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Gomez-Martinez S, Ibaceta Ayala J, Morgado-Carrasco D. Wood's Light in Inflammatory And Autoimmune Dermatoses, Infections and Skin Cancer. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00716-6. [PMID: 39306238 DOI: 10.1016/j.ad.2024.07.018] [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: 04/15/2024] [Revised: 06/27/2024] [Accepted: 07/21/2024] [Indexed: 10/17/2024] Open
Abstract
Wood's light (WL) is a useful, economical and easy-to-learn diagnostic tool. Despite its advantages, the use of LW among dermatologists is limited. In porokeratosis, the "diamond necklace" sign has been described, corresponding to the white fluorescence of the hyperkeratotic scale. Subclinical morphea lesions are seen as well-defined dark macules. Among the pigmentary disorders, the bluish fluorescence of vitiligo, the increased contrast of epidermal melasma, and the follicular-centered red fluorescence of progressive macular hypomelanosis stand out. Regarding skin infections, erythrasma presents a coral red fluorescence; tinea versicolor, yellow-green fluorescence; Pseudomonas aeuriginosa, green fluorescence; and scabies, blue-white fluorescence in the acarine grooves. In skin cancer, LW has been used to delimit the surgical margins of both lentigo maligna and non-melanoma skin cancer, with variable results.
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Affiliation(s)
- S Gomez-Martinez
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
| | | | - D Morgado-Carrasco
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España; Servicio de Dermatología, Hospital de Figueres, Fundació Salut Empordà, Figures, Girona, España.
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Pisano L, Turco M, Supuran CT. Biomedical applications of tyrosinases and tyrosinase inhibitors. Enzymes 2024; 56:261-280. [PMID: 39304289 DOI: 10.1016/bs.enz.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2024]
Abstract
Tyrosinase is involved in several human diseases, among which hypopigmentation and depigmentation conditions (vitiligo, idiopathic guttate hypomelanosis, pityriasis versicolor, pityriasis alba) and hyperpigmentations (melasma, lentigines, post-inflammatory and periorbital hyperpigmentation, cervical idiopathic poikiloderma and acanthosis nigricans). There are increasing evidences that tyrosinase plays a relevant role in the formation and progression of melanoma, a difficult to treat skin tumor. Hydroquinone, azelaic acid and tretinoin (all-trans-retinoic acid) are clinically used in the management of some hyperpigmentations, whereas many novel chemotypes acting as tyrosinase inhibitors with potential antimelanoma action are being investigated. Kojic acid, hydroquinone, its glycosylated derivative arbutin, or the resorcinol derivative rucinol are used in cosmesis in creams as skin whitening agents, whereas no antimelanoma tyrosinase inhibitor reached clinical trials so far, although thiamidol is a recently approved new tyrosinase inhibitor for the treatment of melasma. Kojic acid and vitamin C are used for avoiding vegetable/food oxidative browning due to the tyrosinase-catalyzed reactions, whereas bacterial enzymes show potential in biotechnological applications, for the production of mixed melanins, for protein cross-linking reactions, for producing phenol(s) biosensors, of for the production of L-DOPA, an anti-Parkinson's disease drug.
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Affiliation(s)
- Luigi Pisano
- Section of Dermatology, Health Sciences Department, University of Florence, Florence, Italy
| | - Martina Turco
- Health Sciences Department (DSS), University of Florence, Florence, Italy
| | - Claudiu T Supuran
- Neurofarba Department, Pharmaceutical and Nutraceutical Section, University of Florence, Sesto Fiorentino, Florence, Italy.
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Demir FT, Altun E. Comparison of platelet-rich plasma efficacy with and without photoactivation in melasma: A randomized double-blind study. J Cosmet Dermatol 2024. [PMID: 39175423 DOI: 10.1111/jocd.16540] [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: 05/30/2024] [Revised: 07/25/2024] [Accepted: 08/09/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Photoactivation has been suggested to enhance the efficacy of platelet-rich plasma (PRP) in conditions other than dermatological diseases. AIMS To evaluate the efficacy of photoactivated PRP (P-PRP) treatment for melasma by comparing it with non-photoactivated, classical PRP (C-PRP). METHODS The study consisted of 38 female patients diagnosed with melasma between April 2022 and May 2023. The patients were randomized into the P-PRP and C-PRP groups. Three sessions of P-PRP or C-PRP were applied to the patients at 2-week intervals. The Melasma Area and Severity Index (MASI) and Melasma Quality of Life Index (MELASQoL) scores were compared before and 2 weeks after treatment. RESULTS The median age was 38 years, and the median disease duration was 60 months. Clinically, 94.7% of the cases were centrofacial and 5.3% were malar. According to Wood's lamp examination, 55.3% of the cases were epidermal, 13.2% were dermal, and 31.6% were mixed-type. The median pre- and post-treatment scores were 14.5 and 9, respectively, for MASI and 36.5 and 17, respectively, for MELASQoL. The post-treatment MASI and MELASQoL scores of both groups significantly decreased (p < 0.001 for both). However, the intergroup difference was not significant. When all patients were evaluated together a moderate, positive, and significant relationship was detected between PRP and the pre- and post-treatment MASI and MELASQoL scores (r = 0.494 and p = 0.002). No side effects associated with PRP were observed. CONCLUSION PRP is an effective and safe treatment method for melasma. Further studies are needed to evaluate the contribution of photoactivation to PRP treatment in melasma.
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Affiliation(s)
- Filiz Topaloğlu Demir
- Faculty of Medicine, Department of Dermatological and Venereal Diseases, Istanbul Medipol University, Istanbul, Turkey
| | - Ece Altun
- Faculty of Medicine, Department of Dermatological and Venereal Diseases, Istanbul Medipol University, Istanbul, Turkey
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Ahramiyanpour N, Mahmoudi Z, Nezhad NZ, Khazaeli P, Amiri R, Kasraee B. Topical isoniazid as a novel treatment for melasma: A randomized, double-blind, vehicle-controlled clinical trial. J Cosmet Dermatol 2024; 23:2636-2643. [PMID: 38581222 DOI: 10.1111/jocd.16320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/25/2024] [Indexed: 04/08/2024]
Abstract
INTRODUCTION Melasma is a chronic hyperpigmentation disorder, and its treatment poses a challenge to dermatologists due to its chronicity and resistance to conventional therapies. Oral isoniazid is used for the treatment of tuberculosis. One of us had previously showed that topical isoniazid exerts a strong depigmenting action in animal models. In this clinical trial, we assessed the therapeutic effect of topical isoniazid on melasma. METHODS Twenty female patients suffering from epidermal melasma were enrolled and divided equally into two groups. The treatment group received topical isoniazid 10%, and the control group received the cold cream vehicle as the placebo. All participants were advised to avoid sunlight and used SPF 50 sunscreen. Patients applied topical agents once daily at night for 3 months. The melanin and erythema indices were measured by colorimetric evaluations at baseline and after 4, 8, and 12 weeks of treatment. At these time points, the (mMASI) score was also determined, as was the subjective evaluation through Melasma Quality of Life Scale (MELASQOL) scores. Blood tests were performed to evaluate CBC and the liver enzymes. RESULTS All patients completed the 12-week study. In the treatment group, a significant decrease in melanin index from 63.77 ± 6.27 at baseline to 55.92 ± 5.79 was recorded (p = 0.001). Very minimal clinical changes were also seen in the control group and melanin index was decreased from 62.65 ± 2.23 to 61.25 ± 2.34 (p = 0.004). Clinically significant differences were observed in the rate of changes between both groups. These findings indicate that topical isoniazid has significant depigmenting effects compared to the placebo (p = 0.001). The erythema index remained unchanged in both groups. In the treatment group, the mMASI score was 5.63 ± 3.28 at baseline and 2.13 ± 1.71 at the last follow-up, significantly reduced compared to the control group (p = 0.002). The MELASQOL score indicated a significant improvement in the quality of life in the treatment group. CONCLUSION This clinical trial shows for the first time that topical isoniazid is effective in treating melasma. Further clinical trials are necessary to confirm the efficacy and tolerability of topical isoniazid in comparison with other skin-depigmenting compounds.
