The aim of this study was to compare the efficacy of TXA with other therapies for melasma.Melasma is a common acquired skin condition characterized by hypermelanosis,causing light to dark patches,and is the most preva...The aim of this study was to compare the efficacy of TXA with other therapies for melasma.Melasma is a common acquired skin condition characterized by hypermelanosis,causing light to dark patches,and is the most prevalent in individuals with Fitzpatrick skin typesⅢtoⅥ.It is a complex condition with an unclear etiology,often influenced by factors such as excessive sun exposure and hormonal changes.Treating melasma poses significant challenges for healthcare providers,primarily due to its tendency to reoccur.This makes management strategies crucial for achieving lasting results and improving patient outcomes.A systematic review of randomized controlled trials(RCTs)was conducted using databases such as MEDLINE,EMBASE,Google Scholar,and Cochrane,yielding 10 studies encompassing 455 participants.The analysis incorporated oral,topical,and injectable forms of TXA,with treatment durations ranging from 8 weeks to 1 year.Pooled results using a random-effects model indicated a moderate effect size of 0.477,suggesting TXA′s efficacy in reducing melasma severity.However,high heterogeneity(I 2=97.62%)reflected variations in study protocols,TXA delivery methods,and patient demographics.展开更多
OBJECTIVE:To analyze the chemical components of Mudan Huaban recipe(牡丹化斑方,MHR)and evaluate its efficacy and possible mechanism in melasma mice.METHODS:The chemical compositions of MHR were determined by the ultra...OBJECTIVE:To analyze the chemical components of Mudan Huaban recipe(牡丹化斑方,MHR)and evaluate its efficacy and possible mechanism in melasma mice.METHODS:The chemical compositions of MHR were determined by the ultra-high performance liquid chromatography coupled with quadrupole-exactive mass spectrometry method.Female C57BL/6 mice were exposed to ultraviolet B and progesterone for 21 d to induce melasma,and Fontana-Masson staining was used to assess the effects of MHR on melasma.Luteinizing hormone(LH),estradiol,and follicle-stimulating hormone levels were detected by enzyme-linked immunosorbent assay.The superoxide dismutase(SOD)activity and malonic dialdehyde content were detected by chemiluminescence.Tyrosinase and related proteins expressions were detected by Western blots and immunohistochemistry.RESULTS:A total of 43 chemical components were identified in MHR,MHR significantly decreased the melanin particles of melasma mice.MHR treatment significantly reversed the high contents of LH and low activity of SOD in models.MHR significantly reduced the higher levels of tyrosinase,tyrosinase-related proteins-1(TRP-1),TRP-2,microphthalmia-associated transcription factor and phosphorylation of cyclic adenosine monophosphate response element-binding protein(pCREB)/CREB in the skin of melasma mice.CONCLUSIONS:MHR protects against melasma via regulation of sex hormones,oxidative stress,and melanogenesis-related proteins,suggesting its possible use as a supplement and alternative drug therapy for melasma.展开更多
Objective:To investigate the potential efficacy and safety of Lutai Danshen Baishao granules(LDBG)for treating female melasma associated with kidney deficiency and blood stasis patterns.Methods:A randomized,double-bli...Objective:To investigate the potential efficacy and safety of Lutai Danshen Baishao granules(LDBG)for treating female melasma associated with kidney deficiency and blood stasis patterns.Methods:A randomized,double-blind,placebo-controlled trial was conducted at the Third Central Hospital of Tianjin,China from March to December 2023.A total of 110 female patients with melasma linked to kidney deficiency and blood stasis were enrolled and treated with either LDBG or a placebo twice daily for 60 days.Efficacy was assessed through measures such as the total melasma area,reduced melasma area,reduction rate of melasma area,melasma color score,Melasma Area and Severity Index(MASI)score,and traditional Chinese medicine(TCM)symptom score scale.Safety assessments included routine blood and biochemical tests.Results:Participants in both groups were aged 52-63 