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Yang TT, Ma CW, Jhou JW, Chen YT, Lan CCE. Response predictor for pigment reduction after one session of photo-based therapy using convolutional neural network: A proof of concept study. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2023; 39:498-505. [PMID: 37306455 DOI: 10.1111/phpp.12891] [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: 02/28/2023] [Revised: 05/19/2023] [Accepted: 05/26/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Identifying treatment responders after a single session of photo-based procedure for hyperpigmentary disorders may be difficult. OBJECTIVES We aim to train a convolutional neural network (CNN) to test the hypothesis that there exist discernible features in pretreatment photographs for identifying favorable responses after photo-based treatments for facial hyperpigmentation and develop a clinically applicable algorithm to predict treatment outcome. METHODS Two hundred and sixty-four sets of pretreatment photographs of subjects receiving photo-based treatment for esthetic enhancement were obtained using the VISIA® skin analysis system. Preprocessing was done by masking the facial features of the photographs. Each set of photographs consists of five types of images. Five independently trained CNNs based on the Resnet50 backbone were developed based on these images and the results of these CNNs were combined to obtain the final result. RESULTS The developed CNN algorithm has a prediction accuracy approaching 78.5% with area under the receiver operating characteristic curve being 0.839. CONCLUSION The treatment efficacy of photo-based therapies on facial skin pigmentation can be predicted based on pretreatment images.
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Affiliation(s)
- Ting-Ting Yang
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ching-Wen Ma
- College of Artificial Intelligence, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Jyun-Wei Jhou
- College of Artificial Intelligence, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Yu-Ting Chen
- College of Artificial Intelligence, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Cheng-Che E Lan
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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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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Efficacy and Safety of Low Fluence Nd:YAG Laser Treatment in Melasma: A Meta-Analysis and Systematic Review. Dermatol Surg 2023; 49:36-41. [PMID: 36533794 DOI: 10.1097/dss.0000000000003635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Low-fluence, multisession therapy of Nd:YAG laser has been widely used for treating melasma. OBJECTIVE To evaluate the efficacy and safety of low-fluence Nd:YAG laser toning for melasma using a systematic review and meta-analysis. METHODS The PubMed, Web of Science, Embase, and Cochrane Library databases were searched till December 2020. A total of 50 studies (1,772 patients) and 66 studies were selected for the evaluation of the efficacy and complications, retrospectively. RESULTS The mean Melasma Area and Severity Index/modified Melasma Area and Severity Index scores for laser toning as monotherapy at <4, 4 to <8, 8 to <12, 12 to <24, and ≥24 weeks after treatment compared with that at pretreatment were -0.51, -0.91, -0.97, -0.92, 0.01 SD, whereas those as combination therapy were -1.64, -1.26, -0.94, not available, -1.45 SD, respectively. An increase in light value and a decrease in relative lightness index have remained up to 8 weeks after laser toning. Complications including hypopigmentation/leukoderma, postinflammatory hyperpigmentation, and recurrence were noted. The incidence of hypopigmentation/leukoderma correlated with the number of laser sessions (p = .036). CONCLUSION Low-fluence Nd:YAG laser toning as combination therapy has shown better efficacy than monotherapy and the efficacy seems to diminish with time. This study suggests the positive correlation of hypopigmentation/leukoderma with the number of laser sessions.
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Piętowska Z, Nowicka D, Szepietowski JC. Understanding Melasma-How Can Pharmacology and Cosmetology Procedures and Prevention Help to Achieve Optimal Treatment Results? A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912084. [PMID: 36231404 PMCID: PMC9564742 DOI: 10.3390/ijerph191912084] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 05/06/2023]
Abstract
Melasma is a chronic skin condition that involves the overproduction of melanin in areas exposed to ultraviolet radiation. Melasma treatment is long-term and complicated with recurrence and resistance to treatment. The pathogenesis of melasma is highly complex with multiple pathologies occurring outside of the skin pigment cells. It includes photoaging, excessive melanogenesis, an increased number of mast cells, increased vascularization, and basement membrane damage. In addition, skin lesions related to melasma and their surrounding skin have nearly 300 genes differentially expressed from healthy skin. Traditionally, melasma was treated with topical agents, including hydroquinone, tretinoin, glucocorticosteroids and various formulations; however, the current approach includes the topical application of a variety of substances, chemical peels, laser and light treatments, mesotherapy, microneedling and/or the use of systemic therapy. The treatment plan for patients with melasma begins with the elimination of risk factors, strict protection against ultraviolet radiation, and the topical use of lightening agents. Hyperpigmentation treatment alone can be ineffective unless combined with regenerative methods and photoprotection. In this review, we show that in-depth knowledge associated with proper communication and the establishment of a relationship with the patient help to achieve good adherence and compliance in this long-term, time-consuming and difficult procedure.
