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Biomedical subjects

P E Grimes

Publications and source records attributed to P E Grimes.

At least 19 recordsLinked to original sources
PubMed2006

The safety of hydroquinone.

Hydroquinone is one of the most effective molecules for the treatment of hyperpigmentary disorders, with over 40 years of efficacy and safety data. Concerns over its safety have been raised because of the fact that it is a derivative of benzene and because of the long-term side-effects observed with cosmetic products containing high concentrations of hydroquinone. However, despite 40-50 years use of hydroquinone for medical conditions, there has not been a single documented case of either a cutaneous or internal malignancy associated with this drug. This article reviews the evidence for the safety of hydroquinone in the treatment of hyperpigmentation conditions.

Animals↗
PubMed2001

Laser resurfacing-induced hypopigmentation: histologic alterations and repigmentation with topical photochemotherapy.

BACKGROUND: Hypopigmentation is a relatively common side effect of CO2 laser resurfacing. Little is known regarding the histologic features of the areas of pigmentation loss. To date, hypopigmentation is considered a permanent complication of this procedure. OBJECTIVE: To assess the histologic features of hypopigmentation caused by laser resurfacing and to evaluate the efficacy and safety of topical psoralen photochemotherapy. METHODS: Ten patients were included in this pilot study. Four had baseline biopsies performed. Histologic parameters assessed included epidermal melanin, dermal melanophages, perivascular inflammation, Mel-5 immunostaining for melanocytes, and dermal fibrosis. Seven patients were treated twice a week with topical photochemotherapy utilizing 0.001% 8-methoxypsoralen. RESULTS: All of the biopsy specimens demonstrated varying quantities of epidermal melanin and residual epidermal melanocytes. Mild perivascular inflammation was evident in two specimens. Superficial dermal fibrosis was noted in all biopsy specimens. Topical photochemotherapy induced moderate to excellent repigmentation in 71% of the treated patients. Adverse effects were minimal. CONCLUSION: The results of this investigation suggest that hypopigmentation induced by laser resurfacing may result from a suppression of melanogenesis rather than destruction of area melanocytes. The preliminary data further suggest that hypopigmentation caused by laser resurfacing can be effectively treated by topical photochemotherapy.

Acne Vulgaris↗
PubMed2000

Skin and hair cosmetic issues in women of color.

Women of color comprise many phenotypically heterogeneous groups. Despite the general heterogeneity, however, there are unique skin and hair care issues and needs. These issues often present therapeutically challenging problems for the dermatologist and the skin and hair care industry.

Black People↗
PubMed1999

The safety and efficacy of salicylic acid chemical peels in darker racial-ethnic groups.

BACKGROUND: There is a dearth of published data regarding chemical peels in darker racial-ethnic groups. OBJECTIVE: The purpose of the present investigation was to assess the clinical efficacy and safety of a new superficial salicylic acid peel in individuals of skin types V and VI. METHODS: Twenty-five patients were included in this pilot investigation. Nine had acne vulgaris, 5 had post-inflammatory hyperpigmentation, 6 had melasma, and 5 had rough, oily skin with enlarged pores. The patients were pre-treated for 2 weeks with hydroquinone 4% prior to undergoing a series of five salicylic acid chemical peels. The concentrations of salicylic acid were 20% and 30%. The peels were performed at 2 week intervals. RESULTS. Moderate to significant improvement was observed in 88% of the patients. Minimal to mild side effects occurred in 16%. CONCLUSION: The results of this study suggest that superficial salicylic acid peels are both safe and efficacious for treatment of acne vulgaris, oily skin, textural changes, melasma, and post-inflammatory hyperpigmentation in patients with skin types V and VI.

Acne Vulgaris↗
PubMed1996

Cytomegalovirus DNA identified in skin biopsy specimens of patients with vitiligo.

