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de Freitas ACP, Rigon RB, Bagatin E, Leonardi GR. Perspectives of topical formulations for melasma. Int J Dermatol 2023; 62:260-268. [PMID: 36083295 DOI: 10.1111/ijd.16421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 01/20/2023]
Abstract
Melasma is acquired hyperpigmentation that mainly affects the face, can cause negative changes in self-esteem, and mostly affects women. Treatment is difficult, and different drugs can be used in mono or combination therapy. In this article, we present a brief overview of melasma, how to evaluate it, and a synthesis of the most commonly used topical therapies and their indications, including sunscreens, pharmacological agents, and plant extracts. Hydroquinone (4%) in monotherapy or combined with corticosteroids (dexamethasone and fluocinolone acetonide) and retinoids (tretinoin); arbutin (1%); methimazole (5%); kojic (2%), azelaic (20%), and tranexamic (5%) acids are the pharmacological agents that stand out. Correct application of these substances determines a variable improvement in melasma but often causes adverse reactions such as erythema, itching, and burning at the application site. Vitamin C can contribute to the reduction of melasma and have little or no adverse effects while sunscreens are normally used as coadjuvant therapies. In conclusion, we have compiled specific topical therapies for treating melasma and discussed those that are the most used currently. We consider it important that prescribers and researchers evaluate the best cost-benefit ratio of topical therapeutic options and develop new formulations, enabling efficacy in the treatment with safety and comfort during application, through the reduction of adverse effects.
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Affiliation(s)
| | - Roberta Balansin Rigon
- School of Pharmaceutical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Ediléia Bagatin
- Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
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2
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Niazi S, Gheisari M, Moravvej H, Doroodgar F, Niazi F. Efficacy of Cysteamine and Methimazole in Treating Melasma A Comparative Narrative Review. J Cosmet Dermatol 2022; 21:3867-3875. [PMID: 35751542 DOI: 10.1111/jocd.15180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 05/29/2022] [Accepted: 06/20/2022] [Indexed: 11/29/2022]
Abstract
Melasma is a chronic and acquired pigmentary condition that primarily affects women and undermines patient satisfaction and confidence. Melasma mostly affects females, accounting for 90% of all cases. It affects people of all races, particularly those with skin types IV and V who live in areas with lots of UV radiation. According to the studies, Melasma lesions are seen throughout the face in centrofacial, malar, and mandibular patterns. Melasma lesions on the forehead, cheeks, nose, upper lip, and/or chin are the most prevalent centrofacial pattern. Melasma lesions can also be detected along the periorbital area, especially in Asian people. Melasma is notably resistant to treatment, with many patients experiencing only temporary relief and relapses. Combining therapies that target numerous pathologic components, including photodamage, inflammation, aberrant vascularity, and abnormal pigmentation, generally results in the most dramatic therapeutic improvements. Treatments for dark circles include topical depigmenting medicines like hydroquinone, kojic acid, azelaic acid, and topical retinoic acid, and physical treatments such as chemical peels, surgical adjustments, and laser therapy. The objective of therapy should be to figure out what's causing the hyperpigmentation and what's contributing to it. This article provides an overview of melasma therapies and the efficacy of methimazole and cysteamine for melasma therapy.
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Affiliation(s)
- Sana Niazi
- Medical Students Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Gheisari
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Dermatology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamideh Moravvej
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farideh Doroodgar
- Negah Specialty Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Feizollah Niazi
- Clinical Research Development Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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3
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Artzi O, Horovitz T, Bar-Ilan E, Shehadeh W, Koren A, Zusmanovitch L, Mehrabi JN, Salameh F, Isman Nelkenbaum G, Zur E, Sprecher E, Mashiah J. The pathogenesis of melasma and implications for treatment. J Cosmet Dermatol 2021; 20:3432-3445. [PMID: 34411403 DOI: 10.1111/jocd.14382] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/28/2021] [Accepted: 07/28/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Melasma is a complex and poorly understood disorder, with high rates of treatment failure and recurrences. OBJECTIVES We aimed to review the current knowledge of the pathogenesis of melasma and apply this knowledge to clinical implications on relevant therapeutic interventions. METHODS A systematic PubMed search was performed using the search term "((melasma[Text Word]) OR facial melanosis[Text Word]) AND (pathogenesis OR causality[MeSH Terms])" for articles published between 1990 and 2020. Included articles were then evaluated by two authors and assessed for relevant pathomechanistic pathways, after which they were divided into groups with minimal overlap. We then reviewed current treatment modalities for melasma and divided them according to the involved pathomechanistic pathway. RESULTS A total of 309 search results were retrieved among which 76 relevant articles were identified and reviewed. Five main pathomechanisms observed in melasma were identified: (1) melanocyte inappropriate activation; (2) aggregation of melanin and melanosomes in dermis and epidermis; (3a) increased mast cell count and (3b) solar elastosis; (4) altered basement membrane; and (5) increased vascularization. Treatment modalities were then divided based on these five pathways and detailed in 6 relevant tables. CONCLUSION The pathophysiology of melasma is multifactorial, resulting in treatment resistance and high recurrence rates. This wide variety of pathomechanisms should ideally be addressed separately in the treatment regimen in order to maximize results.
