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Article: The Asian dermatologic patient: Review of common pigmentary disorders and cutaneous diseases

TitleThe Asian dermatologic patient: Review of common pigmentary disorders and cutaneous diseases
Authors
Issue Date2009
PublisherAdis International Ltd. The Journal's web site is located at http://dermatology.adisonline.com/
Citation
American Journal Of Clinical Dermatology, 2009, v. 10 n. 3, p. 153-168 How to Cite?
AbstractThe Asian patient with Fitzpatrick skin types IIIV is rarely highlighted in publications on cutaneous disorders or cutaneous laser surgery. However, with changing demographics, Asians will become an increasingly important group in this context. Although high melanin content confers better photoprotection, photodamage in the form of pigmentary disorders is common. Melasma, freckles, and lentigines are the epidermal disorders commonly seen, whilst nevus of Ota and acquired bilateral nevus of Ota-like macules are common dermal pigmentary disorders. Post-inflammatory hyperpigmentation (PIH) occurring after cutaneous injury remains a hallmark of skin of color. With increasing use of lasers and light sources in Asians, prevention and management of PIH is of great research interest. Bleaching agents, chemical peels, intense pulsed light (IPL) treatments, and fractional skin resurfacing have all been used with some success for the management of melasma. Q-switched (QS) lasers are effective for the management of epidermal pigmentation but are associated with a high risk of PIH. Long-pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers and IPL sources pose less of a PIH risk but require a greater number of treatment sessions. Dermal pigmentary disorders are better targeted by QS ruby, QS alexandrite, and QS 1064-nm Nd:YAG lasers, but hyper- and hypopigmentation may occur. Non-ablative skin rejuvenation using a combination approach with different lasers and light sources in conjunction with cooling devices allows different skin chromophores to be targeted and optimal results to be achieved, even in skin of color. Deep-tissue heating using radiofrequency and infra-red light sources affects the deep dermis and achieves enhanced skin tightening, resulting in eyebrow elevation, rhytide reduction, and contouring of the lower face and jawline. For management of severe degrees of photoaging, fractional resurfacing is useful for wrinkle and pigment reduction, as well as acne scarring.Acne, which is common in Asians, can be treated with topical and oral antibacterials, hormonal treatments, and isotretinoin. Infra-red diode lasers used with a low-fluence, multiple-pass approach have also been shown to be effective with few complications. Fractional skin resurfacing is very useful for improving the appearance of acne scarring. Hypertrophic and keloid scarring, another common condition seen in Asians, can be treated with the combined used of intralesional triamcinolone and fluorouracil, followed by pulsed-dye laser. Esthetic enhancement procedures such as botulinum toxin type A and fillers are becoming increasingly popular. These are effective for rhytide improvement and facial or body contouring. We highlight the differences between Asian skin and other skin types and review conditions common in skin of color together with treatment strategies. © 2009 Adis Data Information BV. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/144283
ISSN
2015 Impact Factor: 3.084
2015 SCImago Journal Rankings: 1.485
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorHo, SGYen_HK
dc.contributor.authorChan, HHLen_HK
dc.date.accessioned2012-01-20T08:59:32Z-
dc.date.available2012-01-20T08:59:32Z-
dc.date.issued2009en_HK
dc.identifier.citationAmerican Journal Of Clinical Dermatology, 2009, v. 10 n. 3, p. 153-168en_HK
dc.identifier.issn1175-0561en_HK
dc.identifier.urihttp://hdl.handle.net/10722/144283-
dc.description.abstractThe Asian patient with Fitzpatrick skin types IIIV is rarely highlighted in publications on cutaneous disorders or cutaneous laser surgery. However, with changing demographics, Asians will become an increasingly important group in this context. Although high melanin content confers better photoprotection, photodamage in the form of pigmentary disorders is common. Melasma, freckles, and lentigines are the epidermal disorders commonly seen, whilst nevus of Ota and acquired bilateral nevus of Ota-like macules are common dermal pigmentary disorders. Post-inflammatory hyperpigmentation (PIH) occurring after cutaneous injury remains a hallmark of skin of color. With increasing use of lasers and light sources in Asians, prevention and management of PIH is of great research interest. Bleaching agents, chemical peels, intense pulsed light (IPL) treatments, and fractional skin resurfacing have all been used with some success for the management of melasma. Q-switched (QS) lasers are effective for the management of epidermal pigmentation but are associated with a high risk of PIH. Long-pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers and IPL sources pose less of a PIH risk but require a greater number of treatment sessions. Dermal pigmentary disorders are better targeted by QS ruby, QS alexandrite, and QS 1064-nm Nd:YAG lasers, but hyper- and hypopigmentation may occur. Non-ablative skin rejuvenation using a combination approach with different lasers and light sources in conjunction with cooling devices allows different skin chromophores to be targeted and optimal results to be achieved, even in skin of color. Deep-tissue heating using radiofrequency and infra-red light sources affects the deep dermis and achieves enhanced skin tightening, resulting in eyebrow elevation, rhytide reduction, and contouring of the lower face and jawline. For management of severe degrees of photoaging, fractional resurfacing is useful for wrinkle and pigment reduction, as well as acne scarring.Acne, which is common in Asians, can be treated with topical and oral antibacterials, hormonal treatments, and isotretinoin. Infra-red diode lasers used with a low-fluence, multiple-pass approach have also been shown to be effective with few complications. Fractional skin resurfacing is very useful for improving the appearance of acne scarring. Hypertrophic and keloid scarring, another common condition seen in Asians, can be treated with the combined used of intralesional triamcinolone and fluorouracil, followed by pulsed-dye laser. Esthetic enhancement procedures such as botulinum toxin type A and fillers are becoming increasingly popular. These are effective for rhytide improvement and facial or body contouring. We highlight the differences between Asian skin and other skin types and review conditions common in skin of color together with treatment strategies. © 2009 Adis Data Information BV. All rights reserved.en_HK
dc.languageengen_US
dc.publisherAdis International Ltd. The Journal's web site is located at http://dermatology.adisonline.com/en_HK
dc.relation.ispartofAmerican Journal of Clinical Dermatologyen_HK
dc.subject.meshAsian Continental Ancestry Groupen_HK
dc.subject.meshBotulinum Toxins, Type A - therapeutic useen_HK
dc.subject.meshCosmetic Techniquesen_HK
dc.subject.meshHumansen_HK
dc.subject.meshPigmentation Disorders - ethnology - therapyen_HK
dc.subject.meshRejuvenationen_HK
dc.subject.meshSkin - pathology - surgeryen_HK
dc.subject.meshSkin Diseases - ethnology - therapyen_HK
dc.titleThe Asian dermatologic patient: Review of common pigmentary disorders and cutaneous diseasesen_HK
dc.typeArticleen_HK
dc.identifier.emailHo, SGY:gyho@hku.hken_HK
dc.identifier.authorityHo, SGY=rp01573en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.2165/00128071-200910030-00002en_HK
dc.identifier.pmid19354330-
dc.identifier.scopuseid_2-s2.0-64849097054en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-64849097054&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume10en_HK
dc.identifier.issue3en_HK
dc.identifier.spage153en_HK
dc.identifier.epage168en_HK
dc.identifier.isiWOS:000265733900002-
dc.publisher.placeNew Zealanden_HK
dc.identifier.scopusauthoridHo, SGY=35205331800en_HK
dc.identifier.scopusauthoridChan, HHL=24555248900en_HK

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