BACKGROUND: Viral infections have been implicated in the pathogenesis of a variety of autoimmune diseases. OBJECTIVE: This investigation was undertaken to determine the presence or absence of viral genomes in the depigmented and uninvolved skin of patients with vitiligo. METHODS: A polymerase chain reaction assay was used to detect viral genomes in paraffin-embedded skin biopsy specimens. Twenty-nine patients with vitiligo and 22 control subjects were included. Biopsy specimens were screened in a blinded fashion for a panel of DNA and RNA viruses including herpes simplex, varicella-zoster, cytomegalovirus (CMV), Epstein-Barr, HIV, and human T-cell lymphotropic virus. RESULTS: CMV DNA was identified in 38% of the patients studied. Twenty-one percent had indeterminate results. Results in all control subjects were negative. Polymerase chain reaction screening for identification of other viral genomes was negative. Although not statistically significant, data trends suggested a correlation between the presence of CMV DNA in biopsy specimens and active vitiligo of relatively brief duration. In addition, CMV-positive patients had a statistically significant increased frequency of other concurrent autoimmune diseases. CONCLUSION: CMV DNA in the depigmented and uninvolved skin of some patients with vitiligo and its absence in control subjects suggest that vitiligo may indeed be triggered by a viral infection in select patients.

Adult↗
PubMed1995

Melasma. Etiologic and therapeutic considerations.

BACKGROUND: Melasma is a common acquired symmetric hypermelanosis characterized by irregular light- to gray-brown macules and patches involving sun-exposed areas of skin. Etiologic factors in the pathogenesis of melasma include genetic influences, exposure to UV radiation, pregnancy, hormonal therapies, cosmetics, phototoxic drugs, and antiseizure medications. OBSERVATIONS: Melasma is often a therapeutically challenging disease, and current treatments include hypopigmenting agents, chemical peels, and lasers. Hypopigmenting agents include phenolic and nonphenolic derivatives. Phenolic agents include hydroquinone and hydroquinone combination preparations. Despite controversies regarding the issue of hydroquinone-induced ochronosis, hydroquinone remains the most effective topically applied bleaching agent approved by the Food and Drug Administration for the treatment of melasma. Nonphenolic bleaching agents include tretinoin and azelaic acid. Superficial, medium, and deep chemical peels are more often used in lighter-complexioned patients. Such peels should be used with caution in blacks. Although lasers have demonstrated significant efficacy in the treatment of a variety of hyperpigmentary disorders, their precise efficacy and place in the therapy of melasma have yet to be established. CONCLUSIONS: In the hierarchy of therapies for melasma, the treating physician must consider the devastating psychosocial impact of pigmentary imperfections within the realm of the benefits and risks associated with each treatment.

Administration, Cutaneous↗
PubMed1994

Sex differences in psychiatrists' practice patterns and incomes.

OBJECTIVE AND METHOD: Using data from the APA's 1988-1989 Professional Activities Survey, the authors compared male and female psychiatrists on demographic characteristics, training, practice patterns, and income. RESULTS: In keeping with previous studies' findings, female respondents on the average were younger than male respondents and more likely to have taken a residency or fellowship in child or adolescent psychiatry, worked fewer hours per week, allocated their working hours differently among types of activities, saw fewer patients per week, and worked in somewhat different settings. Multiple regression analysis showed that women had significantly lower mean net annual income than men after the effects of those predictors were statistically controlled. CONCLUSIONS: Differences in age, training, hours worked in specific settings, and numbers of patients do not completely account for the gender gap in psychiatrists' annual incomes.

Adolescent Psychiatry↗
PubMed1993

Considerations for cosmetic surgery in the black population.

The availability of cosmetic surgical procedures to the general public, especially blacks, has become increasingly widespread. Aesthetic surgeons should not be deterred from performing these procedures in blacks. The myth that all black patients develop keloids or dyspigmentation after surgery should be dispelled; however, in those patients with a history of keloid formation or hypertrophic scarring, elective cosmetic procedures should be either withheld or performed with extreme caution. In general, the cosmetic surgeon can proceed with surgery in blacks and attain good aesthetic results if the procedures are slightly modified when indicated to minimize pigmentary changes and scarring and to maintain ethnic congruency.

Black People↗
PubMed1993

Vitiligo. An overview of therapeutic approaches.

Vitiligo often induces severe cosmetic disfigurement in patients. These patients must function in a society that places profound emphasis and social significance on appearance. Although physically healthy, many patients are greatly affected psychologically by the disease. Hence, concerted efforts should be made to treat these individuals. Despite the inherent difficulties in stimulating melanocytes to repigment vitiliginous lesions, a variety of medical, surgical, and adjunctive/alternative therapies benefit innumerable patients with vitiligo. These treatments may be used as monotherapies or combination therapies to achieve optimal results.

Humans↗
PubMed1991

Cosmetics in blacks.

