How to Whiten Your Skin Naturally
In contrast, if told the native has dark skin, they are more likely to generalize to all natives because skin color tends to be more uniform within a race. However, sensitivity to variability does not imply that people consider the variability of predicates in the same deliberative manner that a scientist should. This phenomenon could be explained by a sensitivity to centrality (Sloman, Love, & Ahn, 1998). Given two properties A and B, such that B depends on A but A does not depend on B, people are more willing to project property A than property B because A is more causally central than B, even if A and B are equated for variability (Hadjichristidis, Sloman, Stevenson, & Over, 2004). More central properties tend to be less variable. Having a heart is more central and less variable among animals than having hair. Cen-trality and variability are almost two sides of the same coin (the inside and outside views, respectively). In Nisbett et al.'s case,...
Most patients will be concerned about accentuation of their previously imperceptible melasma. Ruling out pregnancy or confirming exogenous estrogens in any patient presenting with melasma should be performed first. Essential to any treatment of melasma is strict sun avoidance. Referral to a dermatologist can be made on a nonurgent basis. Melasma. Well-demarcated, hyperpigmented macules are seen on the cheek, nose, and upper lip. (Used with permission from Wolff K, Johnson RA, Suurmond D. Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology. 5th ed. New York, McGraw-Hill, 2005 p. 349.)
Chronic exposure to inorganic arsenic compounds may lead to peripheral and central neurotoxicity. Early events may include paraesthesia (pins and needles) followed by muscle weakness. Both motor and sensory peripheral neurones are affected. Characteristic dermal lesions after chronic oral or inhalation exposure may include hyperpigmentation and hyperkeratosis.
Patients with AT also demonstrate progeric changes of the hair and skin, including early graying of the hair and atrophic, hidebound facial skin. Pigmentary changes are also frequent and consist of hyperpigmentation and hypopigmentation with cutaneous atrophy. A few patients may demonstrate partial albinism, vitiligo, and cafe au lait spots. Seborrheic dermatitis occurs in nearly all patients, and senile keratoses, atopic dermatitis, and eczema are also reported. Another prominent feature of AT is frequent sinopulmonary infections. These may range from infection of the ears, nose, and sinuses to chronic bronchitis and recurrent pneumonia. The latter two may result in bronchiectasis and pulmonary fibrosis. Chronic infections are typically due to common bacteria however, they are sometimes poorly responsive to antibiotic therapy. The predisposition to infection is associated with the presence of an abnormal thymus and a marked deficiency of IgA, which is the predominant immunoglobulin...
The basic illness of AIDS mimics adrenal insufficiency with lethargy, hyperpigmentation, weight loss, and hyponatremia. A high index of suspicion must be maintained to diagnose Addison's disease appropriately in the AIDS patient. Similarly, surgeons consulted to see the AIDS patient with abdominal pain, hypotension, or sepsis must keep Addison's disease in the differential diagnosis. Standard endocrine testing and computed tomography (CT) scans of the abdomen help establish the diagnosis. Empirical corticoid therapy in the severely ill patient may be
Phenytoin became available in 1938 and remains a first-line agent in the treatment of tonic-clonic and partial seizures and status epilepticus. Its primary mechanism of action is inhibition of sustained high-frequency firing through blockade of voltage-gated Na + channels. Phenytoin precipitates in muscle and can cause tissue necrosis if administered intramuscularly. Long-term complications include gingival hyperplasia, hirsutism, coarsening of facial features, hyperpigmentation, acne, pseudolymphoma, cerebellar degeneration, movement disorders including chorea and dystonia, and disorders of vitamin D metabolism. Phenytoin is available in 30-and 100-mg capsules, 50 mg chewable Infatabs, elixir (125 mg 5 ml), and injectable forms. Fosphenytoin sodium, a phosphate ester prodrug of phenytoin, has gained FDA approval and has replaced the injectable formulation of Dilantin. Because of its higher water solubility, fosphenytoin can be safely administered intramuscularly and intravenously at...
