Pearl Grimes

Pearl Grimes
Vitiligo & Pigmentation Institute of Southern California

MD

About

109
Publications
85,140
Reads
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5,265
Citations
Citations since 2017
9 Research Items
1686 Citations
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2017201820192020202120222023050100150200250300
2017201820192020202120222023050100150200250300
Additional affiliations
February 2005 - present
University of California, Los Angeles
Position
  • Clinical Professor of Dermatology
January 1994 - January 2005
University of California, Los Angeles
Position
  • Professor (Associate)
November 1992 - January 1996
Charles R. Drew University of Medicine and Science
Position
  • Professor (Associate)
Education
- January 1974
January 1967 -
Jackson State University
Field of study
  • Biology

Publications

Publications (109)
Article
Vitiligo is a chronic autoimmune disease that targets melanocytes, causing skin depigmentation. Disease pathogenesis is largely regulated by interferon-γ activation of the Janus kinase (JAK) signalling pathway. A cream formulation of the JAK1/JAK2 inhibitor ruxolitinib demonstrated substantial re-pigmentation in two randomized, double-blind, vehicl...
Article
Vitiligo is a chronic inflammatory autoimmune disease that targets melanocytes, causing skin de-pigmentation. A cream formulation of the Janus kinase (JAK) 1/JAK2 inhibitor, ruxolitinib demonstrated substantial re-pigmentation in a phase 2 study in adults with vitiligo. In two multinational, randomized, double-blind, vehicle-controlled phase 3 stud...
Article
No United States paradigm for the treatment of paediatric, adolescent and young adult vitiligo has been developed. To develop evidence and consensus-based expert opinion to promote therapeutic consistency for the diagnosis and treatment of vitiligo. An IRB-exempted process was developed to produce consensus recommendations based on literature revie...
Article
Background: Vitiligo is a chronic autoimmune disease that causes skin depigmentation. A cream formulation of ruxolitinib (an inhibitor of Janus kinase 1 and 2) resulted in repigmentation in a phase 2 trial involving adults with vitiligo. Methods: We conducted two phase 3, double-blind, vehicle-controlled trials (Topical Ruxolitinib Evaluation in...
Article
A Novel Proof of Concept Study Assessing the Lightening Effects and Safety of Malassezin for Treatment of Facial Hyperpigmentation
Poster
The Malassezia species are commensal to the skin microbiome and implicated in skin and scalp diseases, including tinea versicolor and seborrheic dermatitis. In cases of tinea versi-color, Malassezia overgrowth often results in skin pigmentation changes (including both hypo-and hyper-pigmentation). The purpose of this study was to link the benign pi...
Article
Background/objectives: This trial evaluated the effectiveness and safety of Bellafill for full-face acne scar treatment. Patients and methods: In this open-label, nonrandomized, multicenter pilot study investigating the use of polymethylmethacrylate for full-face atrophic acne scar correction, 42 adult subjects with a mean age of 43 years were t...
Article
Full-text available
BACKGROUND: Polymethylmethacrylate (PMMA)-collagen [Bellafill] consists of PMMA microspheres suspended in a carrier of bovine collagen gel.1 A Randomized Double-Blind study demonstrated the safety and effectiveness of this product in correcting atrophic acne scars. Results of the 6-month endpoint was previously described in Karnik et al.2 To determ...
Article
Background: Topical prostaglandin E<sub>2</sub> has shown efficacy in patients with localized, stable vitiligo. Bimatoprost is a synthetic prostamide (prostaglandin-ethanolamides) F<sub>2</sub>a analog. Bimatoprost 0.03% ophthalmic solution showed efficacy in the treatment of vitiligo in one small study. OBJECTIVE: To assess the efficacy and safet...
Article
Full-text available
The color of skin is indeed intriguing for it evokes a plethora of societal perceptions, emotions, inclusionsandexclusions,aswell asunderstanding and misunderstandings. -peg Individuals with darker skin typescomprise the majority of the global population. By the year 2050, the United States census data suggest that at least 50% of Americans will re...
Article
In reply On behalf of all coauthors, we would like to thank Dr Passeron for his interest in our publication.¹ We agree with the statement that because the melanogenic effect of afamelanotide requires the presence of melanocortin-1 receptor (MC1R), stimulation of melanoblast differentiation by phototherapy is required. This very point was discussed...
