Skin disease hyperpigmentation

The symptoms observed in the affected areas of southwest Guizhou Province (Zhou et al, 1993) have all the classic hallmarks of chronic arsenic exposure. The visible features start with an erythematous flush (Fig. 17.4A) which is quite noticeable in this cohort, as freckles are not a common feature in Asian populations. Various degrees of skin lesions, hyperpigmentation, keratosis, and hyperkeratosis (Fig. 17.4B), leading to some probable skin cancers (Fig. 17.4C) were observed. The most common feature observed is keratosis of the hands (Fig. 17.4D). Cancer and severe skin lesions have lessened dramatically in the last 20 years, due to the intervention by local public health officials and the recognition of the etiology of the arsenic poisoning disease. 

In conclusion, the most prevalent lesion in humans after acute exposure to 2,3,7,8-TCDD is a skin lesion referred to as chloracne. This skin disease may be accompanied by hirsutism and hyperpigmentation. After acute exposure to toxic levels, liver function may be impaired and a sensory neuropathy may be present. There may be complaints of weakness, weight loss, severe fatigue, and a general malaise. Many of these acute symptoms and signs revert to normal when exposure ceases. The chloracne is probably the most persistent lesion. No convincing chronic human health effects, other than chloracne, have been reported, nor is the dose of 2,3,7,8-TCDD known that would cause systemic illness or death in humans. 

Askendoside B which exhibited highly potent (IC50 = 13.95 mM) tyrosinase inhibition could be a possible lead molecule for the development of new medications of several skin diseases related with the overexpression of the enzyme tyrosinase, like hyperpigmentation [5]. 

Busulfan -alkylating agent -bone marrow suppression—can have prolonged nadir -ovarian suppression -seizures -hepatic veno-occlusive disease (VOD), particularly at BMT doses -interstitial pulmonary fibrosis -hyperpigmentation (particularly skin creases and nail beds)... 

In general, the levels of arsenic in air and water are low, and the major source of human exposure is food. In certain parts of Taiwan and South America, however, the water contains high levels of this metalloid, and the inhabitants often suffer from dermal hyperkeratosis and hyperpigmentation. Higher levels of exposure result in a more serious condition gangrene of the lower extremities or blackfoot disease. Cancer of the skin also occurs in these areas. 

Bleomycin (Blenoxane) causes chain scission and fragmentation of DNA. With the exception of the skin and lungs, most tissues can enzymatically inactivate bleomycin. Bleomycin is used in the management of squamous cell carcinoma of the head, neck, and esophagus in combination with other drugs in patients with testicular carcinoma, and in the treatment of Hodgkin s disease and other lymphomas. Bleomycin causes stomatitis, ulceration, hyperpigmentation, erythema, and pulmonary fibrosis. 

Skin and muscles Acute rhabdomyolysis (362) as well as dermatomyositis are considered to be rare manifestations of Wilson s disease. Occasionally, there is evidence of hyperpigmentation as well as acanthosis nigricans. Bluish, lunular discolorations of the nails, so-called azure lunulae, are rare. (322) (s. p. 84)... 

Superficial peels are usually safe and well tolerated, with such undesirable effects as burning, irritation, and erythema [281]. With superficial peels, scarring and infection are rare. With medium and deep peels, demarcation lines (technique-related) may occur [281]. Deeper peels may have adverse effects of postinflammatory hyperpigmentation (PIH in dark-skinned individuals), infections, allergic reactions, improper healing, disease exacerbation, and complications secondary to improper application [281]. Chemical injuries may occur when glacial acetic acid is not properly used for chemical peeling [341]. 

A 61-year-old man with a past medical history of acne, orthostatic hypotension and Parkinson s disease experienced bluish skin discolouration of his arms, cheeks and nail beds. The patient and his family members reported that the skin discolouration had an insidious onset. The patient had been treated with minocycline 100 mg PO BID for several years. Due to the fact that the patient s presentation and medical history was consistent with Type I hyperpigmentation associated with minocycline, it was thought to be due to long-term minocycline use [16 ]. 

Iron overload may occur as a result of metabolic defects, such as idiopathic hemochromatosis—an inherited disease, or from high intakes of iron. The clinical signs and symptoms of iron overload may include hyperpigmentation of the skin, cirrhosis of the liver, diabetes, and myocardial failure. Dr. John R. K. Robson, M.D., one of the coauthors of this book, has observed excessive intakes of iron, characterized by hemosiderosis and cirrhosis of the liver, in the Bantu tribe of South Africa who cook their food in iron pots and ferment their beer in iron utensils—and who have iron intakes of up to 100 mg, or more, per day. 

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