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Affiliation(s)
- Najmeh Ahramiyanpour
- Department of Dermatology, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Zahra Mahmoudi
- Department of Dermatology, Afzalipour Faculty of Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Payam Khazaeli
- School of Pharmacy, Kerman University of Medical sciences, Kerman, Iran
| | - Rezvan Amiri
- Department of Dermatology, Afzalipour Faculty of Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Behrooz Kasraee
- Department of Dermatology, Geneva University Hospital, Geneva, Switzerland
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Di Lorenzo R, Di Lorenzo V, Di Serio T, Marzocchi A, Ricci L, Vardaro E, Greco G, Maisto M, Grumetto L, Piccolo V, Morelli E, Laneri S. Phenylalanine Butyramide: A Butyrate Derivative as a Novel Inhibitor of Tyrosinase. Int J Mol Sci 2024; 25:7310. [PMID: 39000417 PMCID: PMC11242249 DOI: 10.3390/ijms25137310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 06/25/2024] [Accepted: 06/27/2024] [Indexed: 07/16/2024] Open
Abstract
Metabolites resulting from the bacterial fermentation of dietary fibers, such as short-chain fatty acids, especially butyrate, play important roles in maintaining gut health and regulating various biological effects in the skin. However, butyrate is underutilized due to its unpleasant odor. To circumvent this organoleptic unfavorable property, phenylalanine butyramide (PBA), a butyrate precursor, has been synthesized and is currently available on the market. We evaluated the inhibition of mushroom tyrosinase by butyrate and PBA through in vitro assays, finding IC50 values of 34.7 mM and 120.3 mM, respectively. Docking calculations using a homology model of human tyrosinase identified a putative binding mode of PBA into the catalytic site. The anti-aging and anti-spot efficacy of topical PBA was evaluated in a randomized, double-blind, parallel-arm, placebo-controlled clinical trial involving 43 women affected by photo-damage. The results of this study showed that PBA significantly improved skin conditions compared to the placebo and was well tolerated. Specifically, PBA demonstrated strong skin depigmenting activity on both UV and brown spots (UV: -12.7% and -9.9%, Bs: -20.8% and -17.7% after 15 and 30 days, respectively, p < 0.001). Moreover, PBA brightened and lightened the skin (ITA°: +12% and 13% after 15 and 30 days, respectively, p < 0.001). Finally, PBA significantly improved skin elasticity (Ua/Uf: +12.4% and +32.3% after 15 and 30 days, respectively, p < 0.001) and firmness (Uf: -3.2% and -14.9% after 15 and 30 days, respectively, p < 0.01).
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Affiliation(s)
- Ritamaria Di Lorenzo
- Department of Pharmacy, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Vincenzo Di Lorenzo
- Department of Organic Chemistry and Technology, Faculty of Chemical Technology and Biotechnology, Budapest University of Technology and Economics, Müegyetem rkp. 3, H-1111 Budapest, Hungary
| | - Teresa Di Serio
- Department of Pharmacy, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Adua Marzocchi
- Department of Pharmacy, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Lucia Ricci
- Department of Pharmacy, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Eleonora Vardaro
- Department of Pharmacy, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Giovanni Greco
- Department of Pharmacy, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Maria Maisto
- Department of Pharmacy, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Lucia Grumetto
- Department of Pharmacy, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Vincenzo Piccolo
- Department of Pharmacy, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Elena Morelli
- Department of Pharmacy, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Sonia Laneri
- Department of Pharmacy, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
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Zheng C, Wen X, Zhang L, Li L, Wen Y, Jiang F, Zeng N, Sun N. Research situation, hot spots, and global trends of melasma therapy: Bibliometric insights and visual analysis from 2000 to 2023. J Cosmet Dermatol 2024. [PMID: 38925583 DOI: 10.1111/jocd.16438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Melasma is a prevalent pigmented disease, yet its pathogenesis remains unclear, posing challenges for effective treatment. Bibliometric analysis, a novel approach to literature research, offers the opportunity to evaluate research trends through qualitative and quantitative methods. This study utilizes bibliometric methods to analyze the existing literature on melasma treatment, examining influential publications, institutions, countries, and authors through statistical analysis. METHODS In order to retrieve manuscripts related to the topic of melasma treatment, we conducted a search using the search formula: (TS = (melasma or Chloasma or "mask of pregnancy")) AND TS = (treatment or therapy). We searched through the Web of Science Core Collection database, covering publications from 2000 to 2023. VOSviewer, CiteSpace and the Bibliometric online site (https://bibliometric.com/app) were used to conduct this bibliometric analysis. Our analysis focused on various factors including publications, authors co-authorship, institutions, countries, citation analysis, keywords co-occurrence, references co-citation and journal co-citation. RESULTS A total of 943 articles and 200 reviews were published between 2000 and 2023, accumulating a total of 8628 citations. The average number of citations per item was 18.85, and the average number of citations per year was 292.69. The most prolific author, Sungeun Chang, contributed a total of 9 articles. Cario University emerged as the top research institution. The United States led in terms of article publications with a count of 276. In the past 5 years, the research trends in this field have primarily focused on tranexamic acid and epidermal melasma, as indicated by the burst analysis of publications and keywords. CONCLUSIONS The United States continues to lead in terms of institutions and research output. The current emphasis is on the meticulous implementation of tranexamic acid and laser therapy. It is crucial to foster enhanced collaboration among countries, institutions, and authors to facilitate improved research.
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Affiliation(s)
- Chenjie Zheng
- Department of Dermatology, Guizhou Province Cosmetic Plastic Surgery Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Xue Wen
- Department of Dermatology, Guizhou Province Cosmetic Plastic Surgery Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Lanfang Zhang
- Department of Dermatology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Lin Li
- Department of Dermatology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yang Wen
- Department of Dermatology, Guizhou Province Cosmetic Plastic Surgery Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Feng Jiang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Ni Zeng
- Department of Dermatology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Nana Sun
- Department of Dermatology, Guizhou Province Cosmetic Plastic Surgery Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, China
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Liu LX, Liao ZK, Dong BQ, Jiang S, Lei TC. Tranexamic Acid Ameliorates Skin Hyperpigmentation by Downregulating Endothelin-1 Expression in Dermal Microvascular Endothelial Cells. Ann Dermatol 2024; 36:151-162. [PMID: 38816976 PMCID: PMC11148312 DOI: 10.5021/ad.23.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/28/2023] [Accepted: 12/25/2023] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Although reports suggest that tranexamic acid (TXA) has clinical benefits for melasma patients by oral, intralesional and topical treatment, the optimal route of TXA therapy and the underlying mechanism involved remain poorly defined. OBJECTIVE To compare the skin lightening effect between oral TXA and topical TXA and to dissect the molecular mechanisms using ultraviolet B (UVB)-induced hyperpigmentation mouse model, ex vivo cultured human skin explant, and cultured melanocytes (MCs) and endothelial cells. METHODS Melanin content and cluster of differentiation 31 (CD31)-positive cell numbers were measured in tail skins from UVB-irradiated mice treated by intragastral or topical TXA using immunofluorescent and Fontana-Masson staining. The conditioned medium (CM) was harvested from human umbilical vein endothelial cells treated with or without 3 mM TXA and was used to treat MCs for 48 hours. mRNA and protein levels of tyrosinase and microphthalmia-associated transcription factor were measured using quantitative real-time reverse transcription polymerase chain reaction and western blotting assays. HMB45- and CD31-positive cell numbers as well as melanin content were also examined in ex vivo cultured human skin explants. RESULTS The hyperpigmented phenotype were significantly mitigated in UVB-irradiated tail skin plus intragastral TXA-treated mice compared with mice treated with UVB only or with UVB plus topical TXA. CD31-positive cell numbers correlated with the anti-melanogenic activity of TXA therapy. The data from cultured cells and skin tissues showed that suppression of endothelin-1 (ET-1) in vascular endothelial cells by TXA reduced melanogenesis and MC proliferation. CONCLUSION Oral TXA outperforms topical TXA treatment in skin lightening, which contributes to suppression of ET-1 in dermal microvascular endothelial cells by TXA.