years,with no significant differences.After the 2-month intervention,the total melasma area decreased in both groups;however,a greater reduction was observed in the test group[462.50 mm^(2)(12.81%)vs.100.00 mm2(3.11%),P<.001].Moreover,LDBG treatment significantly reduced the MASI and melasma color scores in the test group(P<.05).The total TCM symptom evaluation score significantly decreased(test group:6.00 vs.placebo group:7.00,P=.001),with significant relief in symptoms such as improvement in dark lips,nails,and waist soreness in the test group,compared with that in the placebo group(P<.05).Within-group comparisons revealed that TCM syndrome was significantly alleviated in the test group(P<.05).Conclusion:LDBG intervention shows promising effectiveness in reducing female melasma and alleviating TCM syndromes.展开更多
Background:Melasma is a prevalent skin disorder affecting a wide range of populations.In Unani system of medicine,a traditional healing system with a rich historical background,there exists a repository of therapeutic...Background:Melasma is a prevalent skin disorder affecting a wide range of populations.In Unani system of medicine,a traditional healing system with a rich historical background,there exists a repository of therapeutic modalities for melasma,elucidated by esteemed scholars and practitioners.Despite its extensive utilization,the scientific substantiation supporting these interventions remains limited.Objective:This study aims to scientifically evaluate and compare the safety and efficacy of topically applied Raphanus sativus seed powder and honey mixture versus hydroquinone(4%w/w)cream for melasma treatment.Methods:In this 8-week open-label,randomized controlled trial,40 participants(20 per group),aged 18–65 years and diagnosed with melasma,successfully completed the study.The test group applied finely powdered Raphanus sativus seeds mixed with honey twice daily,while the control group used hydroquinone(4%w/w)cream twice daily.Primary outcome measure was change in modified Melasma Area and Severity Index(mMASI)at each follow-up.Secondary measures examined subjective nuances using a 100mm visual analogue scale(VAS)and recorded the dermatology life quality index(DLQI)at baseline and the conclusion of the study.Safety was ensured through comprehensive clinical reviews,with documentation of adverse events during bi-weekly follow-ups.Results:Following the conclusion of the study,the mean difference in the mMASI score between the test and control groups was–0.22(95%CI:–0.75 to 0.30,d=0.27,p=0.394).Additionally,post-trial mean differences in VAS and DLQI scores between the test and control groups were determined as–5.25(95%CI:–10.65 to–0.15,d=0.62,p=0.056)and–0.10(95%CI:–1.53 to 1.33,d=0.04,p=0.888),respectively.Conclusion:Based on the investigative findings,the test intervention involving Raphanus sativus and honey demonstrated therapeutic efficacy statistically comparable to conventional hydroquinone treatment for managing melasma,with no reported adverse reactions.Moreover,both groups exhibited statistically comparable improvements in the dermatology life quality index.展开更多
Melasma is a prevalent and challenging skin condition that affects the face and causes distress in many patients and physicians.Tranexamic acid(TA)has been found to be effective for treating melasma and can be adminis...Melasma is a prevalent and challenging skin condition that affects the face and causes distress in many patients and physicians.Tranexamic acid(TA)has been found to be effective for treating melasma and can be administered through multiple routes.This review details the mechanisms of action of TA in treatment of melasma and assesses the efficacy and safety associated with different administrations,which can contribute to selecting appropriate melasma treatment plan for different patients.展开更多