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Affiliation(s)
- Zuzanna Piętowska
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, 50-368 Wrocław, Poland
| | - Danuta Nowicka
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, 50-368 Wrocław, Poland
- Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland
- Correspondence:
| | - Jacek C. Szepietowski
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, 50-368 Wrocław, Poland
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Kim C, Gao JC, Moy J, Lee HS. Fractional CO2 laser and adjunctive therapies in skin of color melasma patients. JAAD Int 2022; 8:118-123. [PMID: 35875396 PMCID: PMC9305318 DOI: 10.1016/j.jdin.2022.02.010] [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] [Accepted: 02/25/2022] [Indexed: 11/26/2022] Open
Abstract
Background Ablative lasers have long been considered an unfavorable option for melasma in patients with skin of color and continue to be underutilized. Objective To evaluate the safety and outcomes of ablative fractional CO2 lasers on refractory melasma in patients with skin of color. Methods A retrospective chart review of 12 patients from a single-center dermatology clinic. The study included refractory melasma patients receiving ablative fractional CO₂ laser therapy alone or with laser toning and/or tranexamic acid (TXA). A validated modified Melasma Area and Severity Index (mMASI) scoring scale was used to assess disease severity at baseline and approximately 1 month after each treatment session. Results Among the 12 patients, 41.7% patients showed >50% reduction in mMASI scores with 33.3% of patients showing statistical significance (P < .05). The CO₂ laser therapy with the TXA cohort showed the largest decrease in the mean mMASI scores and the CO₂ laser with laser toning showed the lowest decrease in scores. Patients who started on oral TXA earlier, after their initial ablative laser session, showed better clinical improvement. Limitations Retrospective study design with short follow-up period and a small sample size. Conclusion Ablative CO2 laser treatment may be a reasonable option for refractory melasma in patients with skin of color, though future research is needed.
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Affiliation(s)
- Carey Kim
- Department of Dermatology, Metropolitan Medical Center, New York, New York
- Department of Dermatology, New York Medical College, Valhalla, New York
- Correspondence to: Carey Kim, MD, 1901 1st Avenue, New York, NY 10029.
| | - Jia C. Gao
- Department of Dermatology, Metropolitan Medical Center, New York, New York
- Department of Dermatology, New York Medical College, Valhalla, New York
| | - Janet Moy
- Department of Dermatology, Metropolitan Medical Center, New York, New York
- Department of Dermatology, New York Medical College, Valhalla, New York
| | - Hyun Soo Lee
- Department of Dermatology, Mount Sinai Hospital, New York, New York
- Metro Dermatology, New York, New York
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Pan J, Zhao JH, Lv YW, Zeng SW, Zhao JY, Gao FL. Clinical Study of a Q-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser with Different Parameters in the Treatment of Chloasma: A Randomized-Controlled Trial. Photobiomodul Photomed Laser Surg 2022; 40:183-188. [PMID: 35298285 DOI: 10.1089/photob.2021.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: To explore the clinical efficacy of a Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser with different parameters in the treatment of chloasma. Methods: In this study, 30 patients with chloasma, symmetrically distributed on the left and right sides of the face and who were treated with a Fayton Q-switched 1064 nm Nd:YAG laser, were recruited. The patients were randomly selected for the treatment of facial lesions on the left and right sides of the face using a spot diameter of 9 mm and an energy density of 0.8 J/cm2 on one side, and, on the opposite side, a spot diameter of 6 mm with an energy density of 1.2 J/cm2. The laser frequency was 5 Hz and treatment was conducted once every 7-10 days and repeated eight times as a course of treatment. At the end of the course of treatment, as well as 1, 3, and 6 months after treatment, front-facing images and 45° left- and right-side images were taken, respectively. The curative effect of the treatment was evaluated using the Melasma Area Severity Index (MASI) score. Results: The results of this study showed that the total effective rate of a Fayton Q-switched 1064 nm Nd:YAG laser in the treatment of chloasma was 60%. Conclusions: Using a Q-switched 1064 nm Nd:YAG laser represents a safe and effective approach for the treatment of chloasma. The therapeutic effects of the parameter sets, that is, a spot diameter of 9 mm and an energy density of 0.8 J/cm2, and a spot diameter of 6 mm with an energy density of 1.2 J/cm2, were similar. The treatment time and average effective times of the latter were relatively shortened. Clinical Trial Registration number researchregistry6799.
