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Notes:
Volume 2, Issue 3 2017
Journal of Medical Oncology and Therapeutics
Dermatologists & Melanoma 2017
August 31-September 01, 2017
Page 71
&
2
nd
Euro-Global Congress on
August 31-September 01, 2017 London, UK
12
th
Global Dermatologists Congress
Melanoma and Skin Diseases
Leandro Fonseca Noriega et al., J Med Oncl Ther 2017, 2:3
A new important tool in the treatment of the idiopathic guttate hypomelanosis: Report of two cases
Leandro Fonseca Noriega, Angélica Fonseca Noriega
and
Letícia Arsie Contin
Municipal Public Server Hospital, Brazil
Statement of the Problem:
Idiopathic guttate hypomelanosis (IGH) is an acquired leukoderma that usually begins in the fourth
decade of life and presents a progressive increase in incidence with aging. It manifests as multiple asymptomatic hypochromic/
achromic macules of the upper and/or lower limbs, often associated with actinic skin damage. No consensus has been reached
in regard to the therapeutic approach, which may include the use of topical calcineurin inhibitors, tretinoin, cryotherapy,
phenol, dermabrasion, laser modalities, and skin graft. Regardless of the therapeutic option used, the response tends to be
unsatisfactory.
Case reports:
we present 2 cases of IGH treated with microinfusion of drugs in the skin through microneedling equipment,
in which a 5-fluorouracil (5-FU) solution was used (5%). Case 1 presented with lesions in the lower limbs that intensified
after cryotherapy, and the case 2 with lesions in the upper limbs that were unresponsive to treatment with 88% phenol. Both
patients demonstrated a good clinical response 3 months after a single session of this innovative treatment, without evidence
of systemic or local adverse reactions.
Discussion:
we opted for this treatment based on studies that described dermabrasion followed by the use of 5-FU cream for
vitiligo. 5-FU used in low concentrations generates selective destruction of keratinocytes, while melanocytes are maintained
functional. So, the repigmentation occurs due to a favorable microenvironment for melanocyte migration and pigment spread.
Transdermal drug delivery systems enable hydrophilic drugs such as 5-FU to permeate the stratum corneum barrier, and
reach the epidermis. Microinfusion of drugs in the skin with adapted microneedling equipment has been recently described
in the clinical dermatological practice. This low-cost modality creates accurate microperforations at an adjustable depth and
simultaneously deposits micro-doses of the required drug.
Conclusion:
we report the use of 5-FU 5% to treat IGH, through a drug delivery technique.
Biography
Leandro Fonseca Noriega has his expertise in Dermatology. Currently, he works as Dermatologist at the Hospital do Servidor Público Municipal de São Paulo,
São Paulo, Brazil.
leandronorieg@gmail.com