Khurana Neelam, Mehdi Mohammad M, Sawhney Mohinder P S, Bansal Sanjiv K
From the Department of Biosciences and Bioengineering, Lovely Professional University, Phagwara, Punjab, India.
Department of Dermatology and STD, FMHS, SGT University, Chandu-Budhera, Gurugram, Haryana, India.
Indian J Dermatol. 2025 Mar-Apr;70(2):57-62. doi: 10.4103/ijd.ijd_11_24. Epub 2025 Feb 27.
Melasma is an acquired hyperpigmentation disorder of the skin. Recent studies suggest that oxidative stress may contribute to the pathogenesis of melasma. Upregulated levels of circulatory antioxidants in blood serum and vascular endothelial growth factors in melasma lesions have been observed. The prospective study was conducted to compare the effect of the treatment of melasma with and without the use of a 577 nm vascular laser on levels of enzymatic antioxidants.
To compare the modulation in the levels of enzymatic antioxidants in melasma patients treated with 577 nm yellow light laser in combination with topical depigmenting serum as compared to those using depigmenting serum alone.
Sixty patients with melasma of both sexes were randomly divided into groups of 30 each. Group A patients were treated with yellow light laser 577 nm (wavelength) once every 4 weeks for 4 sittings and topical depigmenting serum (4n butyl resorcinol) daily for 24 weeks. Group B patients were treated only with topical depigmenting serum. Levels of total antioxidant capacity (TAC), superoxide dismutase (SOD), inducible nitric oxide synthase (iNOS), glutathione peroxidase (GPx) and malondialdehydes (MDA) were estimated at 0 and 24 weeks.
Mean difference in lowering of the antioxidant levels in Group A and B was SOD1 (0.73 versus 0.12), GPX1, (0.62 versus 0.30), iNOS (1.56 versus 0.52), MDA, (0.73 versus 0.38), TAC (2.24 versus 1.28). A significantly higher mean of difference was observed in patients treated with combination therapy.
Significantly higher reduction of enzymatic antioxidants with 577 nm yellow light laser in combination with 4 N-butyl resorcinol as compared to topical depigmenting agent alone recommends that combination therapy in melasma may target different aspects of a condition to enhance overall effectiveness.
黄褐斑是一种后天性皮肤色素沉着紊乱疾病。近期研究表明，氧化应激可能在黄褐斑的发病机制中起作用。已观察到血清中循环抗氧化剂水平以及黄褐斑皮损中血管内皮生长因子水平上调。开展这项前瞻性研究以比较使用和不使用577nm血管激光治疗黄褐斑对酶类抗氧化剂水平的影响。
比较577nm黄光激光联合外用脱色血清治疗的黄褐斑患者与仅使用脱色血清治疗的患者，其酶类抗氧化剂水平的变化情况。
60例男女黄褐斑患者随机分为两组，每组30例。A组患者每4周接受一次577nm（波长）黄光激光治疗，共治疗4次，同时每天外用脱色血清（4 - 正丁基间苯二酚），持续24周。B组患者仅接受外用脱色血清治疗。在第0周和第24周时评估总抗氧化能力（TAC）、超氧化物歧化酶（SOD）、诱导型一氧化氮合酶（iNOS）、谷胱甘肽过氧化物酶（GPx）和丙二醛（MDA）的水平。
A组和B组抗氧化剂水平降低的平均差异为SOD1（0.73对0.12）、GPX1（0.62对0.30）、iNOS（1.56对0.52）、MDA（0.73对0.38）、TAC（2.24对1.28）。联合治疗的患者观察到的平均差异显著更高。
与单独使用外用脱色剂相比，577nm黄光激光联合4 - 正丁基间苯二酚治疗能显著降低酶类抗氧化剂水平，这表明黄褐斑联合治疗可能针对病情的不同方面以提高整体疗效。
