• Journal of Acupuncture Research
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• v.33 no.1
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• pp.69-77
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• 2016

Objectives : The objective of this study is to review external approaches using acupuncture and related treatments of hyperpigmentation disorders and their classification in traditional medicine. Methods and Results : Hyperpigmentation was recorded for the first time in Treatise on the Pathogenesis and Manifestations of All Diseases published in 610 A.D. This suggests that the symptom has already been recognized as an independent disease in East Asia for more than 1,400 years. Over the course of several centuries, there has been a significant evolution in the traditional treatments for hyperpigmentation. There are many different types of therapy, including body acupuncture, intradermal acupuncture, ear acupuncture, ear acupressure, blood-letting treatment, pharmacopuncture, plum-blossom needle therapy, burning acupuncture therapy, moxibustion, and guasha. In addition, the traditional classification of hyperpigmentation has been changing shape. However, no attempts have been made to establish the academic linkage between the modern classification of hyperpigmentation disorders and the traditional one, on account of different concepts and names of the ailment. This study was designed in an attempt to identify the linkage of the categorization of the Korean Standard Classification of Disease (KCD) and the traditional classification. Conclusions : Through this literature review, we found that there has been a significant evolution in the treatment of hyperpigmentation disorders in East Asia. Traditional medical treatment for skin disease, including hyperpigmentation, is expected to be further developed with the advancement of science and technology.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.765-774
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• 2011

Purpose: Many facial burn patients suffer from hyperpigmentation and its treatment has been challenging. Vitamin C (ascorbic acid) has important physiologic effects on skin, including inhibition of melanogenesis, promotion of collagen biosynthesis, prevention of free radical formation, and acceleration on wound healing. The purpose of this study is to evaluate the effectiveness of Vitamin C iontophoresis for the treatment of postburn hyperpigmentation. Methods: The authors performed a retrospective analysis of 93 patients who were admitted for the treatment of facial burn from February 2008 through February 2010. Among them, 51 patients were treated with Vitamin C iontophoresis to control postburn hyperpigmentation and 42 patients were not. Experimental group was chosen 20 of 51 patients who had been treated with Vitamin C iontophoresis and had normal facial skin on the comparable contralateral aesthetic unit. Control group was chosen 20 of 42 patients who were not treated with Vitamin C iontophoresis and had also contralateral normal aesthetic unit. The resulting color of 20 patients who were treated with Vitamin C iontophoresis was compared with the color of the contralateral normal facial skin using a digital scale color analysis. Results were analyzed with Wilcoxon signed rank test. Results: The analysis revealed significant improvement of hyperpigmentation in the experimental group compared to control group. The difference of intial value and the value in 6 months showed significant change. Mean (${\Delta}^{initial}$-${\Delta}^{6month}$) of experimental group was 11.61 and control group was 7.23. Thus, the difference between the experimental group and the control group was 4.38. Therefore, Vitamin C iontophoresis revealed significant improvement of hyperpigmentation in the experimental group compared with control group. Conclusion: Vitamin C iontophoresis is an effective treatment modality for postburn hyperpigmentation.

• Medical Lasers
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• v.9 no.2
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• pp.187-189
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• 2020

Cold atmospheric plasma (CAP) is a material that generates free radicals through the ionization of air. Despite the application in various medical fields, the efficacy and safety of CAP on post-inflammatory hyperpigmentation due to atopic dermatitis have not been reported. Herein, we report the improvement in post-inflammatory hyperpigmentation of atopic dermatitis, after CAP treatment of three sessions weekly, 10 minutes per session. We examined the clinical severity indexes before and after treatment, including the Investigator's Global Assessment, modified Atopic Dermatitis Antecubital Severity, Eczema Area and Severity Index, and pruritus visual analogue scores. Our results indicate that CAP alleviates the post-inflammatory hyperpigmentation and clinical severity of atopic dermatitis, and effectively improves the atopic skin lesion without severe safety issues. We believe that the previously reported anti-bacterial effects and production of interleukin-6 after CAP treatment are probably responsible for the underlying mechanisms leading to clinical improvement.