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Affiliation(s)
- Jing Pan
- Department of Dermatology and Venereology and Beijing Jishuitan Hospital, Beijing, China
| | - Jing-Hui Zhao
- Department of Dermatology and Venereology and Beijing Jishuitan Hospital, Beijing, China
| | - Yan-Wei Lv
- Clinical Epidemiology Research Center, Beijing Jishuitan Hospital, Beijing, China
| | - Shu-Wen Zeng
- Department of Dermatology, Beijing Xiuzhong Medical Center, Beijing, China
| | - Jun-Ying Zhao
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Feng-Lin Gao
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Prospective study of Q-switched Nd:YAG laser treatment of hyperpigmented split-thickness skin grafts. Lasers Med Sci 2022; 37:2381-2386. [DOI: 10.1007/s10103-021-03476-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 11/17/2021] [Indexed: 10/19/2022]
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Debasmita B, Raj C, Ishan A, Ipsita D. A prospective randomized controlled trial of Q-switched Nd:YAG laser with topical 3% tranexamic acid (TA) versus microneedling with topical 3% tranexamic acid (TA) in treatment of melasma. J Cosmet Dermatol 2021; 21:2801-2807. [PMID: 34636493 DOI: 10.1111/jocd.14532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 09/29/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Treatment of melasma is challenging. Topical TA has shown promising results as an adjuvant, when combined with microneedling or QS Nd:YAG laser. The efficacy of both combinations has been demonstrated but the efficacy between these two combinations has never been compared. AIM AND OBJECTIVES To compare the efficacy and side effects of microneedling and QS Nd:YAG laser when combined with topical 3% TA gel. MATERIALS AND METHODS 60 patients were randomized into 2 groups. Group A received Nd:YAG laser sessions monthly with daily 3% TA gel while Group B underwent microneedling monthly with daily 3% TA gel. A total of 5 sessions were given with follow-up after 2 months. Evaluation using modified Melasma Area and Severity Index (mMASI), Patient satisfaction score, and photography was done at baseline, 3rd session, 5th session, and final follow-up. RESULTS Mean fall in mMASI at follow-up in Group A was 5.12 ± 2.66 to 2.33 ± 1.33 and Group B was 4.60 ± 2.38 to 1.88 ± 1.08 (p < 0.001). Patient satisfaction score was not significantly different. Side effects of both interventions included erythema, pain, and burning sensation. CONCLUSION Our study shows equal efficacy of microneedling and QS Nd:YAG laser when combined with topical 3% TA gel in treating melasma without serious side effects. Microneedling has more downtime and maybe less preferable as a lunchtime procedure.
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Affiliation(s)
- Behera Debasmita
- Institute of Medical Sciences and SUM Hospital, S 'O'A University, Bhubaneswar, India
| | - Chinmoy Raj
- Institute of Medical Sciences and SUM Hospital, S 'O'A University, Bhubaneswar, India
| | - Agrawal Ishan
- Institute of Medical Sciences and SUM Hospital, S 'O'A University, Bhubaneswar, India
| | - Debata Ipsita
- Institute of Medical Sciences and SUM Hospital, S 'O'A University, Bhubaneswar, India
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9
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Abstract
Melanocytes are highly specialised dendritic cells that transfer melanin to keratinocytes in subcellular lysosome-like organelles called melanosomes, where melanin is synthesised and stored. Melanin is a complex pigment that provides colour and photoprotection to the skin, hair, and eyes of mammals. The regulation of melanogenesis includes various mechanisms and factors including genetic, environmental, and endocrine factors. Knowledge of the pigmentation process is important not only to understand hyperpigmentation but also to design treatments and therapies to treat them. Whitening cosmetics with anti-melanogenesis activity are very popular. In the present manuscript, we review the mechanisms and the signalling pathways involved in skin pigmentation and we specifically focus on the alteration of melanogenesis that leads to melasma and results in hyperpigmentation. Finally, current therapies and treatments including topical, oral, and phototherapies are discussed and described, with a special emphasis on the cosmetics’ action.
