This page contains a Flash digital edition of a book.
| dermatology | aRTicle


processes may result in the epidermal hyperpigmentation of melasma. For this reason, it should be highlighted that the use of broad-spectrum sunscreens are mandatory both during and after therapy, regardless of the kind of treatment chosen. the careful avoidance of other exacerbating factors, such as oral contraceptives, cosmetics, phototoxic drugs and anti-seizure medications, should also be recommended. the correct choice of treatment for the patient should


take into account the type of melasma to be treated, the skin complexion of the patient, and any previous treatments. In epidermal melasma, combined preparations, such as the triple combination hydroquinone, tretinoin and steroids, can be considered as a first-line treatment, rather than the use of single agents. In mixed melasma, the combination of chemical peeling with pharmacological treatment (hydroquinone, azelaic acid, kojic acid) seems a good option at present. In this regard, aHas show a higher flexibility as compared with tCa.


References


1. Prignano F, Ortonne JP, Buggiani G, Lotti T. Therapeutical approaches in melasma. Dermatol Clin 2007; 25(3): 337–42


2. Gupta AK, Gover MD, Nouri K, Taylor S. The treatment of melasma : a review of clinical trials. J Am Acad Dermatol 2006; 55(6): 1046–65


3. Victor FC, Gelberg J, Rao B. Melasma: a review. J Cutan Med Surg 2004; 8(2): 97–102


4. Kang HY, Hwang JS, Lee JY et al. The dermal stem cell factor and c-kit are overexpressed in melasma. Br J Dermatol 2006; 154(6): 1094–9


5. Kim EH, Kim YC, Lee ES, Kang HY. The vascular characteristics of melasma. J Dermatol Sci 2007; 46(2): 111–6


6. Imokawa G. Autocrine and paracrine regulation of melanocytes in human skin and in pigmentary disorders. Pigment Cell Res 2004; 17(2): 96–110


7. Young Kang H, Ortonne J.P. Melasma Update. Actas Dermosifiliogr 2009; 2: 110–3


8. Young Kang H, Ortonne J.P. What should be considered in treatment of Melasma. Ann Dermatol 2010; 22: 373–8


9. Gilchrest BA, Fitzpatrick TB, Anderson RR, et al. Localization of melanin pigmentation with Wood’s lamp. Br J Dermatol 1977; 96(3): 245–8


10. Nakayama H, Harada R, Toda M.


Pigmented cosmetic dermatitis. Int J Dermatol 1976; 15(9): 673–5


11. Sharquie KE, Al-Tikreety MM, Al- Mashhadani SA. Lactic acid as a new therapeutic peeling agent in melasma. Dermatol Surg 2005; 31(2): 149–54


12. Serrano G, Pujol C, Cuadra J, Gallo S, Aliaga


A. Riehl’s melanosis: pigmented contact dermatitis caused by fragrances. J Am Acad Dermatol 1989; 21(5 Pt 2): 1057–60i


13. Palumbo A, d’Ischia M, Misuraca G, Prota G. Mechanism of inhibition of melanogenesis by hydroquinone. Biochem Biophys Acta 1991; 1073(1): 85–90


14. Ennes SBP, Paschoalick RC, De Avelar M, Alchorne M. A double-blind, comparative, placebo-controlled study of the efficacy and tolerability of hydroquinone as a depigmenting agent in melasma. J Dermatol Treat 2001; 11: 173–9


15. Bandyopadhyay D. Topical treatment of


melasma. Indian J Dermatol 2009; 54(4): 303–9


16. Kasraee B, Safaee Ardekani GH, Parhizgar


A et al. Safety of topical methimazole for the treatment of melasma. Transdermal absorbtion, the effect on thyroid function and cutaneous adverse effects. Skin Pharmacol Physiol 2008; 21(6): 300–5


17. Zanieri F, Assad GB, Campolmi P, Lotti T.


Melasma: successfull treatment with pidobenzone 4% (K5 lipogel). Dermatol Ther 2008; 21 Suppl 1: S18–9