• Medical Lasers
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• v.10 no.1
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• pp.49-51
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• 2021

The perioral region, which is one of the most conspicuous parts of the face, plays a significant role in interpersonal communication. However, the perioral region is highly susceptible to scarring and pigmentation and is difficult to treat. The causes of perioral hyperpigmentation are many, including physiologic reasons, systemic diseases, drugs, and infections. In the treatment of perioral hyperpigmentation, the cause of the disease must be diagnosed first. Management includes lifestyle modifications such as reducing the UVA exposure time, use of topical treatments including hydroquinone and retinoids, and physical therapy including laser therapy. We report a case of perioral hyperpigmentation treated with 1,064-nm Q-switched neodymium:yttrium-aluminum-garnet laser toning.

• Genomics & Informatics
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• v.21 no.3
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• pp.43.1-43.13
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• 2023

Melanin is synthesized by tyrosinase to protect the skin from ultraviolet light. However, overproduction and accumulation of melanin can result in hyperpigmentation and skin melanoma. Tyrosinase inhibitors are commonly used in the treatment of hyperpigmentation. Natural tyrosinase inhibitors are often favoured over synthetic ones due to the potential side effects of the latter, which can include skin irritation, allergies, and other adverse reactions. Nuciferine, an alkaloid derived from Nelumbo nucifera, exhibits potent antioxidant and anti-proliferative properties. This study focused on the in silico screening of nuciferine for anti-tyrosinase activity, using kojic acid, ascorbic acid, and resorcinol as standards. The tyrosinase protein target was selected through homology modeling. The residues of the substrate binding pocket and active site pockets were identified for the purposes of grid box optimization and docking. Therefore, nuciferine is a potent natural tyrosinase inhibitor and shows promising potential for application in the treatment of hyperpigmentation and skin melanoma.

• Biomolecules & Therapeutics
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• v.22 no.1
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• pp.35-40
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• 2014

Resveratrol is a polyphenolic compound found in various natural products such as grapes and berries and possesses anti-cancer, anti-hyperlipidemia, and anti-aging properties. Recently, it has been reported that resveratrol inhibits ${\alpha}$-melanocyte-stimulating hormone signaling, viability, and migration in melanoma cells. However, these effects have not been confirmed in vivo, specifically brownish guinea pigs. To evaluate the potential of resveratrol as a regulator of melanin for hyperpigmentation therapy, the influence of resveratrol on pigmentation was investigated by ultraviolet B-induced hyperpigmentation in brownish guinea pig skin. We found that resveratrol reduced the expression of melanogenesis-related proteins tyrosinase, tyrosinase-related proteins 1 and 2, and microphthalmia-associated transcription factor in melanoma cells. Furthermore, topical application of resveratrol was demonstrated to significantly decrease hyperpigmentation on ultraviolet B-stimulated guinea pig skin in vivo. Based on our histological data, resveratrol inhibits melanin synthesis via a reduction in tyrosinase-related protein 2 among the melanogenic enzymes. This study is the first to provide evidence supporting resveratrol as a depigmentation agent, along with further clinical investigation of resveratrol in ultraviolet B-induced skin disorders such as hyperpigmentation and skin photoaging.

• Journal of Oral Medicine and Pain
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• v.34 no.3
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• pp.257-260
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• 2009

Gingival hyperpigmentation may cause esthetic problems, especially in patients with a gummy smile. This report presents the use of the $CO_2$ laser for gingival depigmentation. Two cases presented with the same chief complaint of unesthetic gingiva caused by melanin hyperpigmentation. The $CO_2$ laser was setted at 0.8 watt, 40Hz, 0.01sec. The procedure were performed with non-contact mode in all pigmented areas. Ablation of the gingival hyperpigmentation areas were accomplished without any bleeding complications or postoperative pain. After 2 weeks and 4 weeks later, healing is completed and hyperpigmented gingiva appeared pink and firm.

