+441518081136A new important tool in the treatment of the idiopathic guttate hypomelanosis: Report of two cases
2nd Euro-Global Congress on Melanoma and Skin Diseases
August 31-September 01, 2017 London, UK
Leandro Fonseca Noriega, Angélica Fonseca Noriega and Letícia Arsie Contin
Municipal Public Server Hospital, Brazil
Posters & Accepted Abstracts : J Med Oncl Ther
Abstract:
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.
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