Hypocortisolemia can be primary, in which there is a defect intrinsic to the adrenal gland, or secondary, when pituitary or hypothalamic dysfunction causes decreased secretion of CRH or ACTH. Primary adrenal insufficiency was described by Thomas Addison in 1855 and is most commonly associated with destruction of the adrenal glands, either by tuberculosis, acquired immunodeficiency syndrome (AIDS), autoimmune disorder, adrenal hemorrhage, or tumor. In such cases, ACTH levels are high in response to the low plasma levels of gluco-corticoids. Secondary adrenal insufficiency is most often caused by suppression of the hypothalamic-pituitary axis by exogenous glucocorticoid therapy. Endogenous causes are a result of pituitary destruction by large tumors, apoplexy (hemorrhage into a pituitary adenoma), pituitary infarction (Sheehan's syndrome), inflammatory process (lymphocytic hypophysitis, Langerhans cell histiocytosis), or granulomatous disease (sarcoidosis). In almost all cases, loss of...
Keloid scars are due to abnormal collagen metabolism. The excess scar tissue extends out beyond the wound edges and might continue to enlarge after 6 months. Prevalence is higher in patients with dark skin, especially those of African origin, in younger patients and in those with burn wounds.
Cleansing agents for the skin, and oils, soaps, unguents, and other cosmetics used to maintain a good personal appearance and skin tone. Moreover, concern for personal hygiene went far beyond the realm of attracting sexual partners or performing religious cleansing rituals. Greeks and Romans worshiped health and consequently elevated in importance to their life-style the technical knowledge they believed would promote individual health and longevity.
One or more additional features of the POEMS syndrome often are observed, but in many cases, these are not prominent and must be carefully sought. Hepatomegaly may be found in up to 50 percent of patients, whereas lymphadenopathy and splenomegaly are less common. Manifestations of endocrinopathy include diabetes mellitus, hypothyroidism, impotence, gynecomastia, testicular atrophy, amenorrhea, hyperprolactinemia, and hyperestrogenemia. Skin changes include hyperpigmentation, thickening of the skin, hypertrichosis, skin angiomas, clubbing, and white nails. Some skin changes are suggestive of scleroderma. Peripheral edema, ascites and pleural effusions may also be seen. POeMs syndrome, sometimes referred to as Crow-Fukase syndrome, is not unique to osteosclerotic myeloma. It has been observed in multiple myeloma, Waldenstrom's macroglobulinemia, and angiofollicular lymph node hyperplasia, also referred to as Castleman's disease.y
Here's how I perform acupuncture for healthy facial skin and skin tone. I insert tiny 3-6 millimeter needles into worry lines, crow's-feet, and smile lines to bring much-needed circulation to the sagging, malnourished skin. Once I remove the needles, a facial massage is employed. Some practitioners use herbs and oils on the skin that enhance healing. I teach patients to do their own facial massage, allowing more frequent stimulation and helping patients become more involved in the healing process.
Adrenal insufficiency refers to impaired secretion of cortisol with or without impaired secretion of aldo-sterone. Adrenal insufficiency can result from disorders of the adrenal cortex (primary adrenal insufficiency) or of the hypothalamus or pituitary (secondary adrenal insufficiency) (see Figure 19-2). Symptoms of adrenal insufficiency include weakness, abdominal pain, and hyperpigmentation. Chronic primary adrenal insufficiency, or Addison's disease, usually results from autoimmune adrenali-tis and can be treated with cortisol and aldosterone replacement.
Black hairy tongue (BHT) represents a benign reactive process characterized by hyperplasia and dark pigmentation of the tongue's filiform papillae. The elongated filiform papillae may reach up to 2 cm in length and vary in actual degree of pigmentation from light tan to black. Predisposing factors may include excessive smoking, gastroesophageal reflux, poor oral hygiene, chemotherapy, and the use of broad-spectrum oral antibiotics. Pigment from consumed food, beverages, and tobacco products stains the entrapped food debris and desquamated papillary keratin. Some antibiotics may alter normal oral microflora and promote the growth of chromogenic organisms, also contributing to the tongue's discoloration. The darkly pigmented filament-like papillae give the tongue a black, hairy appearance. Males are more often affected than females this condition very rarely occurs in children. Alteration of taste perception and fetid breath may be a consequence of BHT.