Blacks comprise a phenotypically heterogeneous group with respect to skin and hair. They are uniquely multihued with at least 35 different possible shades of pigmentation, and there is considerable variability in hair texture. This accounts for many of the unique skin and hair cosmetic requirements and customs in the black race. These grooming practices may present perplexing problems for the dermatologist when viewed in the context of resultant skin disease; therefore, an awareness and understanding of skin and hair products used by blacks, grooming techniques, and their consequences are essential for clinicians caring for black patients.

Black or African American↗
PubMed1988

Pigmentary disorders in blacks.

An awareness of pigmentary nuances and an understanding of the psychosocial impact of pigmentary disturbances in blacks is essential in rendering optimal dermatologic care to black patients.

Black People↗
PubMed1987

Childhood vitiligo.

Eighty-two children (ages 6 months to 12 years) with clinical and/or histopathologic diagnoses of vitiligo were evaluated; 35 were male and 47, female. Fifty-six were black, 25 white, and 3 classified as "other." Children were compared with control groups of children with other skin diseases and with adults with vitiligo. Children had an increased incidence of segmental vitiligo (p less than 0.01). Children had an increased incidence of autoimmune and/or endocrine disease and also of premature graying in their immediate and extended family members (p less than 0.001). Six of 33 children with vitiligo tested had positive organ-specific serum autoantibodies, which was a higher incidence than in the control group of children (p less than 0.05). Eighteen percent of children treated with topical psoralens and long-wave ultraviolet light (PUVA) therapy had an acceptable response, which was less than an adult group similarly treated. We have found childhood vitiligo to be a distinct subset of vitiligo, showing increased segmental presentation; strong autoimmune and/or endocrine disease background and high incidence of premature graying in the families of affected children; the presence of organ-specific serum autoantibodies and a poor response to topical PUVA therapy.

Adult↗
PubMed1987

Natural cell-mediated cytotoxicity in vitiligo.

Natural cell-mediated cytotoxicity was studied in 18 patients with vitiligo and 13 healthy age-, race-, and sex-matched control subjects. The 4-hour chromium51 (51Cr) release assay was used to determine the activity of natural killer (NK) cells in the peripheral blood against K562 and Molt-4 target cells. Patients with vitiligo had a 50%, 67%, and 60% decrease in the cytotoxic response with Molt-4 cells at effector-target ratios of 25:1, 50:1, and 100:1, respectively, in comparison with control subjects (p less than 0.001). This inhibition was consistent with an 80% decrease in the binding capacity of NK cells to Molt-4 target cells (p less than 0.005). In contrast, cytotoxic responses did not differ in patients and control subjects with K562 target cells. These results suggest that patients with vitiligo have a decreased capacity for effector cell recognition of Molt-4 target cells but not K562 target cells. Hence patients with vitiligo may have defective clones of NK cells that are incapable of initial recognition of Molt-4 target cells, a necessary prerequisite for target cell lysis. Perhaps this phenomenon occurs with other tumor cells, which would explain the association of vitiligo with certain internal malignancies.

Adolescent↗
PubMed1986

T cell profiles in vitiligo.

The purpose of our investigation was to quantitatively assess T cell profiles in vitiligo and to correlate any aberrations in these findings with the spectrum of clinical disease. Twenty randomly selected vitiligo patients and sixteen healthy matched control subjects were studied. The immunofluorescence and complement-mediated cytotoxicity assays were used to determine the percentages of total T (OKT3), helper (OKT4), and suppressor (OKT8) cells in the peripheral blood of patients and controls. Both assays gave comparable results. Patients with vitiligo had a statistically significant decrease in helper cells and helper/suppressor ratios in comparison with control subjects (p less than 0.01). In addition, there was a statistically significant decrease in helper cells among patients with a disease duration of less than 1 year (p less than 0.01) and in patients who produced serum autoantibodies (p less than 0.05). These findings tend to suggest that aberrations in cell-mediated immunity may be operative in the pathogenesis of vitiligo.

Adolescent↗
PubMed1986

Ocular disturbances in vitiligo.

One hundred fifty-six patients with vitiligo were examined for ocular abnormalities. A 2:3 ratio of white to black patients allowed us to evaluate the role of race in the occurrence of ocular disturbances. A large percentage (40%) of all patients showed some degree of fundal pigment disturbance including pigment clumps, focal hypopigmented spots, and choroidal nevi. Although racial variations were found in the incidence of choroidal nevi (p = 0.001) and iris transillumination (p = 0.0012), these variations were believed to reflect normal differences found in patients without vitiligo.

Adolescent↗