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Affiliation(s)
- Lin-Xia Liu
- Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhi-Kai Liao
- Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Bing-Qi Dong
- Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shan Jiang
- Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Tie-Chi Lei
- Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan, China.
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Philipp-Dormston WG. Melasma: A Step-by-Step Approach Towards a Multimodal Combination Therapy. Clin Cosmet Investig Dermatol 2024; 17:1203-1216. [PMID: 38800358 PMCID: PMC11128260 DOI: 10.2147/ccid.s372456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024]
Abstract
Melasma is a common challenge in the field of pigmentary skin disorders, exerting a significant emotional and psychosocial burden on patients. The persistent and recurring nature of melasma complicates its management in routine clinical practice. This comprehensive review outlines a stepwise, practical approach encompassing diagnostic, preventive and therapeutic strategies for the management of melasma. A thorough exploration of aggravating and exacerbating factors, including sun exposure, hormonal imbalances, photosensitizing medication and cosmetics, is essential for a holistic assessment of the disease. With an emphasis on consistent and effective photoprotection, initial topical treatment modalities target the melanin production and/or the transfer of melanosomes to keratinocytes. Topical tyrosine inhibitors emerge as the first choice for reducing and preventing hyperpigmentation, with compounds such as thiamidol or tranexamic acid (TXA) being preferred for their safety profile over hydroquinone (HQ), kojic acid and arbutin. Combination with chemical peels can further enhance the therapeutic efficacy, even in cases with resistant melasma. In more severe cases, laser- and light-based interventions may be considered, but with the caveat of the likelihood of recurrence within 3-6 months. Assisted TXA delivery, via either fractional non-ablative laser or microneedling techniques, can further improve clinical outcomes. In conclusion, an optimal melasma management strategy is a multimodal approach, which includes effective photoprotection and a mix of different topical treatments targeting melanin synthesis, the anti-inflammatory environment, senescence and vascularity. Complementary procedures, such as chemical peels, and laser, light-based or microneedling procedures, with or without TXA, can further expedite melanin clearance in more severely affected instances. Individual discussions with patients regarding treatment expectations, recurrence likelihood and potential side effects are paramount to a comprehensive and successful therapeutic journey.
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Affiliation(s)
- Wolfgang G Philipp-Dormston
- Hautzentrum Köln/Cologne Dermatology, Cologne, Germany
- Faculty of Health, University of Witten/Herdecke, Witten, Germany
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Pamela RD, Vitale MDF, Fusco I, Zingoni T, Yi K. Experience using 675 nm laser on three cases of Fitzpatrick skin type IV-V with melasma. Skin Res Technol 2024; 30:e13748. [PMID: 38766988 PMCID: PMC11103554 DOI: 10.1111/srt.13748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 04/29/2024] [Indexed: 05/22/2024]
Affiliation(s)
- Ruri D. Pamela
- Department of DermatologyVenereology, & AestheticThe General Soedirman National Defense Central HospitalJakartaIndonesia
| | | | - Irene Fusco
- Department of Clinical Research and PracticeEl.En. GroupCalenzanoItaly
| | - Tiziano Zingoni
- Department of Clinical Research and PracticeEl.En. GroupCalenzanoItaly
| | - Kyu‐Ho Yi
- Division of Anatomy and Developmental Biology, Department of Oral BiologyYonsei University College of DentistrySeoulSouth Korea
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Lai D, Cheng S, Zhou S, Hao J, Chen H, Jia K, Liu H, Cui Y. 755-nm picosecond laser plus topical 20% azelaic acid compared to topical 20% azelaic acid alone for the treatment of melasma: a randomized, split-face and controlled trial. Lasers Med Sci 2024; 39:113. [PMID: 38656631 DOI: 10.1007/s10103-024-04052-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/07/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE Melasma remains a refractory skin condition that needs to be actively explored. Azelaic acid has been used for decades as a topical agent to improve melasma through multiple mechanisms, however, there is a lack of research on its combination with laser therapy. This study evaluated the effectiveness of isolated treatment with topical 20% azelaic acid and its combination with 755-nm picosecond laser in facial melasma patients. METHODS A randomized, evaluator-blinded, controlled study was conducted on 30 subjects with facial melasma in a single center from October 2021 to April 2022. All subjects received topical 20% azelaic acid cream (AA) for 24 weeks, and after 4 weeks, a hemiface was randomly assigned to receive 755-nm picosecond (PS) laser therapy once every 4 weeks for 3 treatments. Treatment efficacy was determined by mMASI score evaluations, dermoscopic assessment, reflectance confocal microscopy (RCM) assessments and patient's satisfaction assessments (PSA). RESULTS Treatment with 20% azelaic acid, with or without picosecond laser therapy, significantly reduced the hemi-mMASI score (P < 0.0001) and resulted in higher patient satisfaction. Improvements in dermoscopic and RCM assessments were observed in both sides of the face over time, with no difference between the two sides. RCM exhibited better dentritic cell improvement in the combined treatment side. No patients had serious adverse effects at the end of treatment or during the follow-up period. CONCLUSION The additional use of picosecond laser therapy showed no clinical difference except for subtle differences detected by RCM assessments.The study was registered in the Chinese Clinical Trial Registry (ChiCTR2100051294; 18 September 2021).
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Affiliation(s)
- Dihui Lai
- Department of Dermatology, China-Japan Friendship Hospital, Capital Medical University, NO.2 Yinghua East Road, Chaoyang District, Beijing, China
- Department of Dermatology, Chui Yang Liu Hospital Affiliated to Tsinghua University, Beijing, China
| | - Shaowei Cheng
- Department of Dermatology, Chui Yang Liu Hospital Affiliated to Tsinghua University, Beijing, China
| | - Shaona Zhou
- Department of Dermatology, Chui Yang Liu Hospital Affiliated to Tsinghua University, Beijing, China
| | - Jianchun Hao
- Department of Dermatology, Chui Yang Liu Hospital Affiliated to Tsinghua University, Beijing, China
| | - Hongguang Chen
- Institute of Mental Health, Peking University Sixth Hospital, Beijing, China
| | - Kang Jia
- Department of Dermatology, MEIYAN Aesthetic Plastic Medical Clinic, Beijing, China
| | - Hongmei Liu
- Department of Dermatology, MEIYAN Aesthetic Plastic Medical Clinic, Beijing, China
| | - Yong Cui
- Department of Dermatology, China-Japan Friendship Hospital, Capital Medical University, NO.2 Yinghua East Road, Chaoyang District, Beijing, China.
