Gilchrest B A, Goldwyn R M
Plast Reconstr Surg. 1981 Apr;67(4):435-9. doi: 10.1097/00006534-198104000-00003.
Disorders of epidermal pigmentation not amenable to surgical intervention were treated with topical agents in 15 patients. In cases of hypopigmentation, methoxsalen 1% solution was applied prior to photosensitizing ultraviolet light exposures on alternate days for 2 to 6 months. In cases of hyperpigmentation, hydroquinone 4%, retinoic acid 0.05%, and triamcinolone acetonide 0.25% were applied twice daily for 6 weeks. Of three patients with surgically induced depigmentation, all had moderate repigmentation. Of 12 patients with hyperpigmentation, 4 had significant resolution, 5 had partial resolution, and 3 failed to complete the study. Overall, 6 of the 15 patients reported marked satisfaction with their therapy. Mild localized phototoxicity or irritant reactions were the only complications. Topical chemotherapy produced subjective and objective improvement in all patients who completed a therapeutic trial for either hyperpigmentation or hypopigmentation, and in several patients the results were excellent. The safety of these medications and the lack of acceptable alternatives justify their further use in appropriate clinical settings.
15例不宜手术干预的表皮色素沉着紊乱患者接受了外用药物治疗。对于色素减退病例，在交替日进行光敏性紫外线照射前，外用1%甲氧沙林溶液，持续2至6个月。对于色素沉着过度病例，每日两次外用4%氢醌、0.05%维甲酸和0.25%曲安奈德，持续6周。在3例手术引起色素脱失的患者中，所有患者均有中度色素再沉着。在12例色素沉着过度的患者中，4例有显著改善，5例有部分改善，3例未完成研究。总体而言，15例患者中有6例对治疗表示非常满意。仅出现轻度局部光毒性或刺激性反应等并发症。局部化疗使所有完成色素沉着过度或色素减退治疗试验的患者在主观和客观上均有改善，在一些患者中结果极佳。这些药物的安全性以及缺乏可接受的替代药物证明了它们在适当临床环境中可进一步使用的合理性。