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10
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Micek I, Pawlaczyk M, Kroma A, Seraszek-Jaros A, Urbańska M, Gornowicz-Porowska J. Treatment of melasma with a low-fluence 1064 nm Q-switched Nd:YAG laser: Laser toning in Caucasian women. Lasers Surg Med 2021; 54:366-373. [PMID: 34473361 DOI: 10.1002/lsm.23474] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/22/2021] [Accepted: 08/21/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES Melasma is a common, therapeutically challenging, and very often relapsing disorder of hyperpigmentation most often observed in women. Low-fluence, multipass technique with Q-switched-mode laser-"laser toning" is broadly used to treat melasma, especially in Asia. The study aimed to evaluate the effects of a series of laser treatments with very short, nanosecond pulses in the treatment of melasma in Caucasian women. MATERIAL AND METHODS Forty polish females with Fitzpatrick skin phototype II-III and melasma were treated with 1064 nm Q-switched neodymium:yttrium-aluminum-garnet (QSNY) laser (pulse with 5 ns; spot size, 6-8 mm; fluence, 1.7-3.2 J/cm2 ; 2-8 passes; nine treatments). Melanin index (MI), erythema index (EI) by Mexameter MX18®, the modified Melasma Area Severity Index (mMASI), and the participant's self-assessment were used to evaluate the treatment results. Twenty-one patients were subjected to a 1-year follow-up. RESULTS Significant improvement in melasma pigmentation was observed in the mean MI and mMASI score; both were significantly reduced (p < 0.0001). Significant erythema reduction was achieved (p < 0.001). In total, 70% of participants rated the laser as a method that met their expectations for treating melasma. Clinical follow-up after one year showed that the reduced melasma effect was still maintained. Patients also noticed improved skin conditions (radiance, smoothness, brightness, hydration, regeneration). No serious adverse effects were observed. CONCLUSIONS Low-fluence 1064 nm QSNY laser is an effective, safe, and noninvasive method with long-term results in melasma treatment. QSNY (1064 nm) improves the condition of melasma patients with erythema.
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Affiliation(s)
- Iwona Micek
- Department and Division of Practical Cosmetology and Skin Diseases Prophylaxis, Poznan University of Medical Sciences, Poznan, Poland
| | - Mariola Pawlaczyk
- Department and Division of Practical Cosmetology and Skin Diseases Prophylaxis, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Kroma
- Department and Division of Practical Cosmetology and Skin Diseases Prophylaxis, Poznan University of Medical Sciences, Poznan, Poland
| | - Agnieszka Seraszek-Jaros
- Department of Bioinformatics and Computational Biology, Poznan University of Medical Sciences, Poznan, Poland
| | - Maria Urbańska
- Department and Division of Practical Cosmetology and Skin Diseases Prophylaxis, Poznan University of Medical Sciences, Poznan, Poland
| | - Justyna Gornowicz-Porowska
- Department and Division of Practical Cosmetology and Skin Diseases Prophylaxis, Poznan University of Medical Sciences, Poznan, Poland
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Ibrahim SMA, Farag AS, Ali MS, El-Gendy WMAF. Efficacy and Safety of Topical Silymarin Versus Low Fluence 1064-nm Q Switched Nd:YAG Laser in the Treatment of Melasma: A Comparative Randomized Trial. Lasers Surg Med 2021; 53:1341-1347. [PMID: 34101206 DOI: 10.1002/lsm.23440] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/10/2021] [Accepted: 05/24/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES The management of melasma is challenging and requires multiple uses of available therapeutic options. To compare the short-term efficacy and safety of topical silymarin and low fluence 1064-nm Q-switched ND:YAG laser for treatment of melasma with dermoscopic follow-up. STUDY DESIGN/MATERIALS AND METHODS Fifty female patients with melasma were included in this study. They were randomly divided into two groups. Group A: 25 patients were treated with six sessions of low fluence Q switched ND:YAG 1064-nm laser, and group B: 25 patients were treated with topical silymarin cream 1.4% with a 3-month treatment duration. Patients were evaluated clinically by the modified melasma area and severity index (mMASI) score. Dermoscopic examinations were performed before and after the treatment sessions. RESULTS The severity of melasma, as evaluated dermoscopically and clinically by mMASI score, was significantly reduced after treatment in all patients with no recorded side effects. There was no statistically significant difference between both studied groups regarding the change in mMASI score and dermoscopic assessment of the patients after the treatment sessions. CONCLUSION Both low fluence Q switched ND:YAG 1064-nm laser and topical silymarin cream appear to be safe and effective modalities in the treatment of melasma. © 2021 Wiley Periodicals LLC.