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11
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Liang R, Luo H, Pan W, Yang S, Peng X, Kuang B, Huang H, Liu C. Comparative efficacy and safety of tranexamic acid for melasma by different administration methods: A systematic review and network meta-analysis. J Cosmet Dermatol 2024; 23:1150-1164. [PMID: 38059683 DOI: 10.1111/jocd.16104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/13/2023] [Accepted: 11/06/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Tranexamic acid (TA) is a new and promising drug for the treatment of melasma. OBJECTIVES This network meta-analysis aims to compare the efficacy and safety of various ways of administration of TA on melasma. METHODS We collected researches from PubMed, EMBASE, Cochrane Library and Web of Science. Melasma area severity index (MASI) is used to evaluate the severity of melasma. After treatment with different TA administration methods, a difference in MASI is named ΔMASI. We evaluate the curative effect by comparing the ΔMASI of different TA administration methods at a certain time point. RESULTS At the Weeks 4, 8, and 12 and the last follow-up, the ΔMASI of oral TA combined with routine topical agents (oTA + RTA) was higher than that of intradermal TA (iTA), topical TA (tTA) as well as microneedling TA (MNsTA), with statistical significance. At the 8th week, the ΔMASI of oTA was higher than that of iTA, with statistical significance. Compared with placebo, oTA showed statistically significant differences at Week 4, while tTA, iTA, and MNsTA showed statistically significant differences starting from Week 8. CONCLUSIONS Among various ways of administration of TA, oTA + RTA has the best effect on melasma. In the short term, the curative effect of oTA is better than that of iTA, and the onset time of oTA is faster than that of tTA, iTA and MNsTA. In the long run, the curative effect of TA alone has nothing to do with the mode of administration.
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Affiliation(s)
- Rongzhou Liang
- Department of Laser Cosmetology, The Sixth People's Hospital of Dongguan, Dongguan, Guangdong, China
| | - Haiyan Luo
- Department of Laser Cosmetology, The Sixth People's Hospital of Dongguan, Dongguan, Guangdong, China
| | - Wanwan Pan
- Department of Dermatology, The Sixth People's Hospital of Dongguan City, Dongguan, Guangdong Province, China
| | - Sifen Yang
- Department of Plastic and Cosmetology, The Sixth People's Hospital of Dongguan City, Dongguan, Guangdong Province, China
| | - Xiaoyun Peng
- Department of Plastic and Cosmetology, The Sixth People's Hospital of Dongguan City, Dongguan, Guangdong Province, China
| | - Baizeng Kuang
- Department of Plastic and Cosmetology, The Sixth People's Hospital of Dongguan City, Dongguan, Guangdong Province, China
| | - Hongyin Huang
- Department of Plastic and Cosmetology, The Sixth People's Hospital of Dongguan City, Dongguan, Guangdong Province, China
| | - Chengjiang Liu
- Department of General Medicine, Affiliated Anqing First People's Hospital of Anhui Medical University, Hefei, China
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12
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Zhao S, Wang M, Lai X, Yan Y. Efficacy and Safety of Ablative Fractional Laser in Melasma: A Meta-analysis and Systematic Review. Lasers Med Sci 2024; 39:71. [PMID: 38379033 DOI: 10.1007/s10103-024-03972-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 12/31/2023] [Indexed: 02/22/2024]
Abstract
Melasma is a common acquired skin pigmentation disorder. The treatment is urgent but challenging. Ablative fractional laser (AFL) can improve pigmentation, but the efficacy and potential side effects are still debatable. This study aimed to evaluate the efficacy and safety of ablative fractional lasers in the treatment of melasma. A comprehensive systematic search of literature published before June 20, 2023, was conducted on online databases, including PubMed, Embase, Cochrane Library, and Web of Science. The data obtained were analyzed using Review Manager 5.4 software. Fourteen randomized controlled trials, comprising 527 patients, were included. Compared to the drug alone, the combination of AFL and the drug showed improved therapeutic efficacy in the melasma area and severity index (MASI) (MD = 1.54, 95% CI [0.16, 2.92], P = 0.03) and physician global assessment (RR = 1.61, 95% CI [1.08, 2.41], P = 0.02). However, no statistically significant results were found in patient self-assessment (RR = 1.56, 95% CI [0.88, 2.76], P = 0.12). As an individual therapy, AFL is not superior to any other lasers in terms of MASI (MD = 2.66, 95% CI [-1.32, 6.64], P = 0.19) or melanin index (MD = -7.06, 95% CI [-45.09, 30.97], P = 0.72). Common adverse events included transient erythema, burning, edema, and superficial crusting. Only a few patients experienced reversible post-inflammatory hyperpigmentation, herpes labialis, and acne breakouts. These results support the application of AFL as a viable treatment option for melasma, particularly in refractory and severe cases. Rational parameterization or combination therapy may lead to significant clinical improvement with fewer complications.
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Affiliation(s)
- Shasha Zhao
- Department of Dermatology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.33 Badachu Shijingshan District, Beijing, 100144, China
| | - Meng Wang
- Department of Dermatology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.33 Badachu Shijingshan District, Beijing, 100144, China
| | - Xiaodong Lai
- Department of Dermatology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.33 Badachu Shijingshan District, Beijing, 100144, China
| | - Yan Yan
- Department of Dermatology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.33 Badachu Shijingshan District, Beijing, 100144, China.
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13
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Tolone M, Bennardo L, Zappia E, Scali E, Nisticò SP. New Insight into Nonablative 675-nm Laser Technology: Current Applications and Future Perspectives. Dermatol Clin 2024; 42:45-50. [PMID: 37977683 DOI: 10.1016/j.det.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
In the nonablative laser field, a new technology that emits a 675-nm wavelength red light is emerging. A literature review was performed to examine its efficacy and safety in the treatment of skin diseases. Various databases were searched (PubMed, Google Scholar, and ClinicalTrials.gov) up to March 2023. Skin aging disorders, melasma, and acne scars were the main diseases discussed in the literature. Although the therapeutic outcomes were variable, all of the studies reported good clinical outcomes. The new 675-nm laser system, targeting collagen, is promising in the treatment of aging-related skin conditions, melasma, and acne scars.
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Affiliation(s)
- Martina Tolone
- Department of Health Sciences, Magna Graecia University, Catanzaro 88100, Italy
| | - Luigi Bennardo
- Department of Health Sciences, Magna Graecia University, Catanzaro 88100, Italy
| | - Elena Zappia
- Department of Health Sciences, Magna Graecia University, Catanzaro 88100, Italy
| | - Elisabetta Scali
- Department of Health Sciences, Magna Graecia University, Catanzaro 88100, Italy
| | - Steven Paul Nisticò
- Department of Health Sciences, Magna Graecia University, Catanzaro 88100, Italy.
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14
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Mohamed M, Beshay YMA, Assaf HM. Microneedling with glutathione versus microneedling alone in treatment of facial melasma: Split-face comparative study. J Cosmet Dermatol 2023; 22:3379-3386. [PMID: 37313658 DOI: 10.1111/jocd.15834] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 04/29/2023] [Accepted: 05/12/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND Melasma is a distressing disfiguring acquired pigmentary disorder especially affecting females and it is of high tendency of recurrence. Up till now, treatment of melasma is a challenging problem. OBJECTIVES We evaluated the effectiveness of microneedling with glutathione versus microneedling alone in treatment of melasma. PATIENTS AND METHODS In this study, 29 adult females with epidermal type of melasma (confirmed with Wood's light examination) were enrolled. The affected area was subjected to microneedling using dermapen followed by application of glutathione solution on the right side only. This session was performed every 2 weeks for 3 months (six sessions for every patient). The response to therapy was measured using modified melasma area and severity index (m MASI) that were calculated on each side of the face (Hemi- m MASI) before treatment sessions. RESULTS There was statistically significant reduction in the mean of Hemi- m MASI score over the sessions on both sides of the face but the right side (microneedling with glutathione) showed more reduction and earlier response to therapy than the left side (microneedling alone). On the left side, mean of Hemi- m MASI score before and after sessions was (4.06 ± 1.91, 2.31 ± 1.450) and on the right side, it was (4.21 ± 2.08, 1.96 ± 1.30), respectively and this was statistically significant. Percentage of improvement on the left side was 46.92 ± 16.30 (%) while on the right side was 55.17 ± 15.50 (%) and this was statistically significant. CONCLUSIONS Microneedling is an effective promising tool in treatment of melasma and its combination with glutathione as a whitening agent, increases and accelerates its efficacy. So, combined therapy is more preferred than monotherapy in treatment of facial melasma.
