Department of Dermatology, All India Institute of Medical Sciences, New Delhi, India.
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
Int J Dermatol. 2020 Dec;59(12):1525-1530. doi: 10.1111/ijd.15229. Epub 2020 Oct 5.
No randomized studies compared the efficacy and safety of modified Kligman's triple combination (TC) with 1,064 nm Q-switched Nd-YAG laser (QSNYL) in melasma in darker skin.
To compare the efficacy and safety of QSNYL and TC in the treatment of melasma in Fitzpatrick skin types IV and V.
In this split face randomized controlled trial, participants' cheeks were randomized to receive either weekly QSNYL (group A) or daily TC (group B) for 12 weeks, followed by 12 weeks of follow-up.
Twenty-eight patients completed the intervention, and 21 of them completed follow-up. We found a significant but modest reduction in mean melanin index, modified Melasma Area Severity Index (MASI), and photographic and patient's assessment in both modalities (P < 0.01). No significant differences were detected between the groups. All patients had reappearance of pigmentation by the end of follow-up. Adverse reactions were significantly more in group B (P < 0.001).
The desired sample size could not be achieved.
No statistically significant differences were observed between QSNYL and TC as monotherapy in melasma. Reappearance of melasma is inevitable after stopping treatment.
没有随机研究比较改良的 Kligman 三联疗法（TC）与 1064nm Q-开关 Nd-YAG 激光（QSNYL）在深色皮肤黄褐斑中的疗效和安全性。
比较 QSNYL 和 TC 在治疗 Fitzpatrick 皮肤类型 IV 和 V 黄褐斑中的疗效和安全性。
在这项分割面部随机对照试验中，参与者的脸颊被随机分为每周接受 QSNYL（A 组）或每天接受 TC（B 组）治疗 12 周，然后进行 12 周的随访。
28 例患者完成了干预，其中 21 例完成了随访。我们发现两种治疗方法的平均黑色素指数、改良黄褐斑面积严重程度指数（MASI）和摄影及患者评估均有显著但适度的降低（P<0.01）。两组之间未发现显著差异。所有患者在随访结束时均出现色素沉着再发。不良反应在 B 组明显更多（P<0.001）。
无法达到预期的样本量。
QSNYL 和 TC 作为单一疗法治疗黄褐斑时，未观察到统计学上的显著差异。治疗停止后，黄褐斑必然会再次出现。