Background: Melasma is an acquired pigmentation condition characterized by its refractory nature and a high risk of recurrence. Treatment of melasma is challenging owing to its unclear etiology, stubborn resistance to...Background: Melasma is an acquired pigmentation condition characterized by its refractory nature and a high risk of recurrence. Treatment of melasma is challenging owing to its unclear etiology, stubborn resistance to treatment, and frequent relapses. Therefore, this study aimed to compare the efficacy, effectiveness, and safety of monotherapy and combination therapy(combination of laser and tranexamic acid(TXA)) for the treatment of melasma using a network meta-analysis.Method: The PRISMA guidelines were used in this meta-analysis, with a literature search conducted in reputable sources, such as Cochrane, Science Direct, Pub Med, and Google Scholar.Results: From the initial search, 1 504 relevant studies were identified. After careful analysis, three studies were included in the meta-analysis. The results showed no significant differences in the Melasma Area and Severity Index(MASI) score between monotherapy(control group) and a combination therapy of laser and TXA. The mean difference in MASI score was 1.87(95% confidence interval(CI),-0.78–4.52;P=0.17), indicating no significant difference between the two treatment approaches. Side effects were more common in the combination treatment group than in the control group. The odds ratio for experiencing side effects was 8.85(95% CI, 1.57–50.01;P=0.01).Conclusion: Both the monotherapy and combination therapy groups showed therapeutic improvement;however,the combination therapy group showed a higher incidence of side effects.展开更多
Chloasma, or melasma, is a commonly acquired pigmentary disorder among Asian women. It may be considered as a physiological change during pregnancy. The incidence in Asian women is higher than that in other ethnic gro...Chloasma, or melasma, is a commonly acquired pigmentary disorder among Asian women. It may be considered as a physiological change during pregnancy. The incidence in Asian women is higher than that in other ethnic groups but further epidemiologic data are needed. There are very few studies related to the benefits of sunscreens to prevent this dermatosis. The aim of this study was to assess the effectiveness of a broad-spectrum sunscreen in the prevention of melasma in Korean pregnant women. We tested the effectiveness and tolerance of a sunscreen product (SPF 50+, UVA-PF 30) during a 12-month clinical trial including 220 Korean parturients with skin type III and IV. 217 women completed the study. Only 3 (1%) of the study population developed melasma, which was mild (MASI grade between 1.2 and 2.7). In addition, the clinical effectiveness of the evaluated sunscreen was judged “good to excellent” by the majority of study participants and by the research dermatologists. The “excellent” tolerance of the sunscreen under evaluation was confirmed “good” to “excellent” in 95% and 97% of cases. This study clearly demonstrates that this broad-spectrum sunscreen is well tolerated and effective in the prevention of melasma in Korean pregnant women. Although treatment remains elusive, prevention is possible.展开更多
Background: Facial melanosis is a major pigmentery problem seen in the daily clinical practice. Melasma and lichen planus actinicus are among these common causes. Still some facial melanosis that had features of melas...Background: Facial melanosis is a major pigmentery problem seen in the daily clinical practice. Melasma and lichen planus actinicus are among these common causes. Still some facial melanosis that had features of melasma and butterfly lichen planus actinicus but could not be classified to either of them. Objective: To evaluate melasma, lichen planus actinicus and cases that could not be classified into one or either of them using clinical picture, Wood’s lump examination, and histopathological assessment. Patients and Methods: This is a case descriptive, comparative, clinical and histopathologicasl study carried out in Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq during the period from December 2012-May 2014. Forty patients with facial hyperpigmentation were included in this study. Twelve (30%) were males and 28 (70%) were females with female to male ratio: 2.3:1. Mean age ± SD of studied patients was 37.07 ± 9.63 years. History, physical examination, Wood’s lump examination and photographic pictures were done for all patients. Punch biopsy was taken from each patient, and processed and stained with