Additional side effects have been noted in some women. Women wearing contact lenses may have visual changes and more disturbances with lenses. If normal saline eye drops do not help, referral to an ophthalmologist is recommended. Melasma and chloasma can occur secondary to estrogen stimulation of melanocyte production. Women with darker pigmentation are more susceptible to hyperpigmentation effects. The melasma may not be completely reversible on discontinuation. Progestin-only products may be preferable, and sunscreen use is highly recommended.1
Most of the acute effects of radiotherapy resolve within 1 to 2 months. However, the majority of patients will have some degree of permanent xerostomia, dental problems, skin hyperpigmentation, and soft-tissue fibrosis.35 Efforts to reduce long-term xerostomia include the use of radioprotectors such as amifostine or salivary stimulants such as pilo-carpine.36,37 Meticulous dental care and daily fluoride therapy are effective in minimizing the risk of serious dental complications. Approximately one-third of patients will eventually develop hypothy-roidism. This is usually subclinical and detected by annual screening with thyroid function tests. Thyroid hormone replacement should be prescribed in this setting. Chronic serous otitis media occurs in approximately 15 percent of patients and may be managed
The earliest changes observed in AMD are the presence of drusen, small clumps of material at the level of Bruch's membrane that likely represent the residua of degenerating RPE cells (Ambati et al., 2003). Drusen are visible clinically as yellow spots in the macula (Fig. 19.3) (Machemer, 2005). Additional RPE abnormalities may also be present (areas of death and or hyperpigmentation). This early stage of AMD is called dry, or non-exudative AMD.
Stage I Intact skin with nonblanchable redness of a localized area, usually over a bony prominence. Darkly pig-mented skin may not have visible blanching its color may differ from the surrounding area. The area may be painful, firm, soft, and warmer or cooler compared with adjacent tissue. Stage I may be difficult to detect in individuals with dark skin tones.
Keloids are similar to hypertrophic scars in that they are also the result of an excessive fibrous response. The difference is that keloids take some time to form and may occur years after the initial injury. They can range in size from small papules to large pendulous growths (Munro, 1995). Keloids more commonly occur in individuals aged between 10 and 30 years (Cosman et al, 1961) and in those with a darker skin (Placik & Lewis, 1992). Unfortunately, unlike hypertrophic scars, keloids do not gradually flatten out.
The facial organs that constitute a human smile are likewise plentiful the cheeks, nose, nasal bridge, chin, eyes, eyebrows, forehead, zygomatic arch, lips, and displayed teeth are considered the variable elements governing facial appearance. Race, skin tone, and character complete the overall picture. As a result of the many variations and elements, the overall clinical assessment for any smile is a mere personal perception rather than a step-by-step methodology.
Been reported in breastfed infants, infants with darker skin pigmentation, and even older children with minimal exposure to sunlight. Consequently, all breastfed infants, partially breastfed, non-breastfed infants, and older children ingesting less than 1000 mL day of vitamin D-fortified formula or milk should receive 400 IU day of supplemental vitamin D daily beginning within the first few days of life until the infant or child is ingesting 1000 mL day of vitamin D-forti-fied formula or milk (AAP, 2009). Higher doses of vitamin D may be required in children with chronic fat malabsorption. Vitamin B12 supplementation should be given to breastfed infants whose mothers are strict vegetarians.
Leukocytoclastic vasculitis (LCV) represents the deposition of immune complexes in small blood vessels with subsequent blood vessel destruction and extravasation of blood. Patients present with nonblanching erythematous papules that frequently coalesce into plaques ( palpable purpura ). The lower extremities and dependent areas of the back and the buttocks are most frequently involved. Pruritus can be significant. The face, palms, soles, and mucous membranes are uncommonly involved. Vesicles, ulcers, and necrosis can be seen within the purpuric lesions. The lesions appear over a few days and usually resolve with hyperpigmentation over 4 to 6 weeks or longer. Associated symptoms include fever, arthralgias, myalgias, malaise, and other disease-specific symptoms. Urticarial vasculitis presents with painful urticaria. The lesions are distinguished from common urticaria by their persistence (lasting over 24 hours) and resolution with hyperpigmentation. Urticarial vasculitis can be seen...
