P3203Blood selenium and glutathione peroxidase levels in patients with activevitiligo

Sima Kavand, MD, Skin Research Center of Shohada ye Tajrish Hospital, Tehran,Iran; Marjan Saeedi, MD, Skin Research Center of Shohada ye Tajrish Hospital,Tehran, Iran

Background: Vitiligo is a chronic skin disorder characterized by depigmentedmacules. Several studies propose a possible oxidant stress hypothesis, whichsuggests that accumulation of free toxic radicals lead to melanocytes destruction.Increased nitric oxide and H2O2 levels and decreased catalane level have beenshown in the epidermis of vitiligo patients, suggesting that disturbance in theoxidanteantioxidant system may have an important role in the pathogenesis ofvitiligo. Some abnormalities of blood antioxidants levels have been reported inpatients with vitiligo, like elevated selenium and glutathione peroxidase levels. Nostudy on blood antioxidant level has been performed so far on Iranian patients withskin type III and IV.

Aim: To study serum glutathione peroxidase and selenium levels of Iranian patientswith active vitiligo.

Methods: Blood levels of selenium and glutathione peroxidase were evaluated in 60patients with active vitiligo and 45 healthy volunteers.

Results: The overall results were not significantly different between two groups.

Conclusion: This is the first report of blood antioxidants levels in Iranian patientswith active vitiligo. The normal blood levels of selenium and glutathione peroxidasepropose that other factors may have more important role than oxidative stress in thepathogenesis of vitiligo, but the results need further modification.

MARCH 2

cial support: None identified.

Commer

P3204Phylloid hypermelanosis caused by three aberrant cell lines of partial andcomplete monosomy 13

Haruyo Sasaya, MD, Kinki University School of Medicine, Osakasayama City,Osaka Hu, Japan; Akira Kawada, MD, PhD, Kinki University School of Medicine,Osakasayama City, Osaka Fu, Japan; Naoki Oiso, MD, PhD, Osakasayama City,Osak Fu, Japan; Shigeru Kawara, MD, PhD, Kinki University School of Medicine,Osakasayama City, Osaka Hu, Japan

The mosaic patterns of pigment anomalies include the lines of Blaschko, thecheckerboard pattern, the phylloid pattern, and the patchy pattern without midlineseparation. Phylloid pattern is manifested with peculiar distribution of leaf-shapedor large pear-shaped appearance. Phylloid hypomelanosis is believed to be associ-ated with trisomy 13. Until now, one case of phylloid hypomelanosis was described,although cytogenetic analysis was not performed. We show a 29-year-old Japaneseman with phylloid hypermelanosis caused by three aberrant cell lines of partial andcomplete monosomy 13. Karyotyping of thirty peripheral blood lymphocytesshowed 46, XY, r(13) (p11.2q34) [21] / 45, XY, -13 [7] / 46, XY, dic r(13) (p11.2q34)[2]. Our case suggests that phylloid hypermelanosis is related with monosomy 13.The accumulation of cases of phylloid hypo- and hypermelanosis may offer theopportunity to identify and to understand the pigmentation-associated geneslocated on chromosome 13.

cial support: None identified.

Commer

010

P3205The association of emblica, licorice, and belides is an effective alternativeto hydroquinone for the clinical treatment of melasma

Adilson Costa, MD, Pontifıcia Universidade Catolica de Campinas, Campinas, SP,Brazil; Caio Silva, MMSc, KOLderma Instituto de Pesquisa Clınica, Campinas, SP,Brazil; Lucia Arruda, MD, MMSc, Pontifıcia Universidade Catolica de Campinas,Campinas, SP, Brazil; Mariana Zaniboni, MD, Pontifıcia Universidade Catolica deCampinas, Campinas, SP, Brazil; Tatiana Cordero, MD, KOLderma Instituto dePesquisa Clınica Ltda., Campinas, SP, Brazil; Thaıs Moises, MD, PontifıciaUniversidade Catolica de Campinas, Campinas, SP, Brazil

Background: The best topical substance to treat melasma is hydroquinone. Manyclinical trials have been performed to obtain equally good and safe topicalalternatives to it.

Aims: To evaluate how safe and efficient the association of emblica, licorice andbelides is to treat melasma, when compared with hydroquinone 2%, throughmedical, volunteers and photographic images evaluations.

