El-Husseiny Rania, Rakha Noha, Sallam Mohamad
Dermatology, Venerology and Andrology Department, Ain Shams University Hospitals, Cairo, Egypt.
Dermatol Ther. 2020 Nov;33(6):e14240. doi: 10.1111/dth.14240. Epub 2020 Sep 14.
Various tranexamic acid (TA) formulations have been evaluated for treating melasma, yet the effectiveness of this therapy has not been efficiently comparatively analyzed. To assess and compare the therapeutic efficacy and safety of TA 5% vs hydroquinone (HQ) 4% creams in treating melasma. 100 melasma female patients were treated with daily application of TA 5% cream on right-sided facial lesions and HQ 4% cream on left-sided lesions for 12 weeks. Photographic documentation using digital and Antera 3D camera, Wood's light examination, calculation of Hemi Melasma Area and Severity Index (Hemi MASI), Melasma quality of life (MELASQOL) scores and area% of melanin through histopathological examination was done before and after treatment. Both TA 5% and HQ 4% creams yielded significant improvement of all melasma lesions after 12 weeks of treatment, with no significant difference in treatment response regarding Hemi MASI, MELASQOL scores and Antera average level of melanin (P > .05); however, significant reduction in area % of melanin was recorded with TA 5% than HQ 4% creams (P = .000). TA appears to be a promising therapeutic option in treating melasma with fewer adverse effects, same or even better results in comparison to HQ cream.
已经对多种氨甲环酸（TA）制剂治疗黄褐斑的效果进行了评估，但尚未对该疗法的有效性进行有效的对比分析。为了评估和比较5%TA乳膏与4%氢醌（HQ）乳膏治疗黄褐斑的疗效和安全性。100名患有黄褐斑的女性患者接受治疗，右侧面部皮损每日涂抹5%TA乳膏，左侧皮损每日涂抹4%HQ乳膏，持续12周。在治疗前后，使用数码和Antera 3D相机进行摄影记录、伍德灯检查、计算半侧黄褐斑面积和严重程度指数（Hemi MASI）、黄褐斑生活质量（MELASQOL）评分以及通过组织病理学检查计算黑色素面积百分比。治疗12周后，5%TA乳膏和4%HQ乳膏均使所有黄褐斑皮损有显著改善，在Hemi MASI、MELASQOL评分和Antera黑色素平均水平方面的治疗反应无显著差异（P＞0.05）；然而，与4%HQ乳膏相比，5%TA乳膏的黑色素面积百分比显著降低（P = 0.000）。与HQ乳膏相比，TA似乎是一种治疗黄褐斑的有前景的治疗选择，副作用更少，效果相同甚至更好。