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Affiliation(s)
- Marwa Mohamed
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | | | - Hanan Metwally Assaf
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
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15
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Shin H, Lee Y, Hwang J, Lim S, Choi J, Gong SP, Kang HW. Effect of dual-optical pulses with temporal energy distribution on laser ablation performance in in vivo zebrafish model. JOURNAL OF BIOPHOTONICS 2023; 16:e202300232. [PMID: 37651611 DOI: 10.1002/jbio.202300232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/06/2023] [Accepted: 08/28/2023] [Indexed: 09/02/2023]
Abstract
A Q-switched laser system has been used in a single-pulse mode for skin melasma treatments because of instant heat deposition in the target. Despite the efficient ablation of the melanophores in the skin, the single, high-fluence pulse often causes undesirable damage to the surrounding tissue, leading to high recurrence rates. This study aims to investigate the feasibility of dual-optical pulses with a temporal energy distribution on the melasma treatment in in vivo zebrafish models in comparison to that of the single optical pulse. Based on the optical detection, the dual-optical pulses had a temporal energy distribution ratio of 4:1 and an interval of 61 μs between the two consecutive pulses. According to the histological analysis, the dual pulses removed melanophores and induced a few apoptotic nuclei with minimal recurrence. This study demonstrated that the feasibility of dual-optical pulses (energy ratio = 4:1) could enhance the laser ablation performance in vivo.
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Affiliation(s)
- Hwarang Shin
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, Republic of Korea
| | - Yeachan Lee
- Marine-Integrated Biomedical Technology Center, Pukyong National University, Busan, Republic of Korea
| | - Junghyun Hwang
- Department of Biomedical Engineering, Division of Smart Healthcare, College of Information, Pukyong National University, Busan, Republic of Korea
| | - Seonghee Lim
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, Republic of Korea
| | - Jongman Choi
- Research and Development, Bluecore Company, Busan, Republic of Korea
| | - Seung Pyo Gong
- Division of Fisheries Life Science, Major in Aquaculture and Applied Life Science, Pukyong National University, Busan, Republic of Korea
| | - Hyun Wook Kang
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, Republic of Korea
- Marine-Integrated Biomedical Technology Center, Pukyong National University, Busan, Republic of Korea
- Department of Biomedical Engineering, Division of Smart Healthcare, College of Information, Pukyong National University, Busan, Republic of Korea
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16
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Ma W, Gao Q, Liu J, Zhong X, Xu T, Wu Q, Cheng Z, Luo N, Hao P. Efficacy and safety of laser-related therapy for melasma: A systematic review and network meta-analysis. J Cosmet Dermatol 2023; 22:2910-2924. [PMID: 37737021 DOI: 10.1111/jocd.16006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 09/03/2023] [Accepted: 09/13/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Melasma is a prevalent, persistent hyperpigmentation disorder that negatively affects the psychological health of patients. However, the treatment outcome remains unsatisfactory due to the complexity of pathogenesis, recurrence characteristics, and relatively high morbidity. OBJECTIVES To compare the performance of laser-related therapies in improving the melasma area severity index (MASI) score of melasma and the occurrence of adverse effects by network meta-analysis (NMA). METHODS From the inception to November 2022, eligible randomized controlled trials were identified. Two investigators independently searched relevant studies from PUBMED, EMBASE, and the Cochrane Library database. RESULTS A total of 39 clinical studies with 1394 participants were eligible for enrollment. For efficacy, the NMA demonstrated that Q-switched Nd: YAG laser + topical medications (QSND+TM) was superior to Q-switched Nd:YAG laser (QSND) [MD = -4.21 (-6.80, -1.63)], Er: YAG laser + topical medications (ERYL+TM) [MD = -3.52 (-6.84, -0.19)], and picosecond laser + topical medications (PICO+TM) [MD = -4.80 (-9.33, -0.27)]. The microneedling + topical medications (MN+TM) was superior to picosecond laser (PICO) [MD = -5.26 (-10.44, -0.08)] and topical medications (TM) [MD = -5.22 (-9.20, -1.23)]. The top five of the surface under the cumulative ranking curve value (SUCRA) are Q-switched Nd:YAG laser + topical medications (QSND+TM 85.9%), oral tranexamic acid (oTA 80.1%), microneedling + topical medications (MN+TM 79.7%), Q-switched Nd:YAG laser + intense pulse light (QSND+IPL 78.9%), and fractional carbon dioxide laser + topical medications (FCDL+TM 70.5%). CONCLUSIONS In conclusion, the Qs-Nd:YAG laser with topical medications is the first choice for treating melasma according to the SUCRA value. Among the three treatment modalities, namely MN + TM, PICO, and TM, our recommendation favors MN+TM as the superior choice for enhancing the curative efficacy in melasma. However, the actual clinical choice should also take into account the adverse effects, the skin type of the patient, the duration of the disease, and other relevant factors.
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Affiliation(s)
- Wenyi Ma
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qian Gao
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jinghua Liu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaojing Zhong
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tongtong Xu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qinyao Wu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zilin Cheng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Nana Luo
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Pingsheng Hao
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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17
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Rodríguez-Luna A, Zamarrón A, Juarranz Á, González S. Clinical Applications of Polypodium leucotomos (Fernblock ®): An Update. Life (Basel) 2023; 13:1513. [PMID: 37511888 PMCID: PMC10381169 DOI: 10.3390/life13071513] [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: 06/20/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
Exposure to sun radiation leads to higher risk of sunburn, pigmentation, immunosuppression, photoaging and skin cancer. In addition to ultraviolet radiation (UVR), recent research indicates that infrared radiation (IR) and visible light (VIS) can play an important role in the pathogenesis of some of these processes. Detrimental effects associated with sun exposure are well known, but new studies have shown that DNA damage continues to occur long after exposure to solar radiation has ended. Regarding photoprotection strategies, natural substances are emerging for topical and oral photoprotection. In this sense, Fernblock®, a standardized aqueous extract of the fern Polypodium Leucotomos (PLE), has been widely administered both topically and orally with a strong safety profile. Thus, this extract has been used extensively in clinical practice, including as a complement to photodynamic therapy (PDT) for treating actinic keratoses (AKs) and field cancerization. It has also been used to treat skin diseases such as photodermatoses, photoaggravated inflammatory conditions and pigmentary disorders. This review examines the most recent developments in the clinical application of Fernblock® and assesses how newly investigated action mechanisms may influence its clinical use.
