Lueangarun Suparuj, Sirithanabadeekul Punyaphat, Wongwicharn Prapalpitch, Namboonlue Chutimon, Pacharapakornpong Sarun, Juntongjin Premjit, Tempark Therdpong
Drs. Lueangarun, Sirithanabadeekul, Wongwicharn, Namboonlue, Pacharapakornpong, and Juntongjin are with the Division of Dermatology at the Chulabhorn International College of Medicine of Thammasat University in Pathumthani, Thailand.
Dr. Tempark is with the Department of Pediatrics, Faculty of Medicine at Chulalongkorn University in Bangkok, Thailand.
J Clin Aesthet Dermatol. 2020 Aug;13(8):36-39. Epub 2020 Aug 1.
Despite being an effective treatment for melasma, there have been limited reports on the long-term efficacy of intradermal tranexamic acid (TA) injection. This study sought to evaluate the 48-week efficacy of a 4mg/mL intradermal TA injection for the treatment of melasma. Five female patients with melasma participated in the 48-week follow-up after receiving 4-mg/mL intradermal TA injections on the face every two weeks for seven sessions and a sunscreen prescription. Assessments were performed at baseline and Weeks 4, 8, 12, 16, and 48 using the modified Melasma Area Severity Index (mMASI) score, melanin index, and patient satisfaction score. Safety and adverse effects were also evaluated. The mean (standard deviation) age of patients was 53.6 (8.14) years and Fitzpatrick Skin Type IV (60%) and Fitzpatrick Skin Type V (40%) were observed. The mean (standard deviation) duration of melasma was 7.6 (2.51) years and 60 percent of participants reported a family history of melasma. There was a significant decrease in mMASI score and melanin index at 16 weeks, without a statistically significant improvement of mMASI score at 48 weeks. Melasma recurrence was observed in 60 percent of the participants, with higher mMASI scores recorded, but the severity remained less than at baseline. The patient satisfaction score was lower from Week 16 to Week 48. Interestingly, a statistically significant decrease in the melanin index was observed up to Week 48, with no serious adverse effects. The 4-mg/mL intradermal TA injection yields significant efficacy at Week 16; however, melasma recurrence occurred during the 48-week follow-up. In addition to tranexamic acid injections, maintenance therapy and sun protection should be considered for patients with melasma.
尽管皮内注射氨甲环酸（TA）是治疗黄褐斑的一种有效方法，但关于其长期疗效的报道有限。本研究旨在评估4mg/mL皮内注射TA治疗黄褐斑48周的疗效。五名黄褐斑女性患者接受了每两周一次、共七次的面部4mg/mL皮内TA注射及防晒霜处方，之后进行了48周的随访。在基线、第4、8、12、16和48周时，使用改良黄褐斑面积严重程度指数（mMASI）评分、黑色素指数和患者满意度评分进行评估。同时也评估了安全性和不良反应。患者的平均（标准差）年龄为53.6（8.14）岁，观察到菲茨帕特里克皮肤分型IV型（60%）和V型（40%）。黄褐斑的平均（标准差）病程为7.6（2.51）年，60%的参与者报告有黄褐斑家族史。在第16周时，mMASI评分和黑色素指数显著下降，在48周时mMASI评分无统计学意义的改善。60%的参与者出现了黄褐斑复发，记录的mMASI评分较高，但严重程度仍低于基线。从第16周到第48周，患者满意度评分较低。有趣的是，直到第48周黑色素指数有统计学意义的下降，且无严重不良反应。4mg/mL皮内TA注射在第16周时产生显著疗效；然而，在48周的随访期间出现了黄褐斑复发。对于黄褐斑患者，除了氨甲环酸注射外，还应考虑维持治疗和防晒。