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Affiliation(s)
- Ofir Artzi
- Division of Dermatology and Venereology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamir Horovitz
- Division of Dermatology and Venereology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Efrat Bar-Ilan
- Division of Dermatology and Venereology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Waseem Shehadeh
- Division of Dermatology and Venereology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Koren
- Division of Dermatology and Venereology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lior Zusmanovitch
- Division of Dermatology and Venereology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Joseph N Mehrabi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Fares Salameh
- Division of Dermatology and Venereology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gila Isman Nelkenbaum
- Division of Dermatology and Venereology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Zur
- Compounding Solutions, a Pharmaceutical Consultancy Company, Tel-Mond, Israel
| | - Eli Sprecher
- Division of Dermatology and Venereology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jacob Mashiah
- Division of Dermatology and Venereology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Dermatology Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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4
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Hocker SE, Eshar D, Wouda RM. Rodent Oncology: Diseases, Diagnostics, and Therapeutics. Vet Clin North Am Exot Anim Pract 2017; 20:111-134. [PMID: 27890286 DOI: 10.1016/j.cvex.2016.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Cancer incidence in rodent species varies dramatically from a common occurrence in mice and rats to just a limited number of documented cases in chinchillas and degus. This article summarizes common tumors, both benign and malignant, that have been reported to occur in rodents. Outlined are clinical signs, diagnostics, and treatments that have been described for rodents presenting with specific neoplasms.
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Affiliation(s)
- Samuel E Hocker
- Department of Clinical Sciences, Kansas State University, 1800 Denison Avenue, Manhattan, KS 66506, USA
| | - David Eshar
- Department of Clinical Sciences, Kansas State University, 1800 Denison Avenue, Manhattan, KS 66506, USA.
| | - Raelene M Wouda
- Department of Clinical Sciences, Kansas State University, 1800 Denison Avenue, Manhattan, KS 66506, USA
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5
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Endocrine tumours in the guinea pig. Vet J 2015; 206:268-74. [DOI: 10.1016/j.tvjl.2015.08.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 07/29/2015] [Accepted: 08/10/2015] [Indexed: 11/17/2022]
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6
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Kurbanoglu S, Mayorga-Martinez CC, Medina-Sánchez M, Rivas L, Ozkan SA, Merkoçi A. Antithyroid drug detection using an enzyme cascade blocking in a nanoparticle‐based lab‐on‐a‐chip system. Biosens Bioelectron 2015; 67:670-6. [DOI: 10.1016/j.bios.2014.10.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 10/04/2014] [Accepted: 10/07/2014] [Indexed: 11/27/2022]
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7
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Inhibitory effects of novel synthetic methimazole derivatives on mushroom tyrosinase and melanogenesis. Bioorg Med Chem 2014; 22:2809-15. [PMID: 24703463 DOI: 10.1016/j.bmc.2014.03.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 03/04/2014] [Accepted: 03/06/2014] [Indexed: 11/24/2022]
Abstract
In this study, we synthesized 4 methimazole (2-mercapto-1-methylimidazole, MMI) derivatives. The kinetics of inhibition on mushroom tyrosinase by methimazole and its derivatives were investigated. The results indicated that tert-butyl 3-methyl-2-sulfanylidene-2,3-dihydro-1H-imidazole-1-carboxylate (compound 3; 3), 2-mercaptoimidazole (MI; compound 1; 1) and MMI (compound 2; 2) significantly inhibited tyrosinase activity in a dose-dependent manner, exhibiting an IC50 value of 1.50mM, 4.11 mM, and 1.43 mM. However, compound 4 (4), compound 5 (5), and compound 6 (6) exerted no inhibitory effect on mushroom tyrosinase activity. Kinetic analysis indicated that 3 was a noncompetitive tyrosinase inhibitor, whereas both 1 and 2 were exhibited as mixed-type tyrosinase inhibitors. Furthermore, 3 exerted a potent inhibitory effect on intracellular melanin formation in the B16/F10 murine melanoma cells and did not cause cytotoxicity, as 1 and 2 did.