Article
Importance Narrowband UV-B (NB–UV-B) phototherapy is used extensively to treat vitiligo. Afamelanotide, an analogue of α–melanocyte-stimulating hormone, is known to induce tanning of the skin.Objective To evaluate the efficacy and safety of combination therapy for generalized vitiligo consisting of afamelanotide implant and NB–UV-B phototherapy.D...
Article
Full-text available
Acne scarring remains a stubborn clinical problem. Few treatments have been shown to be definitely effective for this problem. Polymethylmethacrylate (PMMA) microspheres in collagen (ArteFill, Suneva Medical Inc, Santa Barbara, CA) have shown long-term benefit for nasolabial fold treatment. A pilot study has shown benefit for PMMA-collagen in atrop...
Article
Melasma is a chronic, relapsing disorder that can be disfiguring and can have adverse effects on quality of life. Recently, a unique hydroquinone-free topical product addressing multiple pathways involved in pigmentation was shown to have similar efficacy and equally well tolerated as 4% hydroquinone in females with facial hyperpigmentation. The go...
Article
Although the use of the hyaluronic acid with cohesive polydensified matrix hyaluronic acid has been well explored in subjects with lighter skin (i.e., Fitzpatrick skin types I, II, and III), further exploration in subjects with Fitzpatrick skin types IV, V, and IV is warranted. The primary purpose of the study was to assess the safety of a cohesive...
Article
We sought to evaluate the efficacy and tolerability of treating melasma using a 4% hydroquinone skin care system, including a proprietary cleanser, toner, 4% hydroquinone, exfoliation enhancer, and sunscreen, plus tretinoin cream 0.025%. Together these products offer not only treatment of melasma but also a complete skin care regimen. Twenty partic...
Article
Vitiligo is characterized by depigmented patches of skin due to loss of cutaneous melanocytes. Many recent studies have demonstrated defects in the melanocortin system in patients with vitiligo, including decreased circulating and lesional skin levels of α-melanocyte-stimulating hormone (α-MSH). Afamelanotide is a potent and longer-lasting syntheti...
Chapter
Jessner’s solution has been used for over 100 years as a therapeutic agent to treat hyperkeratotic epidermal lesions [1]. This superficial peeling agent constitutes a mixture of salicylic acid, resorcinol, and lactic acid in 95% ethanol. Jessner’s solution causes loss of corneocyte cohesion and induces intercellular and intracellular edema. Jessner...
Chapter
Microdermabrasion is a popular technique for superficial resurfacing of the skin [1]. It involves the propulsion of abrasive microcrystals on to the treatment area in short strokes using a special handpiece. The handset simultaneously vacuums away the used abrasive particles and skin debris. The speed of the particles (and the vacuum suction) can b...
Article
The Melasma Area and Severity Index (MASI), the most commonly used outcome measure for melasma, has not been validated. We sought to determine the reliability and validity of the MASI. After standardized training, 6 raters independently rated 21 patients with mild to severe melasma once daily over a period of 2 days to determine intrarater and inte...
Article
Melasma is often recalcitrant to treatment. Triple combination (TC) cream is an effective and approved treatment for melasma. We sought to determine the efficacy and safety of continuous therapy followed by a maintenance treatment regimen during a period of 24 weeks with a TC cream containing hydroquinone 4%, tretinoin 0.05%, and fluocinolone aceto...
Article
Sarcoidosis is a systemic disease of unknown etiology that is characterized by noncaseating granulomatous inflammation of various organs. Isolated nasal cutaneous involvement is very uncommon (0.3%-4.0% of the patients reported) and rarely do sarcoid lesions present as severe nasal deformities and surgical treatment is rarely warranted. We present...
Article
This 16-week study evaluated once-daily tazarotene 0.1% cream and adapalene 0.3% gel in patients with moderate-to-severe acne. Patients treated with tazarotene 0.1% cream performed better in many acne efficacy measures (reduction in lesion counts, percentage of patients achieving a 50 percent lesion count reduction, overall disease severity, invest...
Article
Full-text available
Tretinoin is considered the benchmark prescription topical therapy for improving fine facial wrinkles, but skin tolerance issues can affect patient compliance. In contrast, cosmetic antiwrinkle products are well tolerated but are generally presumed to be less efficacious than tretinoin. To compare the efficacy of a cosmetic moisturizer regimen vs....