• Journal of Periodontal and Implant Science
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• v.40 no.4
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• pp.201-205
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• 2010

Purpose: The purpose of this study was to evaluate the clinical effectiveness of and patient's satisfaction with treatment of gingival melanin hyperpigmentation with a Nd:YAG laser and a high speed rotary instrument. Methods: Three patients with melanin hyperpigmentation in the anterior parts of the gingiva were chosen for this case study. Clinical photographs were taken at the preoperative state and three patients were treated under local anesthesia. In the maxilla, the gingival deepithelization was conducted with a high speed diamond bur, whereas, in the mandible with a Nd:YAG laser. Clinical photographs were taken immediately after the procedures and at the 1st, 2nd, and 4th week to evaluate clinical color changes. A week after the procedure, the patients filled out a questionnaire about any pain or discomfort. At the 4th week after the procedure, the patients filled out questionnaires about esthetic aspects of the results of treatment. Results: In all cases, both anterior gingival areas were depigmented with satisfaction and the patients did not complain of severe pain or discomfort. At the 1st week of healing, the gingiva showed moderate to fast epithelization. Two weeks after the procedure, clinically, the gingiva showed almost complete healing. Four weeks after the procedure, there was significant improvement in gingival melanin hyperpigmentation. Conclusions: The Nd:YAG laser and the high speed rotary instruments seem to be effective for the esthetic treatment of gingival melanin hyperpigmentation.

• Journal of mucopolysaccharidosis and rare diseases
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• v.3 no.1
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• pp.28-32
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• 2017

Lipoid congenital adrenal hyperplasia (LCAH) is the severe form of congenital adrenal hyperplasia and is characterized by adrenal insufficiency with hyperpigmentation and female external genitalia irrespective of genetic sex. The steroidogenic acute regulatory protein (StAR) is required for the transport of cholesterol into the mitochondria for steroidogenesis, and defects in the StAR gene account for the majority of LCAH cases. In this report, we present a two-day-old hyperpigmented infant with phenotypical female genitalia. With consideration of the clinical and laboratory findings, the infant was suspected of having adrenal insufficiency due to LCAH and treated with glucocorticoid, mineralocorticoid, and sodium chloride. Karyotyping revealed 46, XY. Upon pelvis ultrasonography, adrenal hyperplasia with abdominal masses (thought to be the testicles) was reported. Molecular analysis with targeted exome sequencing revealed the homozygote mutation of c.772C>T ($p.Q258^*$) in exon 7 of the StAR gene. The early detection and treatment of adrenal insufficiency in infants with hyperpigmentation can prevent clinically apparent adrenal crises. During follow-up, the patient had a good clinical condition and maintained normal electrolyte and adrenocorticotropic hormone levels with medication.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.27 no.2
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• pp.1-13
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• 2014

Objective : The purpose of this study is to understand conspicuous features of geroderma with visceral manifestation theory(臟象論). Methods : We categorized skin aging into wrinkles, hyperpigmentation, dry skin and face flush. After investigating the reason, histological changes and mechanism of each classification in western medicine, we interpreted them according to the malfunction of five viscera(五臟) in Korean medicine. Result : The results are as follows. 1. Pathologic change of dermis and subcutaneous fat makes wrinkles. We consider wrinkles as the malfunction of the spleen(脾). 2. Irregular synthesis and disproportion of melanin makes hyperpigmentation. We consider hyperpigmentation as the malfunction of the liver(肝). 3. Dry skin is attributed to a subtle disorder of epidermal maturation. We consider dry skin as the malfunction of the lung(肺). 4. Facial flush is detected in rosacea and menopausal hot flush, which are both related with blood vessel abnormality. We consider facial flush as the malfunction of the heart(心) Conclusion : We interpreted the pathologic changes and mechanism of skin aging in western medicine as the decrease of five viscera(五臟) in visceral manifestation theory(臟象論) of Korean medicine. Further studies are needed to apply these hypothesis to clinical diagnosis and treatment.