Diana Hernández-Blanco

Near‐visible light and UV photoprotection in the treatment of melasma: a double‐blind randomized trial

Melasma is an acquired hyperpigmentation on sun‐exposed areas. Multiple approaches are used to treat it, but all include broad ultraviolet (UV)‐spectrum sunscreens. Visible light (VL) can induce pigmentary changes similar to those caused by UV radiation on darker‐skinned patients.

Use of Raman spectroscopy in the analysis of nickel allergy

Abstract. Raman spectra of the skin of subjects with nickel allergy are analyzed and compared to the spectra of healthy subjects to detect possible biochemical differences in the structure of the skin that could help diagnose metal allergies in a noninvasive manner. Results show differences between the two groups of Raman spectra. These spectral differences can be classified using principal component analysis. Based on these findings, a novel computational technique to make a fast evaluation and classification of the Raman spectra of the skin is presented and proposed as a noninvasive technique for the detection of nickel allergy.

Double-blind, placebo-controlled, randomized study comparing 0.0003% calcitriol with 0.1% tacrolimus ointments for the treatment of endemic pityriasis alba.

Background. Pityriasis alba (PA) is a frequent cause of consultation in tropical areas due to its chronic course, frequent relapses, and notorious hypopigmented lesions in pediatric dark skin populations. Currently, no treatment is widely accepted. Objective. To assess the efficacy of 0.0003% calcitriol and 0.1% tacrolimus ointments compared with placebo in the treatment of endemic PA. Methods. Twenty-eight children aged 3–17 years with 56 symmetrical lesions and phototype IV-V, were randomly assigned to receive the treatments on target lesions on the face. Improvement was evaluated at baseline and 8 weeks later clinically and by digital quantification of the affected area, colorimetry, and transepidermal water loss (TEWL). Results. Tacrolimus and calcitriol ointments induced a mean improvement of 68%, compared to 44% of placebo. We found an elevated TEWL in PA lesions. In the treated plaques, the reduction of the affected area was associated with improvement of pigmentation and TEWL. Conclusions. Calcitriol and tacrolimus induced similar repigmentation in endemic PA lesions. Melanogenic, anti-inflammatory, and barrier defect restoration properties of these drugs may explain these findings.

Relationship between transient receptor potential vanilloid‐1 expression and the intensity of sensitive skin symptoms

Sensitive skin (SS) is a hyper‐reactive condition of the skin secondary to external factors, without objective signs of lesion. Its pathogenesis is still under investigation. Transient receptor potential vanilloid‐1 (TRPV1) is a cation channel that responds to low pH and is related to nociception, neurogenic inflammation, and pruritus.

Hailey–Hailey disease improved by fractional CO2 laser

Abstract Hailey–Hailey disease (HHD), also known as benign familial pemphigus, is an autosomal dominant skin condition that affects the adhesion of epidermal keratinocytes. Although the initial manifestation of flaccid vesicles on erythematous or normal skin in flexure sites frequently goes unnoticed, large, macerated, exudative plaques of superficial erosions with crusting are observed at the time of diagnosis. There is no specific treatment for HHD, and most cases are symptomatically supported. However, infrared laser ablation has been somewhat helpful. We present a case successfully treated with fractional CO2 laser showing a long-term favourable outcome and no adverse effects. Thus, this modality could be an alternative to full ablation for this condition.

Análisis de la pigmentación cutánea en una muestra

espanolAntecedentes: La mezcla de melanina, hemoglobina y carotenos definen el color cutaneo. La pigmentacion constitutiva esta determinada geneticamente, la facultativa se induce cuando la piel se expone al ambiente. El objetivo fue cuantificar ambas pigmentaciones en una muestra de poblacion mexicana, y analizar su relacion con el genero, edad y fototipo. Metodos: Se evaluaron 259 personas durante un periodo invernal. La colorimetria cutanea se obtuvo mediante espectrometria de reflectancia difusa utilizando las coordenadas de la Comision Internacional de Iluminacion. Se registraron los valores L*a*b* y se estimo el angulo tipologico individual (ATI°) en frente, torax, cuello, antebrazos y gluteos. Resultados: La pigmentacion facultativa difirio de la constitutiva en los parametros L*, a*, y ATIo. En hombres, los valores facultativos de L* y ATI° fueron menores. La pigmentacion constitutiva fue similar entre sexos. Los fototipos III, IV y V muestran diferencias en L*, b* y ATI°. Los valores facultativos L*, a*, ATI° y el constitutivo a* se reducen al incrementarse la edad. Conclusiones: Se cuantificaron los tonos cutaneos de una muestra de poblacion reconociendose los valores para la piel blanca, morena clara y morena oscura. Se presenta un marco de referencia para estudios relacionados con la pigmentacion cutanea en Mexico. EnglishBackground: The blend of hemoglobin, carotenes, and melanin defines the skin color. Constitutive pigmentation is genetically determined, facultative color is induced when skin is exposed to environment. The objective was to quantify both pigmentations in a sample of Mexican population and to analyze its relationship with sex, age, and phototype. Methods: We evaluated 259 individuals during the winter. Skin colorimetry was obtained by diffuse reflectance spectrometry, using the International Commission of Illumination coordenates. L*a*b* parameters were measured and the individual typological angle (ITA) was estimated from forehead, thorax, neck, forearms, and buttocks areas. Results: Facultative pigmentation differed from constitutive in L*, a*, and ITA° values. In men, L* and ITA° parameters were lower. Constitutive pigmentation was similar between sexes. Phototypes III, IV, and V showed differences in L*, b*, and ITA°. Facultative values such as L*, a*, ATI°, and the constitutive a* reduce as age increases. Conclusions: The cutaneous tones of a sample of population were quantified recognizing their values for white, light brown, and dark brown skin. A reference frame for research related to cutaneous pigmentation in Mexico is presented.

Metastatic Calcinosis Cutis: A Case in a Child with Acute Pre-B Cell Lymphoblastic Leukemia

Hypercalcemia in children with malignancy is an uncommon condition. It has been described in leukemia patients with impaired renal excretion of calcium or osteolytic lesions. Metastatic calcinosis cutis (MCC) may develop if hypercalcemia persists. We report the case of a 5-year-old girl with an atypical dermatosis and unspecific gastrointestinal symptoms. Considered clinical diagnoses were xanthomas, histiocytosis, molluscum contagiosum, and nongenital warts. Cutaneous histological analysis showed amorphous basophilic deposits in the dermis suggestive of calcium deposits. Laboratory tests confirmed serum hypercalcemia. Extensive investigations such as bone marrow biopsy established the diagnosis of an acute pre-B cell lymphoblastic leukemia. Hypercalcemia in hematopoietic malignancies is unusual, especially as initial manifestation of the disease. Careful review of the literature fails to reveal previous reports of these peculiar cutaneous lesions of MCC in children with leukemia.