Evangeline B. Handog

Chemical peels for acne and acne scars in asians: Evidence based review

Chemical peeling is a widely used procedure in the management of acne and acne scars, but there are very few studies on Asian populations who are more prone to develop hyper pigmentation. This article aims to summarize and evaluate the existing studies on the role of chemical peels in the treatment of acne and acne scars among Asians. An online search was conducted to identify prospective studies published in English that evaluated the use of chemical peels in active acne and acne scars in Asian populations. There were six studies for acne and eight studies for acne scars that were identified using our search parameters. Most were single-centre, open label and with small sample sizes. Acne severity was not uniformly reported and the objective outcome measures of some studies were not explicitly reported as well. The general trend of the results of the studies support the safety and efficacy of chemical peels for acne and acne scars including those of darker skin types. The existing studies support the use of chemical peels in the treatment of acne and acne scars in Asians. Further clinical trials with better study design and more subjects are needed to further establish the role of chemical peels in Asian acne patients.

An open‐label, single‐arm trial of the safety and efficacy of a novel preparation of glutathione as a skin‐lightening agent in Filipino women

Glutathione (GSH) is a naturally occurring thiol that has been reported to cause skin lightening in a manner for which several mechanisms have been proposed. Highest plasma concentrations are achieved with IV administration but are accompanied by greater levels of risk. Oral administration has been less successful in elevating plasma GSH levels.

International Dermatology: The Many Faces and Challenges of the Specialty in the Global Village

The technical advances of the last century changed the understanding of the science of cutaneous physiology and pathology and the role of the dermatologist. The major challenges the international dermatologic community faces today are the lack of a common, logical, and accepted language within the specialty; long-accepted but questionable policies to advance academic careers; and the marginalization of dermatology. Methods for communicating and circulating data and ideas also have changed radically. The distribution of knowledge and essential/practical tools in different regions of the world is inequitable, and developing countries must cope with the challenges of high-impact skin diseases.

Melasma and Vitiligo in Brown Skin

Melasma and Vitiligo in Brown Skin by EB Handog & MJE Macarayo is the first book published focusing on these two diseases of pigmentation among patients of brown race. The editors were able to gather an excellent set of authors who contributed commendably to the book. They have tackled on a complete wide range of topics varying from the anatomy of brown skin, to the epidemiology, pathogenesis, diagnosis and differential diagnosis, associated comorbidities as well as the dermoscopy and histopathologic correlations of these two disease entities. The management of these disorders of pigmentation is always a challenge as each year there are newer alternative treatment options becoming available backed up by good clinical research trials all over the world. This book highlighted on the currently available topical and oral agents for melasma and vitiligo as well as alternative botanical products that are quite promising. They also emphasized on the procedural techniques as well as laser therapy that can be used to treat these conditions. More importantly, this book also tackled on the quality of life of patients suffering from either melasma or vitiligo with the aim that clinicians can use this as a guide to give our patients hope as we try to help alleviate their condition. The book was divided into 4 parts, the basics of brown skin, melasma in brown skin, vitiligo in brown skin, and finally other management options available for both conditions. It has a total of 33 chapters, each of which was equipped with clear photos and well-illustrated tables. It is an excellent well-written comprehensive textbook that is wellreferenced and is highly recommended for all clinicians.

Leprosy in the Philippines: a review.

Leprosy is a skin disease that accounts for serious deformities and disabilities, leading to stigmatization and psychosocial suffering. It is included in “The Neglected Tropical Diseases”. Not surprisingly, its management is increasingly reported as a function of Dermatology Departments, with a strong community‐orientated bias. Prompt and accurate diagnosis of leprosy is crucial in the control of leprosy. Its management requires a multidisciplinary team of skilled physicians, laboratory staff, and nurses. All members of the health sectors should remain vigilant to combat this battle against leprosy.

Topical Corticosteroid Abuse: Southeast Asia Perspective

Topical corticosteroids (TCS), since its discovery in 1952, have been very useful for many dermatologic conditions, particularly inflammatory dermatoses. TCS abuse and misuse have been published and yet continue to exist. Considering that the indication of TCS use is correct, the duration of use, areas of application, and TCS potency/vehicle are the most important factors that may lead to potential side effects. To avoid TCS abuse, it is important to educate our patients well. Adverse reactions from TCS are similar in all countries. Frequency and degree vary due to different factors such as adherence to government policies, availability of different classes of TCS, and cultural differences and beliefs. Avoidance of abuse is vital and patient education plays a major role in this aspect.

The Concept of Brown Skin

The color of one’s skin speaks of so many facets in one’s life. It reflects one’s physical traits, genetic components, history, nationality, and geographic roots. And by these, we mean one’s race. Scientifically, skin color depends on many factors, genetics aside: inflammation, blood hemoglobin level, carotenoids in the dermis, and increased melanin deposition. Melanin in itself is a polymer that comes as pheomelanin (red-yellow) and eumelanin (black-brown).

Oral Lightening Agents

Systemic lightening agents may be valuable in the management of melasma. Mechanism of action may range from their being photoprotective and/or as antioxidants. More researches are needed to explore the adjunctive role of these agents in melasma.

Botanicals in Melasma

Research on novel agents from botanicals without the harmful side effects is ongoing and the results are promising. Botanical agents acting as tyrosinase inhibitors include aloe vera extract, rumex occidentalis, and bearberry. Herbal extracts have other actions such as antioxidants, free radical scavengers, and photoprotectants. Some botanicals may have different or several mechanisms of action like melanosome uptake inhibition by keratinocytes and epidermal melanin removal.

Differential Diagnosis of Melasma in Brown Skin

Melasma is easy to diagnose but a difficult and challenging to manage clinical condition. It is not usual and necessary to take a biopsy to prove that it is melasma. On the basis of circumscribed hyperpigmented macules or patches affecting the face, neck, and arms, almost symmetrically, the following are the most common differential diagnoses to consider: Postinflammatory hyperpigmentation Exogenous ochronosis Acquired bilateral nevus of ota-like macules (Hori’s nevus) Solar lentigines Drug-induced pigmentation, e.g., due to minocycline or nonsteroidal anti-inflammatory drugs Actinic lichen planus Erythema dyschromicum perstans (ashy dermatosis) Riehl’s melanosis Ephelides (freckles)