Methods: Fifty-five female volunteers, ages 18 to 60, suffering from either epidermicor dermoepidermic melasma, were submitted to a randomized, single-blinded,single-center study. After 60 days using an SPF 35 cream only, volunteers weredivided into two different groups for a 60-day study: group A (embli-ca1licorice1belides used twice a day) and group B (hydroquinone 2% used onlyat night). In both groups, SPF 35 cream was applied every 2 hours.

Results: Fifty volunteers (90.1%) completed the study (group A: 23; group B: 27). Inthe medical evaluation, a similar improvement of melasma was observed in groups Aand B (78.3% and 88.9%, respectively; P ¼ .307) and these were statisticallysignificant to the baseline (P\.001). In the volunteers evaluation, the improvementof melasma was of 91.3% and 92.6%, respectively (P ¼ .867) and these werestatistically significant to the baseline (P\.001). According to MASI, both groups Aand B showed improvements in area and severity of melasma, in relation to thebaseline (P \ .001), with no differences between them (P [ .05). In case of allMELAsQOL criteria, both products improved the quality of life of patients withmelasma (P\.001 in each one), with no difference between Groups, in any criteria(P [.05). For UV spots, both in feature counts (number) and absolute scores (size,area, and intensity), obtained by Visia, both groups presented good improvement inrelation to the baseline (group A: P ¼ .001 and P ¼ .001, respectively; group B: P \.001 and P \.001, respectively), with no statistical difference between them (P [.05). In this clinical study, two volunteers from group A and seven from group B hadtransitory skin events, which did not prevent them from continuing with the clinicalstudy.

Discussion: Based on the results obtained in this clinical study, the association ofemblica, licorice, and belides is an efficient and safe alternative to treat melasma(both epidermic and dermo-epidermic), with no statistical difference in relation tohydroquinona 2%.

cial support: Clariderm Clear (emblica1licorice1none 2% and spectraban (SPF 35) were kindly dona

Commer belides),hydroqui ted byLaboratorios Stiefel.

P3206Novel skin lightening cream targeting melanogenesis on multiple levels

Gary D. Monheit, MD, Total Skin & Beauty Dermatology Center, P.C.,Birmingham, AL, United States

Melanogenesis is the result of a cascade of events and processes involving (1)transport of melanin precursors phenylalanine and tyrosine into melanocytes andmelanosomes; (2) enzymatic transformation of tyrosine to dopamine, dopaquinoneand later melanin by tyrosinase, which is enhanced after sun exposure viamelanocyte stimulating hormone (MSH); (3) melansome maturation; and (4)melanosome transfer from melanoctye to keratinocyte. Currently, hydroquinoneat prescription strength is considered the criterion standard for effective skinwhitening. Several products with hydroquinone are marketed; few of them containother actives such as retinoic acid and a steroid for enhanced activity. Whereas mostapproaches focus on the inhibition of tyrosinase, this poster describes a novel skinlightening cream by combining 4% hydroquinone with selected actives to try toadditionally inhibit other key processes involved in melanogenesis. L-Leucine,disodium glycerophosphate, phenylethyl resorcinol and undecylenoyl phenylala-nine were selected and incorporated into an oil-in-water cream. Leucine was shownto compete with tyrosine transport into melanocyte and melanosome in vitro whatmay limit availability of tyrosine needed for melanin formation. Disodium glycero-phosphate binds calcium (II) and therefore potentially influences calcium depen-dent processes in melanogenesis including phenylalanine uptake intomelanosomes, and melanosome transfer similarly as described for a calcium chelatorin vitro. Unlike hydroquinone, phenylethyl resorcinol was shown to strongly inhibittyrosinase without any significant melanocytotoxicity in vitro. In addition, in vitrodata indicate that undecylenoyl phenylalanine acts as an antagonist of MSH. Safetyand efficacy of this novel skin lightening cream was then studied in a human clinicalstudy which involved 20 female subjects between 35 to 65 years of age with mild tosevere facial melasma. After 1, 2, and 3 months of once daily use of the skinlightening cream in the evening in conjunction with a SPF 301 sunscreen during daytime, efficacy was assessed using a photography system at different lighting understandardized condition, global evaluation and MASI scoring by investigator, as wellas subjectively by patient questionnaire. By 4 weeks, severity of melasma lesions asassessed by both global assessment and MASI were reduced as compared to baselineand continued to further reduce after 8 and 12 weeks (P # .05).

cial support: 100% sponsored by Neocutis.

Commer

J AM ACAD DERMATOL AB119