Hematoxylin-Eosin (HE) and Fontana-Masson (FM) for histological evaluations. Results: These diseases were classified into: melasma with 11 patients, female to male ratio: 4.5:1 with mean age ± SD was 33.64 ± 6.516 years, melasma-like lichen planus actinicus with 21 patients, female to male ratio: 2.5:1,mean age ± SD: 39 ± 8.349 years, butterfly lichen planus actinicus with 8 patients, female to male ratio: 1:1, mean age ± SD: 36.75 ± 15.088 years. This classification depends on the following findings: some of these results could be more frequent and intense in one than others;they were the diseases of young age group, that had more tendency to affect females than males, sun light exposure and outdoor activities were the main etiological factors, but these factors were more triggering in lichen planus actinicus followed by melasma-like lichen planus actinicus and to lesser extent in melasma. The skin types were mostly III, the location and distribution of pigmentation were almost similar, Wood’s lamp findings were similar although was not conclusive. The histopathological findings especially the level of melanin deposition and inflammatory infiltrate were comparable but the melanin deposition was more intense in butterfly lichen planus and melasma-like lichen planus actinicus and to lesser extent in melasma. Conclusion: From the epidemiological, clinical and histopathological findings of the present work, we can suggest a conclusion that melasma, butterfly lichen planus actinicus, and melasma-like lichen planus actinicus were inflammatory skin diseases that build up one spectrum where melasma at one pole and lichen planus actinicus at the other pole and melasma-like lichen planus actinicus at the middle. The young age group, during their active reproductive life, will have these diseases in relation to sun light exposure with seasonal variations.展开更多
Melasma, a kind of damaging disease, is commonly found in women during reproductive age. It causes great harm to patient＇s confidence and, has an effect on social contact as well. Melasma has been cured effectively b...Melasma, a kind of damaging disease, is commonly found in women during reproductive age. It causes great harm to patient＇s confidence and, has an effect on social contact as well. Melasma has been cured effectively by modern medicine and traditional Chinese medicine so far, in contrast, the treatment analysis system is far from flawless. Our research team is going to cooperate with Beijing University of Aeronautics and Astronautics and develop a computer-vision treatment analysis system for facial dermatosis based on present technology. It＇s supposed to provide clinical doctors with objective standards for melasma and other facial dermatosis.展开更多
目的:探究六味地黄汤结合表皮干细胞外泌体治疗黄褐斑的效果。方法:选取西安海棠中医美容医院2022年1月-2023年9月收治的120例黄褐斑患者,使用摸球法分为对照组和观察组,各60例。对照组予以表皮干细胞外泌体治疗,观察组予以六味地黄汤...目的:探究六味地黄汤结合表皮干细胞外泌体治疗黄褐斑的效果。方法:选取西安海棠中医美容医院2022年1月-2023年9月收治的120例黄褐斑患者,使用摸球法分为对照组和观察组,各60例。对照组予以表皮干细胞外泌体治疗,观察组予以六味地黄汤结合表皮干细胞外泌体治疗。对比两组临床疗效、黄褐斑严重程度指数(Melasma severity index,MASI)、皮损面积、生活质量、复发率。结果:与对照组(83.33%)相比,观察组临床总有效率(98.33%)更高(P<0.05)。治疗后,观察组M A S I评分(4.13±0.78)分,低于对照组的(5.99±1.10)分(P<0.001)。治疗后,观察组皮损面积(1.96±0.43)cm^(2),小于对照组的(2.83±0.62)cm^(2)(P<0.001)。治疗后,观察组生活质量[皮肤病生活质量指数(Dermatosis life quality index,DLQI)、黄褐斑生活质量评分量表(Melasma quality of life score,MELA-SQOL)]优于对照组(P<0.05)。观察组患者复发率(1.67%)低于对照组的(16.67%)(P<0.05)。结论:六味地黄汤结合表皮干细胞外泌体用于治疗黄褐斑,有助于改善黄褐斑症状与生活质量,减少皮损面积,临床疗效显著,值得临床推广。展开更多
The pathogenesis of melasma is believed to be related to heredity,sun exposure,sex hormones,and other factors.The mechanisms underlying the development of melasma include increased melanin synthesis,vascular prolifera...The pathogenesis of melasma is believed to be related to heredity,sun exposure,sex hormones,and other factors.The mechanisms underlying the development of melasma include increased melanin synthesis,vascular proliferation within the skin lesions,inflammation,and skin barrier dysfunction.The diagnosis of melasma is mainly based on clinical manifestations and noninvasive techniques.Coupling with recent research progress in melasma,the present consensus comprehensively elaborates the etiology,pathogenesis,clinical manifestations,staging,classification,diagnosis,and treatment of melasma to improve the diagnostic and therapeutic skills of Chinese dermatologists.展开更多
