Gheisari Mehdi, Ghalamkarpour Fariba, Moslemi Haghighi Shima, Zaresharifi Shirin, Dadkhahfar Sahar, Al-Zubaidi Nabaa, Ghadirzade Arani Leila, Mollaabasi Faeghe, Robati Reza M
Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Cosmet Dermatol. 2024 Dec;23(12):3968-3973. doi: 10.1111/jocd.16517. Epub 2024 Aug 6.
Macular amyloidosis is a form of primary localized cutaneous amyloidosis presented by pruritic pigmented macules in rippled or reticulate pattern. The aim of this study was to assess the efficacy of using topical tranexamic acid with micro-needling comparing to micro-needling alone in patients with macular amyloidosis.
Patients with bilaterally located macular amyloidosis on trunk or upper extremities were recruited in this trial. The skin lesions in all patients were divided into two parts which were randomly assigned to the group of treatment with micro-needling plus tranexamic acid and the group of micro-needling alone. There were four sessions of treatment with 2 weeks interval. The percentage of improvement in pigmentation (based on photographs and dermoscopy) and rippling of each group was determined by three blinded dermatologists. The level of patient satisfaction and reduction of pruritus was measured by a questionnaire and defined as a percentage.
Twenty females were enrolled in this study. The mean (SD) patients' age was 39.7 (±10.13) years. Both groups showed improvement in pigmentation based on images, dermoscopy, and rippling pattern. Patients' satisfaction was 46.5% in tranexamic acid group and 47.5% in micro-needling alone. Nevertheless, there was no significant difference between both groups (p value >0.05). Interestingly, the pruritus improved 61.66% after four sessions of treatment in both groups.
Micro-needling is a suitable modality for decreasing pruritus and pigmentation in macular amyloidosis. However, topical application of tranexamic acid does not lead to additional improvement.
黄斑部淀粉样变是原发性局限性皮肤淀粉样变的一种形式，表现为呈波纹状或网状的瘙痒性色素沉着斑。本研究的目的是评估与单纯微针治疗相比，局部应用氨甲环酸联合微针治疗黄斑部淀粉样变患者的疗效。
本试验招募了躯干或上肢双侧患有黄斑部淀粉样变的患者。所有患者的皮肤病变均分为两部分，随机分配至微针联合氨甲环酸治疗组和单纯微针治疗组。共进行4次治疗，间隔2周。由3名不知情的皮肤科医生确定每组色素沉着改善百分比（基于照片和皮肤镜检查）及波纹改善情况。通过问卷调查测量患者满意度和瘙痒减轻程度，并以百分比表示。
本研究共纳入20名女性。患者平均年龄为39.7（±10.13）岁。基于图像、皮肤镜检查和波纹模式，两组的色素沉着均有改善。氨甲环酸组患者满意度为46.5%，单纯微针治疗组为47.5%。然而，两组之间无显著差异（p值>0.05）。有趣的是，两组在4次治疗后瘙痒均改善了61.66%。
微针是减轻黄斑部淀粉样变瘙痒和色素沉着的合适方法。然而，局部应用氨甲环酸并未带来额外改善。