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Affiliation(s)
- Azahara Rodríguez-Luna
- Department of Basic Health Sciences, Faculty of Health Sciences, Universidad Rey Juan Carlos (URJC), 28933 Alcorcón, Spain
- Department of Pharmacology, Faculty of Pharmacy, University of Seville, 41012 Seville, Spain
| | - Alicia Zamarrón
- Department of Biology, Faculty of Sciences, Autónoma University of Madrid (UAM), 28049 Madrid, Spain
| | - Ángeles Juarranz
- Department of Biology, Faculty of Sciences, Autónoma University of Madrid (UAM), 28049 Madrid, Spain
| | - Salvador González
- Department of Medicine and Medical Specialties, Alcalá de Henares University, 28805 Madrid, Spain
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18
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Wan J, Liao Z, Dong B, Jiang S, Lei T. Targeting senescent dermal fibroblasts responsible for hyperactive melanocytes in melasma. Chin Med J (Engl) 2023:00029330-990000000-00549. [PMID: 37057732 DOI: 10.1097/cm9.0000000000002488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Indexed: 04/15/2023] Open
Affiliation(s)
- Jing Wan
- Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
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19
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Liang S, Shang S, Zhang W, Tan A, Zhou B, Mei X, Li L. Comparison of the efficacy and safety of picosecond Nd:YAG laser (1,064 nm), picosecond alexandrite laser (755 nm) and 2% hydroquinone cream in the treatment of melasma: A randomized, controlled, assessor-blinded trial. Front Med (Lausanne) 2023; 10:1132823. [PMID: 37056729 PMCID: PMC10086227 DOI: 10.3389/fmed.2023.1132823] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/07/2023] [Indexed: 03/30/2023] Open
Abstract
BackgroundIncreasing numbers of studies demonstrated that picosecond lasers (Picos) were effective and safe for melasma. However, A limited number of randomized controlled trials (RCTs) regarding Picos contribute to a modest level of evidence. Topical hydroquinone (HQ) remains to be the first-line therapy.ObjectiveTo compare the efficacy and safety of non-fractional picosecond Nd:YAG laser (PSNYL), non-fractional picosecond alexandrite laser (PSAL), and 2% HQ cream in the treatment of melasma.MethodSixty melasma patients with Fitzpatrick skin types (FST) III-IV were randomly assigned to the PSNY, PSAL, and HQ groups at a 1:1:1 ratio. Patients in PSNYL and PSAL groups received 3 laser sessions at 4-week intervals. The 2% HQ cream was applied twice daily for 12 weeks in patients of the HQ group. The primary outcome, the melasma area and severity index (MASI) score, was evaluated at weeks 0, 4, 8, 12, 16, 20, and 24. The patient assessment score by quartile rating scale was rated at weeks 12, 16, 20, and 24.ResultsFifty-nine (98.3%) subjects were included in the analysis. Each group showed significant change from baseline in MASI scores from week 4 to week 24. The MASI score in the PSNYL group showed the greatest reduction compared to the PSAL group (p = 0.016) and HQ group (p = 0.018). The PSAL group demonstrated comparable MASI improvement as the HQ group (p = 0.998). The PSNYL group had the highest patient assessment score, followed by the PSAL group and then the HQ group, although only the differences between PSNYL and HQ groups at weeks 12 and 16 were significant. Four patients (6.8%) experienced recurrence. Other unanticipated events were transient and subsided after 1 week to 6 months.ConclusionThe efficacy of non-fractional PSNYL was superior to that of non-fractional PSAL, which was not inferior to 2% HQ, thus non-fractional Picos providing an alternative for melasma patients with FSTs III-IV. The safety profiles of PSNYL, PSAL, and 2% HQ cream were similar.Clinical Trial Registrationhttps://www.chictr.org.cn/showprojen.aspx?proj=130994, ChiCTR2100050089.
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20
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Apt DP, Calderon PD, Kohn BG. Enfrentamiento del paciente con melasma: actualizaciones en tratamiento. REVISTA MÉDICA CLÍNICA LAS CONDES 2023. [DOI: 10.1016/j.rmclc.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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21
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Li Y, Shao WN, Fang QQ, Zhao WY, Wang SQ, Wu LH, Hu YY, Wang XF, Xue YN, Chen L, Tan WQ. A combination treatment of drug-laser-photon for melasma: A retrospective study of clinical cases. J Cosmet Dermatol 2023; 22:822-830. [PMID: 36374742 DOI: 10.1111/jocd.15488] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 09/30/2022] [Accepted: 10/19/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Combinational therapy such as taking tranexamic acid while using laser treatment has been proved potential efficacy by many experiments. However, there is few research which contains large samples and consistent observations. OBJECTIVE We evaluated clinical efficacy and safety of a new systemic treatment of drug-laser-photon therapy. METHODS Retrospective and randomized investigator-blinded study of 75 patients with mixed type melasma was analyzed. At each visit, standardized photographs were taken using VISIA. Modified melasma area and severity index (mMASI) scores were marked using photographs by two dermatologists. RESULTS The mMASI score decreased significantly from 6.92 to 3.84 after the treatment. The VISIA analyze right cheek data shows: Spots (from 49.67 ± 3.43 to 56.09 ± 3.31), UV spots (from 41.39 ± 24.45 to 44.56 ± 25.86), and Brown spots (from 23.97 ± 17.89 to 28.16 ± 21.28) are statistically increased (p = 0.035, p = 0.018, p = 0.07). All patients feel varying degrees of improvement, about 10.17% felt very much improved, 30.51% felt much improved (51%-75%), 45.76% felt moderately improved (26%-50%), and 13.56% felt little improved (1%-25%). LIMITATIONS This study was no control group. CONCLUSION The efficacy and safety profile of the combination of drug-laser-photon therapy systemic treatment in melasma patients has been proved. It has potential possibility to become a new, reliable, widely suitable therapy strategy.
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Affiliation(s)
- Ying Li
- Department of Plastic Surgery, Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei-Na Shao
- Department of Plastic Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qing-Qing Fang
- Department of Plastic Surgery, Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wan-Yi Zhao
- Department of Plastic Surgery, Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shi-Qin Wang
- Department of Plastic Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li-Hong Wu
- Department of Plastic Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan-Yan Hu
- Department of Plastic Surgery, Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao-Feng Wang
- Department of Plastic Surgery, Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ya-Nan Xue
- Department of Plastic Surgery, Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li Chen
- Department of Plastic Surgery, Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei-Qiang Tan
- Department of Plastic Surgery, Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Abstract
Doctors-in-training often receive an inadequate dermatology education. Furthermore, studies have highlighted the under-representation of skin of colour (SOC) in dermatological teaching, learning resources and research. Our image-based questionnaire, distributed to all internal medicine trainees in southwest England, highlighted knowledge gaps regarding SOC among training physicians. It is intrinsically more challenging for clinicians to confidently formulate dermatological diagnoses in SOC. In this review, we provide guidance for physicians to help make the diagnostic process more straightforward. First, we outline how skin colour is determined and classified. We discuss how inflammation presents in SOC, with the typical 'erythema' that physicians often associate with inflammation being a less prominent feature in darker skin tones. We then summarise nine important conditions that we believe physicians working in all specialties should be able to identify in patients with SOC, covering both conditions encountered on the medical take and conditions disproportionately affecting individuals with SOC. The population of the UK is rapidly diversifying; thus, as physicians, we have a professional duty to educate ourselves on dermatological conditions in SOC to provide the best quality of care for all our patients, regardless of their skin type.
