State Clinic of Dermatology, Mureș County Hospital, Tîrgu Mureș, Romania.
Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy.
J Dermatolog Treat. 2022 Jun;33(4):1816-1837. doi: 10.1080/09546634.2021.1914313. Epub 2022 Mar 23.
Melasma is a common chronic refractory disorder of pigmentation affecting people with darker skin types. Overall prevalence varies between 8.8% and 40%, depending on the ethnicity of the population and the geographical area. Therapeutic management of melasma is challenging, with high recurrence rates which significant impacts on the quality of life. No single treatment is universally efficacious. Systemic treatments with tranexamic acid and polypodium leucotmatous had promising results, although the former was related to systemic side effects. Microneedling and peeling were also efficacious, although their superiority to topical hydroquinone, the gold standard in melasma treatment, remains to be established. Similarly, laser and light devices have been beneficial. However, recurrence rates remain high in all treatment groups. Combination therapies, either in double or triple combinations yielded the best results when compared to single terapies. Treatment choice should be made after Wood's lamp examination, as well as dermatoscopic evaluation, in order to select the best treatment option, targeted at each melasma subtype.
黄褐斑是一种常见的慢性难治性色素沉着疾病，影响深色皮肤人群。总体患病率在 8.8%至 40%之间变化，具体取决于人群的种族和地理区域。黄褐斑的治疗管理具有挑战性，复发率高，对生活质量有重大影响。没有单一的治疗方法普遍有效。氨甲环酸和贯叶金丝桃素的系统治疗有很好的效果，尽管前者与全身副作用有关。微针和去皮也有效，尽管它们比黄褐斑治疗的金标准——局部氢醌更有效，但仍有待确定。同样，激光和光设备也有帮助。然而，所有治疗组的复发率仍然很高。与单一疗法相比，双或三联疗法的联合治疗效果最好。治疗选择应在伍德灯检查以及皮肤镜评估后进行，以便根据每个黄褐斑亚型选择最佳治疗方案。
