes (grades I and If),... 

Retinal pigmentary changes, visual field defects, color vision loss Retinal pigmentary changes, disturbances of dark adaptation, color vision loss, visual field defects Impairment of dark adaptation, visual field defects, vascular attenuation Color vision disturbances, entoptic phenomena Color vision disturbances... 

Chlorpromazine (Thorazine) and thioridazine (Mellaril), both phenothiazine derivatives, are used for their antipsychotic effects in the control of severely disturbed or agitated behavior and in schizophrenia. Thioridazine has a higher incidence of antimuscarinic effects but a lower incidence of extrapyramidal symptoms. Pigmentary changes of the retina have been reported occasionally in association with chlorpromazine therapy, although it is recognized that only thioridazine produces retinal toxicity. 

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