Department of Dermatology, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.
Leishmaniosis Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.
Skin Res Technol. 2021 Jan;27(1):24-31. doi: 10.1111/srt.12901. Epub 2020 Jun 25.
Kligman's formula (KF) remains to date the dermatologists' treatment of choice for melasma. This study was aimed at the evaluation of the effectiveness of Modified Kligman's formula (MKF) in comparison with cysteamine 5% cream on the severity of epidermal melasma.
A total of 50 subjects with epidermal melasma were included in this double-blind, randomized trial study. Subjects received either cysteamine 5% cream or an MKF (4% hydroquinone, 0.05% retinoic acid and 0.1% betamethasone). Cysteamine cream (applied once daily, 15 minutes exposure) or MKF (applied once daily, whole night exposure) were used by the subjects over four consecutive months. The efficacy of the treatments was determined through the modified Melasma Area Severity Index (mMASI) score, the Investigator's Global Assessment (IGA) and patient questionnaires.
The mean (SD) age of the subjects was 34.96 (6.17) and 35.76 (5.23) years for cysteamine and MKF group, respectively. The mean mMASI score after 4 months was 7.04 (2.23) in the MKF group and 6.09 (2.01) in the cysteamine group. At both prospective evaluation points (2 months, 4 months), the percentage reduction in mMASI score was approximately 9% greater by cysteamine cream as compared to MKF, and these differences were statistically significant (P = .005 and .001 respectively).
Cysteamine 5% cream showed greater efficacy as compared to MKF. It is thus proposed that cysteamine 5% cream is more effective than MKF in the treatment of melasma, with the advantage of being significantly better tolerated.
截至目前，Kligman 配方（KF）仍然是皮肤科医生治疗黄褐斑的首选方法。本研究旨在评估改良 Kligman 配方（MKF）与半胱氨酸 5%乳膏治疗表皮性黄褐斑严重程度的疗效。
共有 50 名表皮性黄褐斑患者参与了这项双盲、随机试验研究。受试者分别接受半胱氨酸 5%乳膏或 MKF（4%氢醌、0.05%维 A 酸和 0.1%倍他米松）治疗。受试者连续四个月每天使用半胱氨酸乳膏（每天一次，暴露 15 分钟）或 MKF（每天一次，整夜暴露）。通过改良黄褐斑面积严重程度指数（mMASI）评分、研究者总体评估（IGA）和患者问卷来确定治疗效果。
半胱氨酸组和 MKF 组的受试者平均（SD）年龄分别为 34.96（6.17）和 35.76（5.23）岁。MKF 组治疗 4 个月后的平均 mMASI 评分为 7.04（2.23），半胱氨酸组为 6.09（2.01）。在两个前瞻性评估点（2 个月和 4 个月），半胱氨酸乳膏组的 mMASI 评分降低百分比均比 MKF 组高约 9%，差异具有统计学意义（分别为 P=0.005 和 P=0.001）。
半胱氨酸 5%乳膏的疗效优于 MKF。因此，建议半胱氨酸 5%乳膏治疗黄褐斑的效果优于 MKF，且具有更好的耐受性。