Cryotherapy can be easily mastered for treatment of many skin lesions. Cryotherapy is well tolerated and results in minimal to no scar. It is best used in those with lighter skin and in non-hair-bearing areas because of occasional pigment changes or hair loss with deeper treatments. Liquid nitrogen, the most widely available, cost-effective cryogen for medical therapy,
When ingested, inorganic mercury salts can be absorbed from the gastrointestinal tract. However, they are poorly lipid-soluble and only around 10 of an ingested dose would be absorbed. Once absorbed, inorganic mercury is concentrated in the kidneys. Inorganic mercury compounds do not in general pose a significant risk by the inhalation route as they are not encountered in a respirable form. However, there have been recent reports of the use of mercury-containing skin-lightening creams containing significant quantities of mercury being associated with the development of nephrotic syndrome (Choudhury 2011).
Granuloma annulare is a benign, self-limited dermatosis characterized by a raised annular distribution (Fig. 33-35). The condition may be localized, generalized, perforating, or subcutaneous. Except for subcutaneous granuloma annu-lare, the subtypes have similar appearances, but each follows a distinct clinical course. Subcutaneous granuloma annulare appears differently, with deep dermal or subcutaneous nodules. Patients with localized granuloma annulare present with groups of 1-mm to 2-mm papules in an annular arrangement over the distal extremities, ranging in color from skin tone to erythematous. Lesions most frequently appear on the dorsal surfaces of the hands and feet, fingers, and extensor aspects of the arms and legs. In generalized granuloma annulare, patients have a few to thousands of papules and rings that involve many body regions. The rings tend to be distributed symmetrically. Patients with perforating granuloma annulare present with up to hundreds of grouped 1-mm to...
Some proponents believe that cell therapy increases vitality, stamina, skin tone, blood supply, and a general sense of well-being. Enhanced sexual function and reversal of male impotence also have been claimed. Many other successes in treating various diseases are noted, ranging from cancer to Down's syndrome. Finally, as is true of almost all alternative therapies, some proponents speak of cell therapy's value in treating AIDS.
The external appearance of A. africanus, as depicted in Figure 1.3, is inevitably subject to much uncertainty. Surface morphology is heavily defined by traits which do not fossilize, such as the hair and skin. Extant African apes have dark skin due to deposits of epidermal melanin. Likewise African populations of H. sapiens are, typically, dark skinned, and it is thought that this would have been the case in the earliest human populations in Africa. Melanic pigmentation offers protection against exposure to high levels of UV radiation in the tropics (Jablonski and Chaplin 2000 Jablonski 2006). In Figure 1.3, A. africanus is shown as having much less hair on its body and limbs than today's chimpanzees or gorillas. There is no assurance that this is correct. As apes which lived in arboreal environments, as well as in more open, grassland conditions, it is possible that the australopithecines were more hirsute than is shown in Figure 1.3. Loss of hair may only have become pronounced in...
Keloids are fibrous elevated scars that extend outside wound margins. Keloids are unlikely to regress, are likely to recur if excised, and are most likely to occur in patients with darker skin (relative risk RR 15-20). Keloids are frequently located over the midline chest, cheeks, and ear-lobes, and peak incidence is age 10 to 20 years. Wounds that heal by secondary intention and burn wounds are high risks for developing keloids. Keloids may be painful as well as cosmetically unacceptable (Juckett and Hartman-Adams, 2009) (Fig. 28-7).
Chloasma Melasma characterized by irregularly shaped brown patches on the face and other areas of the skin, often seen during pregnancy or associated with the use of oral contraceptives. Hyperpigmentation A common darkening of the skin that occurs when an excess of melanin forms deposits in the skin.
Clinical Features and Associated Disorders. The clinical features of adrenal insufficiency are influenced by the site of dysfunction, because PAI affects all of the adrenocortical hormones, whereas SAI only affects glucocorticoids. Thus, hyperpigmentation, salt craving, and hyperkalemia are unique to patients with PAI. Patients with adrenal insufficiency may present acutely or as a chronic condition. Acute adrenal insufficiency is a medical emergency (so-called addisonian crisis) characterized by mental status changes, fever, hypotension, volume depletion, arthralgias, myalgias, and abdominal pain that may mimic an acute abdomen. yi Chronic adrenal insufficiency may present more insidiously with fatigue, weakness, GI symptoms, amenorrhea, decreased libido, salt craving, arthralgias, and hypoglycemic symptoms. Neurological manifestations can include confusion, apathy, depression, psychosis, paranoia, and myalgias, as well as hypoglycemic symptoms. 102 In addition, a past medical...