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Affiliation(s)
- Eliza Hutchison
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Rakeb Yoseph
- University of Bristol Medical School, Bristol, UK
| | - Hannah Wainman
- Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
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23
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Brasil Dos Santos J, Nagem Lopes LP, de Lima GG, Teixeira da Silva R, da Silva E Souza Lorca B, Miranda Pinheiro G, Faria de Freitas ZM. Microneedling with cutaneous delivery of topical agents for the treatment of melasma: A systematic review. J Cosmet Dermatol 2022; 21:5680-5695. [PMID: 35933690 DOI: 10.1111/jocd.15287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/20/2022] [Accepted: 08/01/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Melasma is an acquired hyperpigmentation disorder. Microneedling is an alternative treatment for melasma especially by improving penetration of pharmacological agents into the skin. OBJECTIVE The main objective of this review was to systematize and analyze available evidence on the efficacy and safety of microneedling alone or associated with topical agents in reducing skin stains and improving melasma-related quality of life in adult patients. METHODS Only randomized clinical trials were included. The following databases were consulted: MEDLINE, Embase, Cochrane, and the gray literature. The Cochrane risk-of-bias tool for randomized trials (RoB 2.0) was used to assess risk of bias. RESULTS The search retrieved 719 records and seven studies were included. A total of 368 participants (96.19% women) were evaluated. Two studies were split-face. Most of the studies evaluated microneedling associated with tranexamic acid. High risk of bias was presented by most studies, especially in the safety outcome. A significant decrease was observed in the MASI, mMASI, or hemi-MASI scores, regardless of the topical agents associated. Meta-analysis was not possible due to the heterogeneity of the studies. CONCLUSION Based on the results of this review, microneedling can, in association with topical agents or isolated, be used safely in the treatment of melasma in the clinical practice, obtaining results on reduction of stain severity and improvement of patients' quality of life.
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Affiliation(s)
- Jenifer Brasil Dos Santos
- Graduate Program in Pharmaceutical Science and Technology, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Gabriela Gomes de Lima
- Graduate Program in Pharmaceutical Science and Technology, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | - Zaida Maria Faria de Freitas
- Graduate Program in Pharmaceutical Science and Technology, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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24
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Zhang B, Xie B, Shen Y, Zhang L, Song X. Single and combined 1064 nm Q-switched Nd: YAG laser therapy in melasma: a meta-analysis. J Cosmet Dermatol 2022; 21:3794-3802. [PMID: 35876484 DOI: 10.1111/jocd.15270] [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: 04/07/2022] [Accepted: 07/21/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE This article attempted to describe the efficacy and safety of 1064QNYL in combination with other treatments for refractory melasma. METHODS Two researchers independently retrieved randomized controlled trials (RCTs) according to inclusion and exclusion criteria. Primary outcome was evaluated with MASI and mMASI scores in control group and experiment group. The secondary outcome was evaluated with MI scores. We calculated 95%CI of standardized mean difference (SMD) and heterogeneity of the included literature by Higgins I2 test, and assessed publication bias by Funnel plots, Egger's, and Begg's tests. RESULTS A total of 12 articles including 322 subjects were analyzed. Experiment group was treated with 1064QNYL combined with single treatment (e.g., PDL, IPL, RF, TA). Control group was treated with 1064QNYL alone. A greater reduction of Melasma Area and Severity Index (MASI)/modified Melasma Area and Severity Index (mMASI) scores were shown in experiment group than that in control group at the end of the treatment (SMD, -0.37; 95%CI -0.70 to -0.04, p=0.03, I2 =33%). The SMD of MI scores further supported this conclusion by -0.32 (95%CI -0.63 to -0.02, P =0.04, I2 =27%). As for adverse events (AEs), combined treatment gave rise to more mild burning, stinging, and erythema that resolved spontaneously. Several studies reported focal purpura, punctate leukoderma, hyperpigmentation and hypopigmentation, and so on. CONCLUSION Combined 1064QNYL treatment was better than single laser treatment, with the highest short-term benefit and long-term follow-up to maintain the effect in favor of combined treatment.
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Affiliation(s)
- Beilei Zhang
- The fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Bo Xie
- Department of Dermatology, Hangzhou Third People's Hospital; Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University; Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yuqing Shen
- Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Li Zhang
- The fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Xiuzu Song
- Department of Dermatology, Hangzhou Third People's Hospital; Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University; Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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The Low-Fluence Q-Switched Nd:YAG Laser Treatment for Melasma: A Systematic Review. Medicina (B Aires) 2022; 58:medicina58070936. [PMID: 35888655 PMCID: PMC9323185 DOI: 10.3390/medicina58070936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/07/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022] Open
Abstract
Melasma is a common pigmentary disorder with a complex pathogenesis, of which the treatment is challenging. Conventional treatment often leads to inconsistent results with unexpected pigmentary side effects and high recurrence rates. Recently, the low-fluence Q-switched Nd:YAG laser (LFQSNY) has been widely used for treating melasma, especially in Asia. We reviewed literatures on the LFQSNY treatment of melasma published between 2009 and May 2022 to evaluate the efficacy and adverse events, including its combination therapy. A systematic PubMed search was conducted and a total of 42 articles were included in this study. It was hard to summarize the heterogenous studies, but LFQSNY appeared to be a generally effective and safe treatment for melasma considering the results of previous conventional therapies. However, mottled hypopigmentation has been occasionally reported to develop and persist as an adverse event of LFQSNY, which may be associated with the high accumulated laser energy. When used aggressively, even LFQSNY can induce hyperpigmentation via unwanted inflammation, especially in darker skin. Although few studies have reported considerable recurrence rates three months after treatment, unfortunately, there is a lack of the long-term follow-up results of LFQSNY in melasma. To enhance the effectiveness and reduce the adverse events, LFQSNY has been used in combination with other treatment modalities in melasma, including topical bleaching agents, oral tranexamic acid, chemical peeling, or diverse energy-based devices, which generally reduced side effects with or without significant superior efficacy compared to LFQSNY alone.
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Avianggi HD, Indar R, Adriani D, Riyanto P, Muslimin M, Afriliana L, Kabulrachman K. The effectiveness of tomato extract on superoxide dismutase (SOD) and severity degree of patients with melasma. Ital J Dermatol Venerol 2022; 157:262-269. [PMID: 35707866 DOI: 10.23736/s2784-8671.22.07152-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Melasma is present in 40% of cases in Southeast Asia. The condition is often unresponsive to therapy; treatment has variable success rates, and melasma has high recurrence rates. Lycopene-rich tomato extract is needed to avoid oxidative stress due to ultraviolet rays that cause melasma through the melanogenesis pathway. The aim of this study was to evaluate the effectiveness of an oral tomato extract supplement as an adjuvant for melasma therapy. METHODS The study recruited 62 subjects with melasma to a true-experimental clinic with a double-blind, randomized, pre and post-test control design over 12 weeks at the Diponegoro National Hospital, Indonesia. The subjects received an oral tomato extract supplement contains lycopene 30 mg (placebo). All subjects applied topical sunscreen and hydroquinone-4%-cream. Subjects were assessed by superoxide dismutase (SOD) and melasma area and severity index (MASI). RESULTS Fifty-nine patients completed the research. The serum SOD levels in the treatment group (tomato extract supplementation) were higher than in the control group given the placebo, with delta SOD (P<0.05). The difference in MASI Scores after therapy in the treatment group had a significant decrease compared to the control group, with statistical review results suggesting that the difference was significant (P<0.05). CONCLUSIONS Supplementation of tomato extract as an adjuvant therapy can increase serum SOD levels and improve melasma severity.