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Affiliation(s)
- Shady M A Ibrahim
- Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, 11651, Egypt
| | - Asmaa S Farag
- Department of Dermatology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, 11651, Egypt
| | - Mona S Ali
- Department of Dermatology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, 11651, Egypt
| | - Wafaa M A F El-Gendy
- Department of Dermatology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, 11651, Egypt
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Neagu N, Conforti C, Agozzino M, Marangi GF, Morariu SH, Pellacani G, Persichetti P, Piccolo D, Segreto F, Zalaudek I, Dianzani C. Melasma treatment: a systematic review. J DERMATOL TREAT 2021; 33:1816-1837. [PMID: 33849384 DOI: 10.1080/09546634.2021.1914313] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Melasma is a common chronic refractory disorder of pigmentation affecting people with darker skin types. Overall prevalence varies between 8.8% and 40%, depending on the ethnicity of the population and the geographical area. Therapeutic management of melasma is challenging, with high recurrence rates which significant impacts on the quality of life. No single treatment is universally efficacious. Systemic treatments with tranexamic acid and polypodium leucotmatous had promising results, although the former was related to systemic side effects. Microneedling and peeling were also efficacious, although their superiority to topical hydroquinone, the gold standard in melasma treatment, remains to be established. Similarly, laser and light devices have been beneficial. However, recurrence rates remain high in all treatment groups. Combination therapies, either in double or triple combinations yielded the best results when compared to single terapies. Treatment choice should be made after Wood's lamp examination, as well as dermatoscopic evaluation, in order to select the best treatment option, targeted at each melasma subtype.
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Affiliation(s)
- Nicoleta Neagu
- State Clinic of Dermatology, Mureș County Hospital, Tîrgu Mureș, Romania
| | - Claudio Conforti
- Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy
| | - Marina Agozzino
- Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy
| | | | | | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Paolo Persichetti
- Plastic and Reconstructive Surgery Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | | | - Francesco Segreto
- Plastic and Reconstructive Surgery Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy
| | - Caterina Dianzani
- Plastic and Reconstructive Surgery Unit, Campus Bio-Medico University of Rome, Rome, Italy
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13
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Vachiramon V, Leerunyakul K, Kositkuljorn C, Chayavichitsilp P. Combined isobutylamido thiazolyl resorcinol and low-fluence Q-switched Nd: YAG laser for the treatment of facial hyperpigmentation: A randomized, split-face study. J Cosmet Dermatol 2020; 20:1724-1731. [PMID: 33118677 DOI: 10.1111/jocd.13790] [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: 04/27/2020] [Revised: 06/28/2020] [Accepted: 10/07/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Isobutylamido thiazolyl resorcinol (ITR) is a novel anti-tyrosinase recently shown to be effective in the treatment of hyperpigmentation. Low-fluence Q-switched Nd:YAG 1064-nm laser (LFQS) has proven to be effective for various hyperpigmentary conditions. However, there is no study on the efficacy and safety of combined ITR and LFQS treatment. OBJECTIVES To compare the efficacy and safety of combined ITR and LFQS with LFQS monotherapy for facial hyperpigmentation. MATERIALS AND METHODS Patients with symmetrical facial hyperpigmentation were treated with five sessions of once weekly LFQS on the whole face. One side was randomly treated with ITR and the other side received a placebo cream for 12 weeks. Patients were followed for 8 weeks after the last laser treatment. Relative lightness index (RL*I), Facial Hyperpigmentation Severity Score on the malar area (FHSSm ), patient satisfaction, recurrence, and adverse events were recorded. RESULTS Twenty-four patients completed the study. Both sides demonstrated significant reductions of mean RL*I and mean FHSSm from baseline (P < .01). At the 4th week, the ITR-treated side showed more improvement of mean RL*I than the placebo-treated side (62.5% vs 47.3% improvement, P < .05). The mean FHSSm on the ITR-treated was reduced at a significantly higher percentage than the placebo-treated side (54.4% vs 40.2% reduction, P < .05). Partial recurrence was observed on both sides. No serious side effects were noted. CONCLUSION Combined ITR and LFQS therapy was more superior than LFQS monotherapy in the treatment of facial hyperpigmentation. ITR may serve as adjuvant for patients with such condition.