Metal cations and organic species carrying positive charge(s), possess a strong affinity to melanins, and binding occurs through an ion-exchange mechanism. This characteristic phenomenon has been studied by different authors to explain the medicinal aspects which may involve affinity and binding of various molecules to melanins in substantia nigra, in malignant melanoma cells, and in the toxicity of drugs. For example, a pathological pigmentation often occurs in the skin of the patients taking large doses of chlorpromazine (251). It has been suggested that chlorpromazine acts on the autonomic nervous system by blocking the production of pigment-lightening factors such as melatonin (252). According to some authors, white light produces free radicals from chlorpromazine and the formation of a stable charge-transfer complex with melanin is the mechanism of action for this chemical hyperpigmentation (253,254).
Jaundice is the most common condition requiring medical attention in the term newborn. Hyperbilirubinemia is one of the primary reasons for hospital readmission during the first week of life (Brown et al., 1999). Visible jaundice refers to a yellow coloration of the skin and sclera in infants with elevated levels of bilirubin and may be difficult to detect in infants with darker skin. Visible jaundice occurs in more than 50 of healthy term newborns. Although rare, high levels of bilirubin occurring in the first week of life can cause kernicterus, a permanent and devastating form of brain damage (Palmer et al., 2003). Neonatal hyperbilirubinemia results from the accelerated production of bilirubin in newborns and their limited ability to excrete it. The newborn liver has limited ability to conjugate bilirubin, and unconjugated bilirubin is not readily excreted.
In addition to the skin changes of the breast already discussed, hyperpigmentation is common, especially in women with dark hair and a dark complexion. The linea alba darkens to become the linea nigra, as shown in Figure 23-7A. Areas prone to friction (e.g., medial thighs, axilla) also tend to darken. New pigmentation on the face, called chloasma, also commonly develops on the cheeks, forehead, nose, and chin. These skin changes are caused by the presence of high levels of ovarian, placental, and pituitary hormones. A woman with chloasma appears in Figure 23-7B.
Renal disease is a major concern to dental implant therapy. First, it should be carefully evaluated through the medical history (Wakley and Baylink 1988), because epinephrine and norepinephrine are naturally produced in the medulla of the kidney and are responsible for regulation of blood pressure, myocardial contraction, and excitability. Glucocorticoids from the cortex are responsible for regulation of carbohydrates, fat, and protein metabolism. Hypofunction of the adrenal gland may lead to Addison's disease, which is manifested by weight loss, hypotension, and nausea with or without vomiting. Oral manifestation is hyperpigmentation of lips and gingiva. The hyperfunction causes Cushing's syndrome, manifested by moon face, hypertension, and decreased collagen production patients suffer from
Busulfan is an alkylating agent that forms DNA-DNA and DNA-protein cross-links to inhibit DNA replication. Oral busulfan is well absorbed, has a terminal half-life of 2 to 2.5 hours, and is eliminated primarily by metabolism. Busulfan has shown significant clinical activity in the treatment of acute myelogenous leukemia and chronic myelo-cytic leukemia. Side effects include bone marrow suppression, hyperpigmentation of skin creases, and rarely, pulmonary fibrosis. High doses used for bone marrow transplant preparatory regimens result in severe nausea and vomiting, tonic-clonic seizures, and sinusoidal obstruction syndrome (formerly known as veno-occlusive disease). Patients receiving high-dose busulfan should receive anticonvulsant prophylaxis.
Seen almost entirely in females characterized by skin lesions present during the first few weeks of life that are erythematous, macular, papular, vesicular, or bullous second stage, skin lesions are variably verrucous, lichenoid, or keratotic third stage, lesions are notable for hyperpigmentation abnormalities of the eyes, central nervous system, hair, teeth, and bone are commonly associated
VP is particularly found in southern Africa. It mimics AIP and CHP clinically, and photosensitivity is common. 76 In addition, a variety of skin lesions, including hyperpigmentation, hypertrichosis, vesicles, and bullae, are seen in patients with VP. Excretion patterns are similar to those of HCP, except the excreted amount of porphobilinogen exceeds coproporphyrin in VP whereas they are approximately equal in HCP. Treatment is the same as for AIP and HCP.
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