目的观察微针导入贻贝黏蛋白(mussel adhesive protein,MAP)治疗黄褐斑的安全性和有效性。方法纳入30例色素合并血管型(M+V型)黄褐斑患者,左右面部随机分为观察侧和对照侧,均采用微针导入治疗,观察侧导入贻贝黏蛋白,对照侧导入生理盐水,...目的观察微针导入贻贝黏蛋白(mussel adhesive protein,MAP)治疗黄褐斑的安全性和有效性。方法纳入30例色素合并血管型(M+V型)黄褐斑患者,左右面部随机分为观察侧和对照侧,均采用微针导入治疗,观察侧导入贻贝黏蛋白,对照侧导入生理盐水,每2周治疗1次,共治疗3次。分别于首次治疗前及末次治疗后2周,评估患者黄褐斑面积和严重程度指数(melasma area and severity index,MASI)评分,检测患者同一皮损部位的红斑指数(erythemal index,EI)、黑素指数(melanin index,MI)、角质层含水量和经皮水分流失率(transepidermal water loss,TEWL)。使用分光光谱测色仪检测L值、a值、b值(L值为色彩亮度坐标值,L值越小皮肤灰度越高,L值越大亮度越高;a值为皮肤的红绿色饱和度;b值为黄蓝饱和度)用于定量分析色素沉着程度及其变化。观察患者临床疗效及不良反应。结果治疗前,患者两侧MASI评分、a值、b值、EI值、TEWL值、L值、MI值与皮肤含水量比较,差异无统计学意义(P>0.05)。治疗后,观察侧MASI评分、a值、b值、EI值、TEWL值均较治疗前降低,L值与皮肤含水量升高,差异有统计学意义(P<0.05)。治疗后,两侧MI值均降低,差异有统计学意义(P<0.05)。观察侧MASI评分、a值、b值、EI值、TEWL值低于对照侧,皮肤含水量高于对照组,差异有统计学意义(P<0.05)。结论微针导入贻贝黏蛋白治疗黄褐斑安全、有效。展开更多
文摘The aim of this study was to compare the efficacy of TXA with other therapies for melasma.Melasma is a common acquired skin condition characterized by hypermelanosis,causing light to dark patches,and is the most prevalent in individuals with Fitzpatrick skin typesⅢtoⅥ.It is a complex condition with an unclear etiology,often influenced by factors such as excessive sun exposure and hormonal changes.Treating melasma poses significant challenges for healthcare providers,primarily due to its tendency to reoccur.This makes management strategies crucial for achieving lasting results and improving patient outcomes.A systematic review of randomized controlled trials(RCTs)was conducted using databases such as MEDLINE,EMBASE,Google Scholar,and Cochrane,yielding 10 studies encompassing 455 participants.The analysis incorporated oral,topical,and injectable forms of TXA,with treatment durations ranging from 8 weeks to 1 year.Pooled results using a random-effects model indicated a moderate effect size of 0.477,suggesting TXA′s efficacy in reducing melasma severity.However,high heterogeneity(I 2=97.62%)reflected variations in study protocols,TXA delivery methods,and patient demographics.
基金Beijing University of Chinese Medicine Transversal Project:"Internal and External"Product and Technology Development for Herbal Acne and Blemish Removal(No.2019110031001241)the Youth Project Under the National Natural Science Foundation of China:Revealing the Scientific Connotation of Tongfu Chinese Herb Rhubarb in Treating Ischemic Stroke from the Perspective of"Intestinal Tryptophan Metabolism and Central Microglia Polarisation"(No.82104440)。
文摘OBJECTIVE:To analyze the chemical components of Mudan Huaban recipe(牡丹化斑方,MHR)and evaluate its efficacy and possible mechanism in melasma mice.METHODS:The chemical compositions of MHR were determined by the ultra-high performance liquid chromatography coupled with quadrupole-exactive mass spectrometry method.Female C57BL/6 mice were exposed to ultraviolet B and progesterone for 21 d to induce melasma,and Fontana-Masson staining was used to assess the effects of MHR on melasma.Luteinizing hormone(LH),estradiol,and follicle-stimulating hormone levels were detected by enzyme-linked immunosorbent assay.The superoxide dismutase(SOD)activity and malonic dialdehyde content were detected by chemiluminescence.Tyrosinase and related proteins expressions were detected by Western blots and immunohistochemistry.RESULTS:A total of 43 chemical components were identified in MHR,MHR significantly decreased the melanin particles of melasma mice.MHR treatment significantly reversed the high contents of LH and low activity of SOD in models.MHR significantly reduced the higher levels of tyrosinase,tyrosinase-related proteins-1(TRP-1),TRP-2,microphthalmia-associated transcription factor and phosphorylation of cyclic adenosine monophosphate response element-binding protein(pCREB)/CREB in the skin of melasma mice.CONCLUSIONS:MHR protects against melasma via regulation of sex hormones,oxidative stress,and melanogenesis-related proteins,suggesting its possible use as a supplement and alternative drug therapy for melasma.
基金funded by the National Key Research and Development Plan of the Traditional Chinese Medicine Modernization Research Key Project(2018YFC1706800).