Article
Recently, the cosmetic market has seen an increase in the options for treatment for people with dark skin. This study evaluates the use of calcium hydroxylapatite (CaHA), a dermal filler indicated for the correction of moderate to severe facial wrinkles and folds, including the nasolabial folds (NLFs) in individuals with dark skin. This open-label,...
Article
To assess the safety and effectiveness of hyaluronic acid (HA) fillers in skin of color. Two prospective studies followed up subjects with Fitzpatrick skin phototypes of IV, V, or VI for 24 weeks after dermal filler injections. In a double-blind, randomized study, subjects were injected with one of three high concentration (24 mg/mL) HA fillers (Ju...
Article
Melasma is a common disorder affecting a significant percentage of the population, particularly those with skin of color. Therapy with hydroquinone, a depigmenting agent, as a single agent or in combination with other agents has been used with variable success. A triple-combination (TC) cream combining hydroquinone 4% with tretinoin 0.05% and fluoc...
Article
Skin aging integrates the impact of extrinsic skin insults (e.g., ultraviolet [UV] light, etc.) with chronological, genetically programmed decreases in cellular function. A genomic study of aged skin highlighted the mechanistic importance of skin barrier function, exfoliation, control of reactive oxygen species and maintenance of extracellular matr...
Article
Dyschromias, in particular hyperpigmentation, are major issues of concern for people of color. Pigmentary disorders such as melasma and postinflammatory hyperpigmentation (PIH) can cause psychological and emotional distress and can pose a negative impact on a person's health-related quality of life. The precise etiology of these conditions is unkno...
Article
Postinflammatory hyperpigmentation (PIH) commonly occurs in Fitzpatrick skin types III to VI and can have a considerable impact on quality of life. The majority of cases will improve spontaneously, but this can take months or even years to resolve and in some cases can be permanent. Treatment may be prolonged, lasting 6 to 12 months or longer for a...
Article
It has been generally believed that the four main causes of melasma are pregnancy, hormonal contraception, family history and sun exposure; however, there are few published comprehensive studies that confirm these assertions. The Pigmentary Disorders Academy - an international group of experts in pigmentary disorders - designed and conducted a glob...
Article
Histologic differences (e.g., dermal thickness, collagen fibers) between Caucasian and other racial and ethnic groups may affect wrinkle formation and influence responses to treatment with botulinum toxin type A (BoNT-A). To evaluate the degree and duration of efficacy of 20 and 30 U of BoNT-A for the treatment of glabellar lines in African-America...
Article
It is well known that the setting of clinical trials for registration studies do not necessarily represent efficacy seen in clinical practice, where physicians have the flexibility to select, combine, and change the acne treatment prescription. In this phase 4, open-label, multicenter, community-based study, 544 patients who were dissatisfied with...
Chapter
IntroductionSpectrum of diseaseTherapeutic approachesTopical steroid therapyTopical photochemotherapy (out-patient)Topical photochemotherapy wth sunlightSystemic photochemotherapyAutologous graftingAdjunctive therapySummary
Article
Melasma is a common disorder of hyperpigmentation typically characterized by relatively symmetric brown or gray-brown patches on sun-exposed facial areas. Treating melasma is challenging because of the prolonged time to response and the substantial relapse rate when therapy is discontinued. The objective of this 12-week study was to compare the cli...
Article
Background: Salicylic acid is a beta-hydroxy acid with keratolytic, comedolytic and anti-inflammatory properties. Patients with darker skin tones require superficial peeling agents effective for ther primary skin condition like acne as well as for associated postinflammatory hyperpigmentation that is commonly present. The scientific literature prov...
Article
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...
Article
This article focuses on developments in pigmentary disorders that extend dermatologists' understanding of the field. Areas that are reviewed include the basic biochemistry, pharmacology, and physiology of the melanocortin system; melanosome development; genetic diseases associated with pigmentary disorders; pigmentary disorders secondary to systemi...