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Affiliation(s)
- Hayra D Avianggi
- Department of Dermatovenereology, Faculty of Medicine, Diponegoro University, Semarang, Indonesia -
| | - Retno Indar
- Department of Dermatovenereology, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Diah Adriani
- Department of Dermatovenereology, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Puguh Riyanto
- Department of Dermatovenereology, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Muslimin Muslimin
- Department of Dermatovenereology, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Liza Afriliana
- Department of Dermatovenereology, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
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Liu Y, Wu S, Wu H, Liang X, Guo D, Zhuo F. Comparison of the Efficacy of Melasma Treatments: A Network Meta-Analysis of Randomized Controlled Trials. Front Med (Lausanne) 2021; 8:713554. [PMID: 34660626 PMCID: PMC8511390 DOI: 10.3389/fmed.2021.713554] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 08/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Melasma is an acquired pigmentation disorder with challenges in treatment because of its refractory nature and high risk of recurrence. Objectives: This study aimed to compare the efficacy and side effects of 14 common therapies for melasma using a systematic review and network meta-analysis (NMA). Methods: The PubMed, Embase, and Cochrane Library databases were searched till December 2020 using the melasma area and severity index as a therapeutic index. A total of 59 randomized controlled trials (RCTs) met the inclusion criteria and were selected. Results: The ranking of relative efficacy compared with placebo in descending order was Q-switched Nd:Yag 1,064-nm laser (QSND), intense pulsed light, ablative fractional laser (AFL), triple combined cream (TCC), topical vitamin C, oral tranexamic acid (oTA), peeling, azelaic acid, microneedles (MNs), topical tranexamic acid (tTA), tretinoin, picosecond laser, hydroquinone (HQ), and non-AFL. Moreover, QSND was more effective than HQ and tTA against melasma. The ranking of percentage (%) of side effects in ascending order for each of 14 therapies with more than 80 participants was tretinoin (10.1%), oTA (17.6%), HQ (18.2%), AFL (20.0%), QSND (21.5%), TCC (25.7%), tTA (36.75%), peeling (38.0%), and MN (52.3%). Taking both efficacy and safety into consideration, TCC was found to be the most favorable selection among the topical drugs for melasma. QSND and AFL were still the best ways to treat melasma among photoelectric devices. oTA as system administration was a promising way recommended for melasma. Among 31 studies, 87% (27/31) studies showed that the efficacy of combination therapies is superior to that of single therapy. The quality of evidence in this study was generally high because of nearly 50% of split-face RCTs. Conclusions: Based on the published studies, this NMA indicated that QSND, AFL, TCC, and oTA would be the preferred ways to treat melasma for dermatologists. However, more attention should be paid to the efficacy and safety simultaneously during the clinical application. Most of the results were in line with those of the previous studies, but a large number of RCTs should be included for validation or update. Systematic Review Registration: identifier: CRD42021239203.
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Affiliation(s)
- Yi Liu
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shanshan Wu
- National Clinical Research Center of Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Haixuan Wu
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xuelei Liang
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Dechao Guo
- Department of General Surgery, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Fenglin Zhuo
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Bonan P, Verdelli A, Pieri L, Fusco I. Could 675-nm Laser Treatment Be Effective for Facial Melasma Even in Darker Phototype? PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:634-636. [PMID: 34597175 DOI: 10.1089/photob.2021.0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: The study assesses the safety and efficacy of a 675-nm laser source on melasma. Background: Melasma is a frequent acquired skin disease defined by the presence of hyperpigmented macules on the face. Methods: Study protocol included up to three sessions of the 675-nm laser. Objective evaluation was assessed by using a 5-point visual analogue pain scale (VAS) (range, 0-4). Treatment tolerance was assessed using the 5-point VAS. Results: A mean 3.1 ± 0.7 improvement was reached according to photographic evaluation by VAS. Patients treated one time showed mean clearance of 3.3 ± 0.76, patients treated two times showed mean clearance of 3.0 ± 0.71, and patients treated three times showed mean clearance of 3.0 ± 1. Pain score mean was 1.2 ± 0.4. Conclusions: The 675-nm laser system seems to be safe and effective even in the treatment of facial melasma in patients with Fitzpatrick phototypes IV to V.
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Affiliation(s)
- Paolo Bonan
- Laser Cutaneous Cosmetic and Plastic Surgery Unit, Villa Donatello Clinic, Florence, Italy
| | - Alice Verdelli
- Laser Cutaneous Cosmetic and Plastic Surgery Unit, Villa Donatello Clinic, Florence, Italy
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Kim H, Hwang JK, Choi J, Kang HW. Dependence of laser-induced optical breakdown on skin type during 1064 nm picosecond laser treatment. JOURNAL OF BIOPHOTONICS 2021; 14:e202100129. [PMID: 34114344 DOI: 10.1002/jbio.202100129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/28/2021] [Accepted: 06/04/2021] [Indexed: 06/12/2023]
Abstract
The current study aims to evaluate the dependence of laser-induced optical breakdown (LIOB) on skin types by using 1064 nm picosecond laser with micro-lens arrays (MLA) and diffractive optical elements (DOE). Both black and white skin tissues were examined to comparatively assess the LIOB effects in the skin in terms of laser-induced vacuolization. The black skin irradiated at 3.0 J/cm2 demonstrated that MLA yielded a deeper distribution (180-400 μm) of laser-induced vacuoles with a size of 67 μm, compared to DOE (180-280 μm; 40 μm in size). However, the white skin presented that MLA created larger vacuoles (134 μm in size) in a smaller number at deeper distributions (125-700 μm) than MLA with the black skin. DOE generated no laser-induced vacuolization in the white skin. The white skin tissue with inherent higher scattering could be responsible for deeper vacuolization after the picosecond laser treatment. Further investigations are expected to determine the optimal treatment conditions for various skin types.
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Affiliation(s)
- Hyeonsoo Kim
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, Republic of Korea
| | - Jewan Kaiser Hwang
- Mymirae Research Institute for Dermatologic Science, Seoul, Republic of Korea
| | - Jongman Choi
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, Republic of Korea
- Research and Development, Bluecore Company, Busan, Republic of Korea
| | - Hyun Wook Kang
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, Republic of Korea
- Department of Biomedical Engineering, Pukyong National University, Busan, Republic of Korea
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Boo YC. Arbutin as a Skin Depigmenting Agent with Antimelanogenic and Antioxidant Properties. Antioxidants (Basel) 2021; 10:antiox10071129. [PMID: 34356362 PMCID: PMC8301119 DOI: 10.3390/antiox10071129] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/15/2021] [Accepted: 07/15/2021] [Indexed: 12/27/2022] Open
Abstract
Arbutin is a compound of hydroquinone and D-glucose, and it has been over 30 years since there have been serious studies on the skin lightening action of this substance. In the meantime, there have been debates and validation studies about the mechanism of action of this substance as well as its skin lightening efficacy and safety. Several analogs or derivatives of arbutin have been developed and studied for their melanin synthesis inhibitory action. Formulations have been developed to improve the stability, transdermal delivery, and release of arbutin, and device usage to promote skin absorption has been developed. Substances that inhibit melanin synthesis synergistically with arbutin have been explored. The skin lightening efficacy of arbutin alone or in combination with other active ingredients has been clinically evaluated. Combined therapy with arbutin and laser could give enhanced depigmenting efficacy. The use of arbutin causes dermatitis rarely, and caution is recommended for the use of arbutin-containing products, especially from the viewpoint that hydroquinone may be generated during product use. Studies on the antioxidant properties of arbutin are emerging, and these antioxidant properties are proposed to contribute to the skin depigmenting action of arbutin. It is hoped that this review will help to understand the pros and cons of arbutin as a cosmetic ingredient, and will lead to future research directions for developing advanced skin lightening and protecting cosmetic products.
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Affiliation(s)
- Yong Chool Boo
- Department of Molecular Medicine, Cell and Matrix Research Institute, BK21 Plus KNU Biomedical Convergence Program, School of Medicine, Kyungpook National University, Daegu 41944, Korea
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