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Affiliation(s)
- Vasanop Vachiramon
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kanchana Leerunyakul
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chaninan Kositkuljorn
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pamela Chayavichitsilp
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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14
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Karadağ Köse Ö, Borlu M. Efficacy of the combination of Q-switched Nd:YAG laser and microneedling for melasma. J Cosmet Dermatol 2020; 20:769-775. [PMID: 32696614 DOI: 10.1111/jocd.13629] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/03/2020] [Accepted: 07/15/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Melasma is a common, multifactorial, and recurring disease which is not easy to treat. AIMS The purpose of this study is to evaluate the efficacy of microneedling in combination with Q-switched neodymium-doped yttrium aluminum garnet laser (QsNd-YAG laser) for treatment of melasma. PATIENTS/METHODS Fifteen female patients with epidermal or mixed-type melasma on the face were included in the study. Patients were first treated with QsNd-YAG laser, and then with microneedling containing mesotherapy products of biomimetic peptides, at the same session. Modified Melasma Area Severity Index (mMASI) scores were calculated before the first session and again 2 weeks after the last session. The same treatment protocol was repeated every 2 weeks for five sessions within period of 3 months of therapy. The evaluation was performed according to the before and after photographs taken from three angles including 90-degree front and 45 degrees from left and right with the VISIA device. RESULTS Of the 15 patients included in the study, the mean mMASI scores before and after treatment were 9.2 ± 5.7 (3.8-23.1) and 3.6 ± 4.0 (0.6-16.8), respectively. mMASI scores were significantly reduced after completion of the protocol. Six (40%) patients had "very good response," 4 (26.7%) patients had "good response," and 5 (33.3%) patients were "unresponsive." Six (40%) patients were followed up for 1 year, and only 1 patient had a recurrence (6.7%). CONCLUSIONS In addition to the use of photoprotective measures, multimodality treatment including QsNd-YAG laser and microneedling with mesotherapy products containing biomimetic peptides is effective to treat melasma and they work synergistically.
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Affiliation(s)
- Özlem Karadağ Köse
- Department of Dermatology and Venereology, Saltat Policlinic, İstanbul, Turkey
| | - Murat Borlu
- Department of Dermatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
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15
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Siadat AH, Zolfaghari A, Shahmoradi Z, Shariat S, Sohrabi K. Application of laser for treatment of cutaneous leishmaniasis: a review of literature. Lasers Med Sci 2020; 35:1451-1457. [PMID: 32333334 DOI: 10.1007/s10103-020-03006-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 03/25/2020] [Indexed: 12/28/2022]
Abstract
Cutaneous leishmaniasis (CL) is a major health problem in developing countries with high economic and health impact. Despite suggested treatment for CL, there is still no definite therapy for this infection, and many of these treatments are associated with serious local and systemic side effects. In the current paper, use of different laser types including continuous and fractional CO2, argon, PDL, erbium glass, and Nd:YAG have been reviewed. Based on our review, given the high reported efficacy and low side-effect profile, use of laser can be considered as a good alternative to standard treatment of cutaneous leishmaniasis (CL). Performing more studies using different types of lasers is recommended to evaluate the efficacy of this method for treatment of CL.
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Affiliation(s)
- Amir Hossein Siadat
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azadeh Zolfaghari
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Zabiholah Shahmoradi
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sheila Shariat
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Karim Sohrabi
- Isfahan University of Medical Sciences, Isfahan, Iran
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16
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Cho MY, Roh MR. Successful Treatment of Riehl's Melanosis With Mid‐Fluence Q‐Switched Nd:YAG 1064‐nm Laser. Lasers Surg Med 2020; 52:753-760. [DOI: 10.1002/lsm.23214] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2019] [Indexed: 01/25/2023]
Affiliation(s)
- Mi Yeon Cho
- Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute Yonsei University College of Medicine 211 Eonjuro Gangnam‐gu Seoul 06273 Korea
| | - Mi Ryung Roh
- Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute Yonsei University College of Medicine 211 Eonjuro Gangnam‐gu Seoul 06273 Korea
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