文摘Objective:To investigate the potential efficacy and safety of Lutai Danshen Baishao granules(LDBG)for treating female melasma associated with kidney deficiency and blood stasis patterns.Methods:A randomized,double-blind,placebo-controlled trial was conducted at the Third Central Hospital of Tianjin,China from March to December 2023.A total of 110 female patients with melasma linked to kidney deficiency and blood stasis were enrolled and treated with either LDBG or a placebo twice daily for 60 days.Efficacy was assessed through measures such as the total melasma area,reduced melasma area,reduction rate of melasma area,melasma color score,Melasma Area and Severity Index(MASI)score,and traditional Chinese medicine(TCM)symptom score scale.Safety assessments included routine blood and biochemical tests.Results:Participants in both groups were aged 52-63 years,with no significant differences.After the 2-month intervention,the total melasma area decreased in both groups;however,a greater reduction was observed in the test group[462.50 mm^(2)(12.81%)vs.100.00 mm2(3.11%),P<.001].Moreover,LDBG treatment significantly reduced the MASI and melasma color scores in the test group(P<.05).The total TCM symptom evaluation score significantly decreased(test group:6.00 vs.placebo group:7.00,P=.001),with significant relief in symptoms such as improvement in dark lips,nails,and waist soreness in the test group,compared with that in the placebo group(P<.05).Within-group comparisons revealed that TCM syndrome was significantly alleviated in the test group(P<.05).Conclusion:LDBG intervention shows promising effectiveness in reducing female melasma and alleviating TCM syndromes.
文摘Background:Melasma is a prevalent skin disorder affecting a wide range of populations.In Unani system of medicine,a traditional healing system with a rich historical background,there exists a repository of therapeutic modalities for melasma,elucidated by esteemed scholars and practitioners.Despite its extensive utilization,the scientific substantiation supporting these interventions remains limited.Objective:This study aims to scientifically evaluate and compare the safety and efficacy of topically applied Raphanus sativus seed powder and honey mixture versus hydroquinone(4%w/w)cream for melasma treatment.Methods:In this 8-week open-label,randomized controlled trial,40 participants(20 per group),aged 18–65 years and diagnosed with melasma,successfully completed the study.The test group applied finely powdered Raphanus sativus seeds mixed with honey twice daily,while the control group used hydroquinone(4%w/w)cream twice daily.Primary outcome measure was change in modified Melasma Area and Severity Index(mMASI)at each follow-up.Secondary measures examined subjective nuances using a 100mm visual analogue scale(VAS)and recorded the dermatology life quality index(DLQI)at baseline and the conclusion of the study.Safety was ensured through comprehensive clinical reviews,with documentation of adverse events during bi-weekly follow-ups.Results:Following the conclusion of the study,the mean difference in the mMASI score between the test and control groups was–0.22(95%CI:–0.75 to 0.30,d=0.27,p=0.394).Additionally,post-trial mean differences in VAS and DLQI scores between the test and control groups were determined as–5.25(95%CI:–10.65 to–0.15,d=0.62,p=0.056)and–0.10(95%CI:–1.53 to 1.33,d=0.04,p=0.888),respectively.Conclusion:Based on the investigative findings,the test intervention involving Raphanus sativus and honey demonstrated therapeutic efficacy statistically comparable to conventional hydroquinone treatment for managing melasma,with no reported adverse reactions.Moreover,both groups exhibited statistically comparable improvements in the dermatology life quality index.
文摘Melasma is a prevalent and challenging skin condition that affects the face and causes distress in many patients and physicians.Tranexamic acid(TA)has been found to be effective for treating melasma and can be administered through multiple routes.This review details the mechanisms of action of TA in treatment of melasma and assesses the efficacy and safety associated with different administrations,which can contribute to selecting appropriate melasma treatment plan for different patients.
