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 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
目的:观察微针注射胶原蛋白及氨甲环酸治疗黄褐斑的临床疗效。方法:选取武汉大学中南医院2023年3月-2023年4月收治的60例黄褐斑患者,采用随机数字表法分为两组。对照组采用微针注射氨甲环酸治疗,观察组给予微针注射胶原蛋白联合氨甲环...目的:观察微针注射胶原蛋白及氨甲环酸治疗黄褐斑的临床疗效。方法:选取武汉大学中南医院2023年3月-2023年4月收治的60例黄褐斑患者,采用随机数字表法分为两组。对照组采用微针注射氨甲环酸治疗,观察组给予微针注射胶原蛋白联合氨甲环酸治疗。统计两组治疗疗效,检测两组面部图像分析参数水平,并评估两组黄褐斑面积和严重指数(Melasma area and severity index,MASI)评分差异。结果:观察组临床总有效治疗率明显高于对照组(P<0.05)。治疗前,两组面部图像分析参数比较,差异无统计学意义(P>0.05)。治疗后,两组L^(*)值均明显升高(P<0.05),a^(*)值、b^(*)值、色斑、棕斑和红色区均有不同程度降低,且观察组L^(*)值高于对照组(P<0.05),a^(*)值、b^(*)值、色斑、棕斑均低于对照组(均P<0.05)。治疗前,两组MASI评分比较,差异无统计学意义(P>0.05),治疗后,两组MASI评分均降低(P<0.05),且观察组MASI评分低于对照组(P<0.05)。结论:微针注射胶原蛋白联合氨甲环酸治疗黄褐斑可改善患者色素沉着,提高治疗效果。展开更多
目的:基于Web of Science核心合集数据库收录的文献,通过文献计量方法分析黄褐斑的研究现状及未来发展趋势。方法:检索2005年-2022年Web of Science数据库核心合集中收录的黄褐斑相关文献,运用文献计量学方法,使用VOSviewer和CiteSpace...目的:基于Web of Science核心合集数据库收录的文献,通过文献计量方法分析黄褐斑的研究现状及未来发展趋势。方法:检索2005年-2022年Web of Science数据库核心合集中收录的黄褐斑相关文献,运用文献计量学方法,使用VOSviewer和CiteSpace软件进行可视化分析,将结果以可视化形式呈现。结果:共检索到1276篇黄褐斑相关文献,其中论著1067篇,综述209篇。这些文献来自63个国家的1662个机构的4853名作者,发表在278种期刊上。美国在出版物总数、总被引频次和H指数方面排名第一,发文量最多的机构是埃及知识库,刊文量最多的期刊是Journal of Cosmetic Dermatology,发文量最多的作者是Helio Miot。目前该领域的研究热点主要集中在药物治疗及防晒等方面。结论:应用VOSviewer和CiteSpace软件进行可视化分析,可客观反映出2005年-2022年黄褐斑文献数量变化及分布情况。关键词涉及黑色素生成、对苯二酚、氨甲环酸、CO_(2)激光、Nd∶YAG激光等,黄褐斑的研究热点已从其机制研究及外用药物治疗逐渐转移到氨甲环酸、维生素C治疗及防晒等方面。展开更多
目的:探讨氨甲环酸联合超分子水杨酸换肤治疗黄褐斑临床疗效及对血清丙二醛(MDA),雌二醇(E2)水平的影响。方法:将2019年12月-2021年12月合肥市第二人民医院皮肤科经治的116例黄褐斑患者随机分为对照组(58例,口服氨甲环酸片)和观察组(58...目的:探讨氨甲环酸联合超分子水杨酸换肤治疗黄褐斑临床疗效及对血清丙二醛(MDA),雌二醇(E2)水平的影响。方法:将2019年12月-2021年12月合肥市第二人民医院皮肤科经治的116例黄褐斑患者随机分为对照组(58例,口服氨甲环酸片)和观察组(58例,口服氨甲环酸片联合30%超分子水杨酸治疗),两组患者均治疗20周。比较两组患者临床疗效[医生整体评价(Physician's global assessment,PGA)、黄褐斑面积和严重指数(Melasma area and severity index,MASI)、皮损评分、经表皮水分流失及皮肤角质层含水量]、主观指标(满意度、睡眠及精神状态)及血清MDA、E2水平。结果:观察组有效率93.10%高于对照组63.79%(P<0.05);两组治疗后MASI、皮损评分、经表皮水分流失及血清MDA、E2水平均较治疗前下降,且观察组改善优于对照组(P<0.05);两组治疗后角质层含水量均升高,且观察组升高更显著(P<0.05)。观察组PGA评分低于对照组(P<0.05)。观察组治疗后治疗满意度评分、睡眠评分、精神状态评分显著高于对照组(P<0.05)。两组治疗期间均未出现不良反应。结论:氨甲环酸联合超分子水杨酸换肤治疗黄褐斑效果显著,并可改善患者氧化应激反应及雌激素水平。展开更多
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 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.
