Lima Emerson V A, Lima Mariana Modesto D A, Paixão Mauricio Pedreira, Miot Hélio Amante
Santa Casa de Misericórdia, Praça Fleming, 35/1201 Jaqueira, Recife, PE, 52050-180, Brazil.
UNIFESP, São Paulo, SP, Brazil.
BMC Dermatol. 2017 Nov 28;17(1):14. doi: 10.1186/s12895-017-0066-5.
Melasma is a common chronic and relapsing acquired dyschromia. Skin microneedling was reported resulting sustained long-term improvement of recalcitrant melasma, however, the exact mechanism that promotes this skin lightening is not known. This study aimed to investigate clinical and histologic alterations promoted by skin microneedling in facial melasma.
Open pilot trial including six women with facial refractory melasma submitted to two sessions of microneedling (1.5 mm) each 30 days followed by daily triple combination and broad-spectrum sunscreen. Comparison of pretreatment (T0) and 15 days after last microneedling procedure (T45) was made by standardized pictures, skin colorimetry, MASI, MELASQoL and histological parameters (haematoxylin-eosin, picrosirius-red, periodic acid Schiff and Fontana-Masson staining).
The age of the subjects varied from 34 to 46 years-old, the phototypes were III and IV (Fitzpatrick), and age of melasma onset was 20 to 38 years. Improvement of melasma was perceived in all subjects. There was a significant reduction of MASI score (-70%), MELASQoL (-55%) and increase in L* (+13%) colorimetric value (p < 0.03). All cases evidenced epithelium thickening, decrease in melanin pigmentation and densification of upper dermis collagen (p = 0.03). Patients were followed by 6 months under broad-spectrum sunscreen and triple combination without relapse.
In addition to classic treatment (broad-spectrum sunscreen and triple combination), skin microneedling promoted clinical and histological improvement of refractory facial melasma.
黄褐斑是一种常见的慢性复发性获得性色素沉着异常。有报道称皮肤微针治疗可使顽固性黄褐斑获得持续长期改善，然而，促进这种皮肤色素减退的确切机制尚不清楚。本研究旨在探讨皮肤微针治疗对面部黄褐斑所引起的临床和组织学改变。
开放性试点试验，纳入6名面部难治性黄褐斑女性患者，每30天进行2次微针治疗（1.5毫米），随后每日使用三联组合疗法和广谱防晒霜。通过标准化图片、皮肤比色法、MASI、MELASQoL和组织学参数（苏木精-伊红染色、苦味酸天狼星红染色、过碘酸希夫染色和Fontana-Masson染色）对治疗前（T0）和最后一次微针治疗后15天（T45）进行比较。
受试者年龄在34至46岁之间，皮肤光类型为III型和IV型（Fitzpatrick分型），黄褐斑发病年龄为20至38岁。所有受试者的黄褐斑均有改善。MASI评分显著降低（-70%），MELASQoL评分显著降低（-55%），L*比色值增加（+13%）（p < 0.03）。所有病例均显示上皮增厚、黑色素沉着减少和真皮上层胶原致密化（p = 0.03）。患者在广谱防晒霜和三联组合疗法下随访6个月无复发。
除了经典治疗（广谱防晒霜和三联组合疗法）外，皮肤微针治疗可促进难治性面部黄褐斑的临床和组织学改善。