文摘Background: Melasma is an acquired pigmentation condition characterized by its refractory nature and a high risk of recurrence. Treatment of melasma is challenging owing to its unclear etiology, stubborn resistance to treatment, and frequent relapses. Therefore, this study aimed to compare the efficacy, effectiveness, and safety of monotherapy and combination therapy(combination of laser and tranexamic acid(TXA)) for the treatment of melasma using a network meta-analysis.Method: The PRISMA guidelines were used in this meta-analysis, with a literature search conducted in reputable sources, such as Cochrane, Science Direct, Pub Med, and Google Scholar.Results: From the initial search, 1 504 relevant studies were identified. After careful analysis, three studies were included in the meta-analysis. The results showed no significant differences in the Melasma Area and Severity Index(MASI) score between monotherapy(control group) and a combination therapy of laser and TXA. The mean difference in MASI score was 1.87(95% confidence interval(CI),-0.78–4.52;P=0.17), indicating no significant difference between the two treatment approaches. Side effects were more common in the combination treatment group than in the control group. The odds ratio for experiencing side effects was 8.85(95% CI, 1.57–50.01;P=0.01).Conclusion: Both the monotherapy and combination therapy groups showed therapeutic improvement;however,the combination therapy group showed a higher incidence of side effects.
文摘Chloasma, or melasma, is a commonly acquired pigmentary disorder among Asian women. It may be considered as a physiological change during pregnancy. The incidence in Asian women is higher than that in other ethnic groups but further epidemiologic data are needed. There are very few studies related to the benefits of sunscreens to prevent this dermatosis. The aim of this study was to assess the effectiveness of a broad-spectrum sunscreen in the prevention of melasma in Korean pregnant women. We tested the effectiveness and tolerance of a sunscreen product (SPF 50+, UVA-PF 30) during a 12-month clinical trial including 220 Korean parturients with skin type III and IV. 217 women completed the study. Only 3 (1%) of the study population developed melasma, which was mild (MASI grade between 1.2 and 2.7). In addition, the clinical effectiveness of the evaluated sunscreen was judged “good to excellent” by the majority of study participants and by the research dermatologists. The “excellent” tolerance of the sunscreen under evaluation was confirmed “good” to “excellent” in 95% and 97% of cases. This study clearly demonstrates that this broad-spectrum sunscreen is well tolerated and effective in the prevention of melasma in Korean pregnant women. Although treatment remains elusive, prevention is possible.
文摘Background: Facial melanosis is a major pigmentery problem seen in the daily clinical practice. Melasma and lichen planus actinicus are among these common causes. Still some facial melanosis that had features of melasma and butterfly lichen planus actinicus but could not be classified to either of them. Objective: To evaluate melasma, lichen planus actinicus and cases that could not be classified into one or either of them using clinical picture, Wood’s lump examination, and histopathological assessment. Patients and Methods: This is a case descriptive, comparative, clinical and histopathologicasl study carried out in Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq during the period from December 2012-May 2014. Forty patients with facial hyperpigmentation were included in this study. Twelve (30%) were males and 28 (70%) were females with female to male ratio: 2.3:1. Mean age ± SD of studied patients was 37.07 ± 9.63 years. History, physical examination, Wood’s lump examination and photographic pictures were done for all patients. Punch biopsy was taken from each patient, and processed and stained with Hematoxylin-Eosin (HE) and Fontana-Masson (FM) for histological evaluations. Results: These diseases were classified into: melasma with 11 patients, female to male ratio: 4.5:1 with mean age ± SD was 33.64 ± 6.516 years, melasma-like lichen planus actinicus with 21 patients, female to male ratio: 2.5:1,mean age ± SD: 39 ± 8.349 years, butterfly lichen planus actinicus with 8 patients, female to male ratio: 1:1, mean age ± SD: 36.75 ± 15.088 years. This classification depends on the following findings: some of these results could be more frequent and intense in one than others;they were the diseases of young age group, that had more tendency to affect females than males, sun light exposure and outdoor activities were the main etiological factors, but these factors were more triggering in lichen planus actinicus followed by melasma-like lichen planus actinicus and to lesser extent in melasma. The skin types were mostly III, the location and distribution of pigmentation were almost similar, Wood’s lamp findings were similar although was not conclusive. The histopathological findings especially the level of melanin deposition and inflammatory infiltrate were comparable but the melanin deposition was more intense in butterfly lichen planus and melasma-like lichen planus actinicus and to lesser extent in melasma. Conclusion: From the epidemiological, clinical and histopathological findings of the present work, we can suggest a conclusion that melasma, butterfly lichen planus actinicus, and melasma-like lichen planus actinicus were inflammatory skin diseases that build up one spectrum where melasma at one pole and lichen planus actinicus at the other pole and melasma-like lichen planus actinicus at the middle. The young age group, during their active reproductive life, will have these diseases in relation to sun light exposure with seasonal variations.
