Pazyar Nader, Dezfuly Motahareh Babazadeh, Hadibarhaghtalab Maryam, Parvar Seyedeh Yasamin, Molavi Seyedeh Nasrin, Mapar Mohammad Ali, Zeinali Maryam
Dr. Pazyar is an Assistant Professor with the Department of Dermatology at Imam Khomeini Hospital at Ahvaz Jundishapur University of Medical Sciences in Ahvaz, Iran.
Drs. Dezfuly and Molavi are Assistants of Dermatology with the Department of Dermatology at Imam Khomeini Hospital at Ahvaz Jundishapur University of Medical Sciences in Ahvaz, Iran.
J Clin Aesthet Dermatol. 2023 Jan;16(1):35-40.
Melasma is an acquired and chronic hyperpigmentation disorder associated with a negative impact on patients' quality of life. This study compares the efficacy of 100mg/mL intradermal TA with 4% topical HQ on female patients presenting with melasma lesions.
In this randomized double-blind controlled trial, 48 women with melasma were allocated into two groups, treated with either 100mg/mL intradermal TA or topical 4% HQ. The MASI (Melasma Area and Severity Index) score was assessed by paired t-tests and repeated measured ANOVAs. The Dynamic Physician General Assessment (PGA) was also performed by taking photographs with a digital camera.
The average MASI score for the HQ and TA groups was 7.7 (3.0 SD) and 5.9 (2.5 SD), respectively. In both groups, the MASI decreased significantly after three months of treatment; however, the decrease was not significant between the two groups (=0.1). All participants developed mild degrees of burning pain in the injection site without serious adverse effects.
First, we only used the MASI score to measure melasma degree. Second, this is a single-center study with a small sample size. Third, the before-after photos were not taken with a high-quality camera.
The results of our study showed that both TA and continuous HQ significantly reduced the MASI score of patients without any significant differences and serious side effects. Although many treatment modalities are available for melasma, this condition is still challenging for dermatologists with a high recurrence rate after treatment.
黄褐斑是一种获得性慢性色素沉着障碍，对患者的生活质量有负面影响。本研究比较100mg/mL皮内注射曲安奈德（TA）与4%外用氢醌（HQ）对有黄褐斑皮损的女性患者的疗效。
在这项随机双盲对照试验中，48例黄褐斑女性患者被分为两组，分别接受100mg/mL皮内注射TA或外用4%HQ治疗。通过配对t检验和重复测量方差分析评估黄褐斑面积和严重程度指数（MASI）评分。还通过数码相机拍照进行动态医师总体评估（PGA）。
HQ组和TA组的平均MASI评分分别为7.7（标准差3.0）和5.9（标准差2.5）。两组在治疗三个月后MASI均显著下降；然而，两组之间的下降无显著差异（P = 0.1）。所有参与者在注射部位均出现轻度灼痛，无严重不良反应。
首先，我们仅使用MASI评分来衡量黄褐斑程度。其次，这是一项单中心、小样本量的研究。第三，前后照片不是用高质量相机拍摄的。
我们的研究结果表明，TA和持续使用HQ均能显著降低患者的MASI评分，且无显著差异和严重副作用。尽管有多种治疗方式可用于黄褐斑，但这种疾病对皮肤科医生来说仍然具有挑战性，治疗后复发率很高。
