Department of Dermatology, Henry Ford Hospital, 3031 West Grand Blvd, Detroit, MI, 48202, USA.
Department of Physics and Astronomy, Wayne State University, Detroit, MI, USA.
Arch Dermatol Res. 2020 Dec;312(10):725-730. doi: 10.1007/s00403-020-02071-4. Epub 2020 Apr 6.
Postinflammatory hyperpigmentation (PIH) occurs following cutaneous injury and is common following resolution of acne especially in patients with skin of color. The objective of this study was to further validate a trichloroacetic acid (TCA)-induced PIH model and compare it to acne-induced PIH using topical bakuchiol, a botanical extract that has been shown to have antimicrobial, anti-inflammatory, antioxidant, and antiacne properties. A prospective, non-randomized clinical trial was conducted on subjects with skin phototypes IV-VI with a history of acne-induced PIH. Subjects applied bakuchiol or vehicle cream twice daily to 2 acne-induced and 2 TCA-induced PIH lesions for 28 days with a third lesion serving as a control in each group. Degree of improvement was defined as the change in the Investigator Global Assessment (IGA) score over 28 days of treatment. Twenty subjects (6 males, 14 females) completed the study. For TCA-induced PIH sites, there was a statistically significant (p < 0.05) degree of improvement with bakuchiol treatment (- 0.50 ± 0.18) compared to vehicle (0.05 ± 0.15) and control (- 0.06 ± 0.17). For acne-induced PIH, there was a greater degree of improvement for bakuchiol (- 1.06 ± 0.23) when compared to vehicle (- 0.56 ± 0.16) and control (- 0.69 ± 0.18); however, statistical significance was not reached (p > 0.05). TCA-induced PIH sites were uniform in size and pigment intensity thereby allowing better comparison among sites. This emphasizes the relevance of using this model for PIH which may help reduce the barriers in clinical trials and help improve access to treatments for patients who suffer from PIH. The results suggest that topical bakuchiol may decrease the severity of PIH.
炎症后色素沉着(PIH)发生于皮肤损伤后,在痤疮消退后很常见,尤其是在肤色较深的患者中。本研究的目的是进一步验证三氯乙酸(TCA)诱导的 PIH 模型,并将其与使用植物提取物补骨脂素治疗的痤疮诱导的 PIH 进行比较,补骨脂素已被证明具有抗菌、抗炎、抗氧化和抗痤疮的特性。在有痤疮诱导的 PIH 病史的皮肤光型 IV-VI 的受试者中进行了一项前瞻性、非随机临床试验。受试者每天两次将补骨脂素或载体霜应用于 2 个痤疮诱导的和 2 个 TCA 诱导的 PIH 病变,每组的第三个病变作为对照。改善程度定义为治疗 28 天后的研究者全球评估(IGA)评分变化。20 名受试者(6 名男性,14 名女性)完成了这项研究。对于 TCA 诱导的 PIH 部位,与载体(0.05 ± 0.15)和对照(-0.06 ± 0.17)相比,补骨脂素治疗有统计学意义的改善(p < 0.05)(-0.50 ± 0.18)。对于痤疮诱导的 PIH,与载体(-0.56 ± 0.16)和对照(-0.69 ± 0.18)相比,补骨脂素的改善程度更大(-1.06 ± 0.23);然而,未达到统计学意义(p > 0.05)。TCA 诱导的 PIH 部位大小和色素强度均匀,因此可以更好地比较各部位。这强调了使用这种 PIH 模型的相关性,这可能有助于减少临床试验中的障碍,并有助于改善患有 PIH 的患者获得治疗的机会。结果表明,局部补骨脂素可能会降低 PIH 的严重程度。