Chunekamrai Puri, Chatpimolkul Nattasit, Thummawatwimon Soravit, Treesirichod Arucha
Department of Pediatrics, Faculty of Medicine, Srinakharinwirot University, HRH Princess Maha Chakri Sirindhorn Medical Center, Rangsit- Nakhonnayok Road, Ongkharak, Nakhonnayok, 26120, Thailand.
Arch Dermatol Res. 2025 Jan 20;317(1):297. doi: 10.1007/s00403-025-03821-y.
Acanthosis nigricans (AN) is a dermatological condition, marked by hyperpigmentation and skin thickening, frequently affecting body folds like the axillae. Treatment options for axillary hyperpigmentation remain underexplored. This study evaluated the efficacy of 0.025% tretinoin cream in treating axillary hyperpigmentation associated with AN. In a randomized, intra-individual, split-side design study, participants applied 0.025% tretinoin cream on one axilla and a cream-based on the other. The study spanned 12 weeks, with topical application for the first 8 weeks, followed by a 4-week cessation period. Efficacy was measured using the melanin (M) index via narrowband reflectance spectrophotometry. Overall success was evaluated through investigator- and participant-global evaluation (IGE and PGE) scales, with adverse effects monitored. Twenty participants completed the study. The 0.025% tretinoin cream significantly reduced hyperpigmentation compared to the control (p < 0.001). By week 8, the mean M index reduction with tretinoin was 28.05%±12.20%, versus 6.55%±12.66% with the control. Hyperpigmentation reappeared partially after treatment cessation. By week 8, 75% of participants in the tretinoin group achieved more than 75% improvement in IGE, compared to 35% in the cream-based group. Similarly, 75% of the tretinoin group reported more than 75% improvement in PGE, whereas only 15% of the cream-based group achieved more than 50% improvement. Adverse effects were mild and included slight erythema, peeling, and itching. The 0.025% tretinoin cream significantly improved AN patients' axillary hyperpigmentation, demonstrating a safe and effective treatment option with minimal side effects.
黑棘皮病（AN）是一种皮肤病，其特征为色素沉着过度和皮肤增厚，常累及腋窝等身体褶皱部位。腋窝色素沉着过度的治疗方案仍未得到充分探索。本研究评估了0.025%维甲酸乳膏治疗与AN相关的腋窝色素沉着过度的疗效。在一项随机、个体内、双侧设计研究中，参与者在一侧腋窝涂抹0.025%维甲酸乳膏，另一侧腋窝涂抹一种乳膏基质。该研究为期12周，前8周进行局部涂抹，随后有4周的停药期。通过窄带反射分光光度法使用黑色素（M）指数测量疗效。通过研究者和参与者整体评估（IGE和PGE）量表评估总体疗效，并监测不良反应。20名参与者完成了研究。与对照组相比，0.025%维甲酸乳膏显著减少了色素沉着过度（p < 0.001）。到第8周时，维甲酸组的平均M指数降低了28.05%±12.20%，而对照组为6.55%±12.66%。停药后色素沉着过度部分复发。到第8周时，维甲酸组75%的参与者在IGE方面改善超过75%，而乳膏基质组为35%。同样，维甲酸组75%的参与者报告PGE改善超过75%，而乳膏基质组只有15%的参与者改善超过50%。不良反应轻微，包括轻微红斑、脱皮和瘙痒。0.025%维甲酸乳膏显著改善了AN患者的腋窝色素沉着过度，证明是一种安全有效的治疗选择，副作用最小。
