Objectives: Inaesthetic leg stasis: Treatment by peeling
So what is it possible to propose to reduce the pigmentation?
It is possible to propose laser, IPL or peels? IPL exposes to the risk of burns as others lasers emitting in millisecond. With laser device, most of them are efficient but the burn risk is high except with the Q-switched laser. It allows to result in medium-superficial peel effect like TCA peels.
Introduction: Legs Cutaneous pigmentation often causes cosmetic problems for the patients.
Stasis dermatitis occurs secondary to venous hypertension of the lower extremities.
Hemosiderin and/or melanin have been considered responsible for the brown pigmentation
Materials / method: Melanin is the major determinant of the normal skin color. Other contributing chromophores are oxyhemoglobin (red), deoxygenated hemoglobin (blue), and carotene (yellow-orange). However, there has been no report except except few articles clarthrifying the role of melanin or melanocytes in the production of cutaneous pigmentation in stasis dermatitis.
Results: Stasis dermatitis develops as a complication of impaired venous return, and shows the vascular proliferation, red blood cells extravasation, and hemosiderin deposition histologically.
Inflammatory cytokines or growth factors have been considered responsible for the pathogenesis of venous leg ulceration. The mechanism suggested that iron (hemosiderin), various cytokines or growth factors derived from vascular inflammation might have an unproven effect on possible pluripotent stem cells which are involved in the development of dermal melanocytes inducing the pigmentation.
Conclusion: With peels, the difficulty is to obtain an homogenen penetration of active ingredients. We propose specific peels under occlusion during 4t o 6 hours to induce a progressive unpainfull epidermolysis for whitening the skin. Even, it take between 1 to 3 sessions every 6 weeks, we can expect a reduction around 60% of the ocer dermatitis.
From some clinical cases we propose to illustrate this and to define therapeutic conduct.
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