Article
Melasma is a common hyperpigmentation disorder that is frequently recalcitrant to treatment. An 8-week, multicenter, open-label, community-based study evaluated a new therapeutic approach that combines tretinoin 0.05%, hydroquinone 4.0%, and fluocinolone acetonide 0.01% (RA+HQ+FA) in a hydrophilic cream formulation. The trial enrolled 1290 patients...
Article
In summary, multiple studies have documented the efficacy of topical agents (retinoids, antioxidants, and topical bleaching agents) used in combination with superficial and/or mediumdepth or deep peeling agents for photodamage. The treatment of photodamage requires a multifaceted approach incorporating sun protection, antioxidants, exfoliating agen...
Article
Optimal treatment for PIH includes prevention of further pigment deposition and clearing of the deposited pigment. Chemical peels work best when used in combination with topical bleaching regimens. Given the propensity of darker skin types to develop post-inflammatory hyperpigmentation, superficial peels work best, while minimizing complications.
Article
P.G. Unna, a German dermatologist, was the first to describe the properties and use of salicylic acid. It has since been used for many decades as a keratolytic agent in concentrations of 3–6%. Salicylic acid is frequently utilized in topical acne preparations because of its comedolytic effects. In addition, it facilitates the penetration of other t...
Article
The author has extensive experience using the combination of salicylic acid and TCA 10–15% for facial peeling [1]. She has treated innumerable patients with moderate to severe melasma with this combination regimen. In the initial series of 27 patients, 9 were classified as Fitzpatrick skin type IV, 11 were skin type V, and 7 were skin type VI. Many...
Article
In contrast to the previous decade, chemical peels are commonly performed in darker racial-ethnic groups, individuals comprising skin types IV-VI (Asians,Hispanics, Blacks, and Native Americans). Serial superficial glycolic acid, salicylic acid, Jessner's solution, and TCA peels (when appropriate) offer substantial benefits for post-inflammatory hy...
Article
Previous investigations have reported the efficacy of tazarotene 0.1% cream for the treatment of dyschromia associated with photoaging and for acne vulgaris. The present investigation assessed tazarotene 0.1% cream for the treatment of postinflammatory hyperpigmentation (PIH) in a double-blind, randomized, vehicle-controlled study of 74 patients fr...
Article
Microdermabrasion has become one of the most popular forms of superficial resurfacing. The benefits and efficacy of microdermabrasion remain an intensely debated topic among dermatologic surgeons. This article reviews the efficacy, safety, epidermal barrier function, histopathologic effects, complications, advantages, and disadvantages of microderm...
Article
Despite new technologies, few studies have assessed the histologic alterations in patients with melasma. Using current technologies, the present study was designed to re-evaluate the light microscopic, immunohistochemical, and ultrastructural changes of the hyperpigmented and adjacent normal skin of patients with melasma. Twenty-one patients were i...
Article
Quiz Ref IDVitiligo is a relatively common, acquired pigmentary disorder characterized by areas of depigmented skin resulting from loss of epidermal melanocytes. The prevalence of this disease varies from 0.1% to 2% in various global populations. Onset may occur at any age, but the incidence usually peaks in the second and third decades of life. Pa...
Article
Disorders of hyperpigmentation such as melasma and postinflammatory hyperpigmentation (PIH) are common, particularly among people with darker skin types. Hydroquinone (HQ) bleaching creams are considered the gold standard for treating hyperpigmentation. Recently, a new formulation of HQ 4% with retinol 0.15% entrapped in microsponge reservoirs was...
Conference Paper
Disorders of hyperpigmentation such as melasma and postinflammatory hyperpigmentation (PIH) are common, particularly among people with darker skin types. Hydroquinone (HQ) bleaching creams are considered the gold standard for treating hyperpigmentation. Recently, a new formulation of HQ 4% with retinol 0.15% entrapped in microsponge reservoirs was...
Article
Previous studies have documented humoral and cell-mediated immunologic defects in patients with vitiligo. This 24-week study assessed the efficacy and safety of tacrolimus 0.1% ointment in patients with generalized vitiligo as well as the pretreatment and post-treatment expression of cytokines in the depigmented and normal skin of patients compared...
Article
Conflicting data have been published on the inherent differences in skin surface properties among various ethnic groups, though there is a widespread perception that differences exist. This study included subjective and objective assessments of skin surface properties in African American and white subjects. A dermatologist conducted visual assessme...
