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SHORT COMMUNICATION
Long-term Use of Topical Bimatoprost on Rhododendrol-induced Refractory Leukoderma: A Case
Report
Saki FUKAYA 1 , Masahiro KAMATA 1 *, Tomoko KASANUKI 2 , Makoto YOKOBORI 2 , Shintaro TAKEOKA 1 , Kotaro HAYASHI 1 ,
Takamitsu TANAKA 1 , Atsuko FUKUYASU 1 , Takeko ISHIKAWA 1 , Takamitsu OHNISHI 1 , Satoshi IIMURO 2 , Shinichi WATANABE 1
and Yayoi TADA 1
1
Department of Dermatology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, and 2 Teikyo Academic
Research Center, Teikyo University, Tokyo, Japan. *E-mail: [email protected]
Rhododendrol (RD) inhibits melanin synthesis, and has
been used in skin-whitening cosmetic products. How
ever, some individuals have developed leukoderma on
the skin at the site of RD application and refractory
depigmentation has occurred even after ceasing appli-
cation of RD (1–4). Skin-whitening cosmetic products
containing RD were discontinued in 2013. Bimatoprost
is a prostaglandin F2α analogue, which is often used to
promote eyelash growth (5) for cosmetic reasons and in
the treatment of glaucoma (6, 7). Following reports that
bimatoprost induces skin pigmentation as an adverse
effect (8–12), we previously conducted an open-label
single-centre pilot study to evaluate the effectiveness
of bimatoprost on refractory RD-induced leukoderma
(13). Following the previous study, in which patients
applied bimatoprost for 6 months, one patient requested
to continue application of bimatoprost. Five months after
Accepted Aug 22, 2019; E-published Aug 22, 2019
discontinuation of bimatoprost at the end of the pilot
study, she re-started topical application of bimatoprost
and continued for 14 months. We report here a case of
refractory RD-induced leukoderma treated with bimato-
prost for approximately 1.5 years in total.
CASE REPORT
A 40-year-old Japanese woman started using cosmetics containing
RD in April 2011. She developed leukoderma on her face and neck
in April 2013 where she had applied RD. Thereafter, she disconti-
nued the cosmetics containing RD in August 2013. Although the
leukoderma on her face gained repigmentation without any further
treatment after discontinuation of RD, the leukoderma on her neck
had not improved for more than 3 years. The patient was enrolled in
the previous pilot study to evaluate the effectiveness of bimatoprost
on refractory RD-induced leukoderma in November 2016 at the
age of 45 years (patient number RD-07), and applied bimatoprost
on leukoderma on the left side of the neck
once daily for 3 months, and then twice
daily for another 3 months. The method is
described in detail in the previous paper
(13). The area of leukoderma on her neck,
which was treated with bimatoprost, redu-
ced in size significantly (Fig. 1A, B), and
the patient requested to continue applying
bimatoprost after the end of the study.
After receiving another approval from
Teikyo University Institutional Review
Board, 5 months after discontinuation of
application of bimatoprost in the study,
she re-started to apply bimatoprost on
leukoderma on both the right and left side
of her neck and continued application of
bimatoprost for 14 months (Fig. 1C, D).
The areas of leukoderma reduced in size
further after application of bimatoprost.
Fig. 1. Case report. (A) Rhododendrol (RD)-
induced leukoderma before topical application
of bimatoprost to the neck. (B) RD-induced
leukoderma on the neck 6 months after
starting application of bimatoprost in the pilot
study. (C) RD-induced leukoderma 5 months
after discontinuation of topical application of
bimatoprost and before re-starting to apply
bimatoprost. (D) RD-induced leukoderma 14
months after re-starting to apply bimatoprost.
mo: month; mos: months. (E) Changes in
the results of the colour-difference meter on
leukoderma on the left side of the neck. Time
0: time at which bimatoprost application was
started in the pilot study in this patient. Circle:
L* value; triangle: a* value; square: b* value.
doi: 10.2340/00015555-3299
Acta Derm Venereol 2019; 99: 1178–1179
This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta
Journal Compilation © 2019 Acta Dermato-Venereologica.