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Malek J, Chedraoui A, Nikolic D, Barouti N, Ghosn S, Abbas O. Successful treatment of hydroquinone-resistant melasma using topical methimazole. Dermatol Ther 2013; 26:69-72. [DOI: 10.1111/j.1529-8019.2012.01540.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Joelle Malek
- Dermatology Department; American University of Beirut Medical Center; Beirut; Lebanon
| | - Adele Chedraoui
- Dermatology Department; American University of Beirut Medical Center; Beirut; Lebanon
| | - Damian Nikolic
- Department of Dermatology; Geneva University Hospital; Geneva; Switzerland
| | - Neda Barouti
- Department of Dermatology; Geneva University Hospital; Geneva; Switzerland
| | - Samer Ghosn
- Dermatology Department; American University of Beirut Medical Center; Beirut; Lebanon
| | - Ossama Abbas
- Dermatology Department; American University of Beirut Medical Center; Beirut; Lebanon
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Kim H, Choi HR, Kim DS, Park KC. Topical hypopigmenting agents for pigmentary disorders and their mechanisms of action. Ann Dermatol 2012; 24:1-6. [PMID: 22363147 PMCID: PMC3283838 DOI: 10.5021/ad.2012.24.1.1] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 11/15/2011] [Indexed: 01/23/2023] Open
Abstract
Melanin is produced in melanocytes and stored in melanosomes. In spite of its beneficial sun-protective effect, abnormal accumulation of melanin results in esthetic problems. Hydroquinone, competing with tyrosine, is a major ingredient in topical pharmacological agents. However, frequent adverse reactions are amongst its major limitation. To solve this problem, several alternatives such as arbutin, kojic acid, aloesin, and 4-n-butyl resorcinol have been developed. Herein, we classify hypopigmenting agents according to their mechanism of action; a) regulation of enzyme, which is subdivided into three categories, i) regulation of transcription and maturation of tyrosinase, ii) inhibition of tyrosinase activity, and iii) post-transcriptional control of tyrosinase; b) inhibition of melanosome transfer, and c) additional mechanisms such as regulation of the melanocyte environment and antioxidant agents.
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Affiliation(s)
- Hyojin Kim
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea
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10
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Kasraee B, Nikolic DS, Salomon D, Carraux P, Fontao L, Piguet V, Omrani GR, Sorg O, Saurat JH. Ebselen is a new skin depigmenting agent that inhibits melanin biosynthesis and melanosomal transfer. Exp Dermatol 2011; 21:19-24. [DOI: 10.1111/j.1600-0625.2011.01394.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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11
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Topical use of systemic drugs in dermatology: A comprehensive review. J Am Acad Dermatol 2011; 65:1048.e1-22. [DOI: 10.1016/j.jaad.2010.08.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Revised: 07/28/2010] [Accepted: 08/06/2010] [Indexed: 11/24/2022]
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12
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Woolery-Lloyd H, Kammer JN. Treatment of Hyperpigmentation. ACTA ACUST UNITED AC 2011; 30:171-5. [DOI: 10.1016/j.sder.2011.06.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Accepted: 06/08/2011] [Indexed: 11/15/2022]
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13
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Mayer J, Wagner R, Taeymans O. Advanced diagnostic approaches and current management of thyroid pathologies in Guinea pigs. Vet Clin North Am Exot Anim Pract 2010; 13:509-523. [PMID: 20682433 DOI: 10.1016/j.cvex.2010.05.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The authors have encountered multiple clinical cases of clinical hyperthyroidism in the guinea pig, which responded positively to clinical treatment. Hyperactive thyroids in the guinea pig appear to exist causing typical clinical signs. An early accurate diagnosis of this pathologic state is important in the clinical setting. One of the authors has encountered a few clinical cases of hypothyroidism in guinea pigs. Hypothyroidism appears to be a rare condition and has been described anecdotally in the German literature. Because of the rarity of hypothyroidism, the text focuses mainly on the guinea pig as a hyperthyroid case. A short description of the clinical presentation of the hypothyroid animal is included at the end of the text.
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Affiliation(s)
- Jörg Mayer
- Department of Clinical Sciences, Tufts University Cummings School of Veterinary Medicine, 200 Westboro Road North Grafton, MA 01536, USA.