文摘目的:观察微针注射胶原蛋白及氨甲环酸治疗黄褐斑的临床疗效。方法:选取武汉大学中南医院2023年3月-2023年4月收治的60例黄褐斑患者,采用随机数字表法分为两组。对照组采用微针注射氨甲环酸治疗,观察组给予微针注射胶原蛋白联合氨甲环酸治疗。统计两组治疗疗效,检测两组面部图像分析参数水平,并评估两组黄褐斑面积和严重指数(Melasma area and severity index,MASI)评分差异。结果:观察组临床总有效治疗率明显高于对照组(P<0.05)。治疗前,两组面部图像分析参数比较,差异无统计学意义(P>0.05)。治疗后,两组L^(*)值均明显升高(P<0.05),a^(*)值、b^(*)值、色斑、棕斑和红色区均有不同程度降低,且观察组L^(*)值高于对照组(P<0.05),a^(*)值、b^(*)值、色斑、棕斑均低于对照组(均P<0.05)。治疗前,两组MASI评分比较,差异无统计学意义(P>0.05),治疗后,两组MASI评分均降低(P<0.05),且观察组MASI评分低于对照组(P<0.05)。结论:微针注射胶原蛋白联合氨甲环酸治疗黄褐斑可改善患者色素沉着,提高治疗效果。
文摘目的:基于Web of Science核心合集数据库收录的文献,通过文献计量方法分析黄褐斑的研究现状及未来发展趋势。方法:检索2005年-2022年Web of Science数据库核心合集中收录的黄褐斑相关文献,运用文献计量学方法,使用VOSviewer和CiteSpace软件进行可视化分析,将结果以可视化形式呈现。结果:共检索到1276篇黄褐斑相关文献,其中论著1067篇,综述209篇。这些文献来自63个国家的1662个机构的4853名作者,发表在278种期刊上。美国在出版物总数、总被引频次和H指数方面排名第一,发文量最多的机构是埃及知识库,刊文量最多的期刊是Journal of Cosmetic Dermatology,发文量最多的作者是Helio Miot。目前该领域的研究热点主要集中在药物治疗及防晒等方面。结论:应用VOSviewer和CiteSpace软件进行可视化分析,可客观反映出2005年-2022年黄褐斑文献数量变化及分布情况。关键词涉及黑色素生成、对苯二酚、氨甲环酸、CO_(2)激光、Nd∶YAG激光等,黄褐斑的研究热点已从其机制研究及外用药物治疗逐渐转移到氨甲环酸、维生素C治疗及防晒等方面。
文摘目的:探讨氨甲环酸联合超分子水杨酸换肤治疗黄褐斑临床疗效及对血清丙二醛(MDA),雌二醇(E2)水平的影响。方法:将2019年12月-2021年12月合肥市第二人民医院皮肤科经治的116例黄褐斑患者随机分为对照组(58例,口服氨甲环酸片)和观察组(58例,口服氨甲环酸片联合30%超分子水杨酸治疗),两组患者均治疗20周。比较两组患者临床疗效[医生整体评价(Physician's global assessment,PGA)、黄褐斑面积和严重指数(Melasma area and severity index,MASI)、皮损评分、经表皮水分流失及皮肤角质层含水量]、主观指标(满意度、睡眠及精神状态)及血清MDA、E2水平。结果:观察组有效率93.10%高于对照组63.79%(P<0.05);两组治疗后MASI、皮损评分、经表皮水分流失及血清MDA、E2水平均较治疗前下降,且观察组改善优于对照组(P<0.05);两组治疗后角质层含水量均升高,且观察组升高更显著(P<0.05)。观察组PGA评分低于对照组(P<0.05)。观察组治疗后治疗满意度评分、睡眠评分、精神状态评分显著高于对照组(P<0.05)。两组治疗期间均未出现不良反应。结论:氨甲环酸联合超分子水杨酸换肤治疗黄褐斑效果显著,并可改善患者氧化应激反应及雌激素水平。