文摘Melasma, a kind of damaging disease, is commonly found in women during reproductive age. It causes great harm to patient＇s confidence and, has an effect on social contact as well. Melasma has been cured effectively by modern medicine and traditional Chinese medicine so far, in contrast, the treatment analysis system is far from flawless. Our research team is going to cooperate with Beijing University of Aeronautics and Astronautics and develop a computer-vision treatment analysis system for facial dermatosis based on present technology. It＇s supposed to provide clinical doctors with objective standards for melasma and other facial dermatosis.
文摘目的:探究六味地黄汤结合表皮干细胞外泌体治疗黄褐斑的效果。方法:选取西安海棠中医美容医院2022年1月-2023年9月收治的120例黄褐斑患者,使用摸球法分为对照组和观察组,各60例。对照组予以表皮干细胞外泌体治疗,观察组予以六味地黄汤结合表皮干细胞外泌体治疗。对比两组临床疗效、黄褐斑严重程度指数(Melasma severity index,MASI)、皮损面积、生活质量、复发率。结果:与对照组(83.33%)相比,观察组临床总有效率(98.33%)更高(P<0.05)。治疗后,观察组M A S I评分(4.13±0.78)分,低于对照组的(5.99±1.10)分(P<0.001)。治疗后,观察组皮损面积(1.96±0.43)cm^(2),小于对照组的(2.83±0.62)cm^(2)(P<0.001)。治疗后,观察组生活质量[皮肤病生活质量指数(Dermatosis life quality index,DLQI)、黄褐斑生活质量评分量表(Melasma quality of life score,MELA-SQOL)]优于对照组(P<0.05)。观察组患者复发率(1.67%)低于对照组的(16.67%)(P<0.05)。结论:六味地黄汤结合表皮干细胞外泌体用于治疗黄褐斑,有助于改善黄褐斑症状与生活质量,减少皮损面积,临床疗效显著,值得临床推广。
文摘The pathogenesis of melasma is believed to be related to heredity,sun exposure,sex hormones,and other factors.The mechanisms underlying the development of melasma include increased melanin synthesis,vascular proliferation within the skin lesions,inflammation,and skin barrier dysfunction.The diagnosis of melasma is mainly based on clinical manifestations and noninvasive techniques.Coupling with recent research progress in melasma,the present consensus comprehensively elaborates the etiology,pathogenesis,clinical manifestations,staging,classification,diagnosis,and treatment of melasma to improve the diagnostic and therapeutic skills of Chinese dermatologists.
文摘目的观察微针导入贻贝黏蛋白(mussel adhesive protein,MAP)治疗黄褐斑的安全性和有效性。方法纳入30例色素合并血管型(M+V型)黄褐斑患者,左右面部随机分为观察侧和对照侧,均采用微针导入治疗,观察侧导入贻贝黏蛋白,对照侧导入生理盐水,每2周治疗1次,共治疗3次。分别于首次治疗前及末次治疗后2周,评估患者黄褐斑面积和严重程度指数(melasma area and severity index,MASI)评分,检测患者同一皮损部位的红斑指数(erythemal index,EI)、黑素指数(melanin index,MI)、角质层含水量和经皮水分流失率(transepidermal water loss,TEWL)。使用分光光谱测色仪检测L值、a值、b值(L值为色彩亮度坐标值,L值越小皮肤灰度越高,L值越大亮度越高;a值为皮肤的红绿色饱和度;b值为黄蓝饱和度)用于定量分析色素沉着程度及其变化。观察患者临床疗效及不良反应。结果治疗前,患者两侧MASI评分、a值、b值、EI值、TEWL值、L值、MI值与皮肤含水量比较,差异无统计学意义(P>0.05)。治疗后,观察侧MASI评分、a值、b值、EI值、TEWL值均较治疗前降低,L值与皮肤含水量升高,差异有统计学意义(P<0.05)。治疗后,两侧MI值均降低,差异有统计学意义(P<0.05)。观察侧MASI评分、a值、b值、EI值、TEWL值低于对照侧,皮肤含水量高于对照组,差异有统计学意义(P<0.05)。结论微针导入贻贝黏蛋白治疗黄褐斑安全、有效。