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14
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Park KC, Huh SY, Choi HR, Kim DS. Biology of melanogenesis and the search for hypopigmenting agents. DERMATOL SIN 2010. [DOI: 10.1016/s1027-8117(10)60011-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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15
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Solano F, Briganti S, Picardo M, Ghanem G. Hypopigmenting agents: an updated review on biological, chemical and clinical aspects. ACTA ACUST UNITED AC 2007; 19:550-71. [PMID: 17083484 DOI: 10.1111/j.1600-0749.2006.00334.x] [Citation(s) in RCA: 454] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
An overview of agents causing hypopigmentation in human skin is presented. The review is organized to put forward groups of biological and chemical agents. Their mechanisms of action cover (i) tyrosinase inhibition, maturation and enhancement of its degradation; (ii) Mitf inhibition; (iii) downregulation of MC1R activity; (iv) interference with melanosome maturation and transfer; (v) melanocyte loss, desquamation and chemical peeling. Tyrosinase inhibition is the most common approach to achieve skin hypopigmentation as this enzyme catalyses the rate-limiting step of pigmentation. Despite the large number of tyrosinase inhibitors in vitro, only a few are able to induce effects in clinical trials. The gap between in-vitro and in-vivo studies suggests that innovative strategies are needed for validating their efficacy and safety. Successful treatments need the combination of two or more agents acting on different mechanisms to achieve a synergistic effect. In addition to tyrosinase inhibition, other parameters related to cytotoxicity, solubility, cutaneous absorption, penetration and stability of the agents should be considered. The screening test system is also very important as keratinocytes play an active role in modulating melanogenesis within melanocytes. Mammalian skin or at least keratinocytes/melanocytes co-cultures should be preferred rather than pure melanocyte cultures or soluble tyrosinase.
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Affiliation(s)
- Francisco Solano
- Department of Biochemistry and Molecular Biology B, University of Murcia, Murcia, Spain.
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16
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Kasraee B, Handjani F, Parhizgar A, Omrani GR, Fallahi MR, Amini M, Nikbakhsh M, Tran C, Hügin A, Sorg O, Saurat JH. Topical Methimazole as a New Treatment for Postinflammatory Hyperpigmentation: Report of the First Case. Dermatology 2005; 211:360-2. [PMID: 16286748 DOI: 10.1159/000088509] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2005] [Accepted: 02/25/2005] [Indexed: 11/19/2022] Open
Abstract
We have previously shown that the peroxidase inhibitor methimazole (1-methyl-2-mercapto imidazole; MMI) is a noncytotoxic inhibitor of melanin production in cultured B16 melanocytes. It was further demonstrated that the topical application of 5% MMI on brown guinea pig skin for 6 weeks causes a significant reduction in the amount of epidermal melanin, resulting in visually recognizable cutaneous depigmentation. Herein, we report a 27-year-old male with postinflammatory hyperpigmentation (due to acid burn), successfully treated with topical MMI as a new skin depigmenting agent. Topical 5% MMI caused a moderate to marked improvement of the hyperpigmented lesions within 6 weeks of once-daily application. Topical MMI was well tolerated by the patient and did not affect the level of serum thyroid hormones (free thyroxin, free triiodothyronine and the thyroid-stimulating hormone). Unlike most known depigmenting agents, such as hydroquinone and kojic acid, MMI is a noncytotoxic, nonmutagenic compound, and it is possible that MMI could serve as a novel agent for the treatment of hyperpigmentary disorders in human.
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Kasraee B, Hügin A, Tran C, Sorg O, Saurat JH. Methimazole is an inhibitor of melanin synthesis in cultured B16 melanocytes. J Invest Dermatol 2004; 122:1338-41. [PMID: 15140243 DOI: 10.1111/j.0022-202x.2004.22509.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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18
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Briganti S, Camera E, Picardo M. Chemical and instrumental approaches to treat hyperpigmentation. PIGMENT CELL RESEARCH 2003; 16:101-10. [PMID: 12622786 DOI: 10.1034/j.1600-0749.2003.00029.x] [Citation(s) in RCA: 535] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Many modalities of treatment for acquired skin hyperpigmentation are available including chemical agents or physical therapies, but none are completely satisfactory. Depigmenting compounds should act selectively on hyperactivated melanocytes, without short- or long-term side-effects, and induce a permanent removal of undesired pigment. Since 1961 hydroquinone, a tyrosinase inhibitor, has been introduced and its therapeutic efficacy demonstrated, and other whitening agents specifically acting on tyrosinase by different mechanisms have been proposed. Compounds with depigmenting activity are now numerous and the classification of molecules, based on their mechanism of action, has become difficult. Systematic studies to assess both the efficacy and the safety of such molecules are necessary. Moreover, the evidence that bleaching compounds are fairly ineffective on dermal accumulation of melanin has prompted investigations on the effectiveness of physical therapies, such as lasers. This review which describes the different approaches to obtain depigmentation, suggests a classification of whitening molecules on the basis of the mechanism by which they interfere with melanogenesis, and confirms the necessity to apply standardized protocols to evaluate depigmenting treatments.
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Affiliation(s)
- Stefania Briganti
- San Gallicano Dermatological Institute, Via Elio Chianesi, Rome, Italy
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