Article
The beneficial effects of alpha-hydroxyacids (AHAs) on skin were discovered by Drs. Van Scott and Yu in the early 1970s, including exfoliation, skin smoothing, and antiaging effects. A new generation of AHAs, called polyhydroxy acids (PHAs), was discovered that provide similar effects as AHAs but do not cause the sensory irritation responses that c...
Article
We describe 6 patients with generalized vitiligo who responded to treatment with tacrolimus ointment. Moderate to excellent repigmentation was achieved in 5 patients. Although the number of cases in this noncontrolled, nonblinded series is small, tacrolimus ointment may be an efficacious and safe treatment option for vitiligo.
Article
Microdermabrasion has become an extremely popular method for superficial resurfacing. Despite the popularity of this technique, published studies of skin barrier function changes following microdermabrasion are lacking. To study assessed transepidermal water loss (TEWL), hydration, pH, and sebum production following aluminum oxide (Al2O3) and sodiu...
Article
The syndrome of idiopathic CD4+ T lymphocytopenia (ICTL) is defined as the persistent depletion of peripheral blood CD4+ T lymphocytes below 300 cells/mm(3) or less than 20% of the total lymphocytes in the absence of either HIV infection or other known causes of immunodeficiency. To date no known viral origin has been identified. ICTL has a variabl...
Article
Vitiligo is a cosmetically disfiguring and emotionally exhausting disease that affects all races and ethnic groups. In the past few years, significant advances have been made in treating this challenging condition. This article reviews considerations in choosing a therapy, provides details regarding various practical and efficacious therapies, and...
Article
BACKGROUND: Microdermabrasion has become an extremely popular method for superficial resurfacing. Despite the popularity of this technique, published studies of skin barrier function changes following microdermabrasion are lacking. OBJECTIVE: To study assessed transepidermal water loss (TEWL), hydration, pH, and sebum production following aluminum...
Article
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. To assess the histologic features of hypopigmentation caused by laser resurfacing and to evaluate the e...
Article
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 resurfacin...
Article
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.
Article
There is a dearth of published data regarding chemical peels in darker racial-ethnic groups. 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. Twenty-five patients were included in this pilot investigation. Nine had acne vulgaris, 5...
Article
This multicenter, randomized, double-masked, parallel-group study assessed the efficacy, safety, and tolerability of azelaic acid 20% cream compared with those of its vehicle for the treatment of facial hyperpigmentation in darker-skinned patients (phototypes IV to VI). Following a 24-week treatment period, azelaic acid produced significantly great...
Article
Viral infections have been implicated in the pathogenesis of a variety of autoimmune diseases. This investigation was undertaken to determine the presence or absence of viral genomes in the depigmented and uninvolved skin of patients with vitiligo. A polymerase chain reaction assay was used to detect viral genomes in paraffin-embedded skin biopsy s...
Article
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....
Article
The precise mechanisms responsible for the induction of immunological aberrations in vitiligo are unknown. Clinical and experimental evidence suggests that a variety of chemicals may have profound effects on the immune system by influencing antibody and cytokine production. Benzene, a ubiquitous chemical, is the parent compound for phenols, catecho...
Article
Background: Melasma is a common acquired symmetric hypermelanosis characterized by irregular light- to gray-brown macules and patches involving sunexposed 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...
Article
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 t...
Article
Vitiligo is a disease of unknown origin that causes destruction of melanocytes in the skin, mucous membranes, the eyes, and occasionally in hairbulbs and in the ears. The loss of melanocytes alters both structure and function of these organs. The goals of therapy are multifold. The primary goal is to restore melanocytes to the skin so that the epid...
Article
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...
Article
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 prac...
Article
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.
Article
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...
Article
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...
Article
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, a...
Article
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 w...
Article
Because the therapy of vitiligo is long and tedious, often requiring twelve to eighteen months, one must first evaluate the intensity of the patient's desire for treatment. If a decision is made to treat the patient, the physician must then decide whether oral or topical therapy is indicated. If the area to be treated occupies less than 20 percent...
Article
Vitiligo patients may experience profound psychological despair secondary to this disease. Physicians at large have been insensitive to the psychological needs of the vitiligo patient and to the importance of treatment. Vitiligo can and should be treated, especially in those individuals whose life-style, self-esteem, and productivity have been dram...

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