18. Roméro C, Aberdam E, Larnier C, Ortonne JP. Retinoic acid as modulator of UVB-induced melanocyte differentiation. Involvement of the melanogenic enzymes expression. J Cell Sci 2002; 107(Pt 4): 1095–103


19. Ortonne JP. Retinoid therapy of


pigmentary disorders. Dermatol Ther 2006; 19(5): 280–8


20.Torok HM. A comprehensive review of the


long-term and short-term treatment of melasma with a triple combination cream. Am J Clin Dermatol 2006; 7(4): 223–30


21. Sharquie KE, Al-Mashhadani SA, Salman HA. Topical 10% zinc sulfate solution for treatment of melasma. Dermatol Surg 2008; 34(10): 1346–9


22. Ertam I, Mutlu B, Unal I, Alper S, Kivçak B,


Ozer O. Efficiency of ellagic acid and arbutin in melasma: a randomized, prospective, open-label study. J Dermatol 2008; 35(9): 570–4


23. Fitton A, Goa KL. Azelaic acid. A review of its pharmacological of properties and therapeutic efficacy in acne and hyperpigmentary skin disorders. Drugs 2001; 41(5): 780–98


24.Verallo-Rowell VM, Verallo V, Graupe K,


Lopez-Villafuerte L, Garcia-Lopez M. Double-blind comparason of azelaic acid and hydroquinone in the treatment of melasma. Acta Derm Venereol Suppl (Stockh) 1999; 143: 58–61


25. Ballina LM, Graupe K. The treatment of


melasma with 20% azelaic acid versus 4% hydroquinone cream. Int J Dermatol 2001; 30: 893–5


26. Cestari T, Arellano I, Hexsel D et al. Melasma in Latin America; options for therapy and treatment algorithm. J Eur Acad Dermatol Venereol 2009; 23(7): 760–72


27. Kakita LS, Lowe NJ. Azelaic acid and


glycolic acid combination therapy for facial hyperpigmentation in darker-skinned patients: a clinical comparison with hydroquinone. Clin Ther 1998; 20(5): 960–70


28.Cabanes J, Chazarra S, Garcia-Carmona F. Kojic acid, a cosmetic skin whitening agent, is a slow-binding inhibitor of cathecolase activity of tyrosinase. J Pharm Pharmacol 2004; 46(12): 982–5


29. Garcia A, Fulton JE Jr. The combination of


glicoli acid and hydroquinone or kojic acid for the treatment of melasma and related conditions. Dermatol Surg 1996; 22(5): 443–7


30.Nakagawa M, Kawai K, Kawai K. Contact


allergy to kojic acid in skin care products. Contact Dermatitis 2005; 32(1): 9–13


31. Nair X, Tramposch KM. The Yucatan miniature swine as an in vivo model for screening skin depigmentation. J Dermatol Sci. 1991; 2(6): 428–33


32. Espinal-Perez LE, Moncada B, Castanedo- Cazares JP. A double-blind randomized trial of


5% ascorbic acid vs. 4% hydroquinone in melasma. Int J Dermatol 2004; 43(8): 604–7


33. Hwang SW, Oh DJ, Lee D, Kim JW, Park SW. Clinical efficacy of 25% L-ascorbic acid (C’ensil) in the treatment of melasma. J Cutan Med Surg 2009; 13(2): 74–81


34.Greatens A, Hakozaki T, Koshoffer A et al.


Effective inhibition of melanosome transfer to keratinocytes by lectins and niacinamide is reversible. Exp Dermatol 2005; 14(7): 498–508


35. Torok HM, Jones T, Rich P, Smith S, Tschen


E. Hydroquinone 4%, tretinoin 0.05%, fluocinolone acetonide 0.01%: a safe and efficacious 12-month treatment for melasma. Cutis 2005; 75(1): 57–62


36. Rendom M, Cardona LM, Bussear EW,


Benitez AL, Colòn LE, Johnson LA. Successful treatment of moderate to severe melasma with triple-combination cream and glycolic acid peels: a pilot study. Cutis 2008; 82: 372–8


37. Chan R, Park KC, Lee MH et al. A


randomized controlled trial of the efficacy and safety of a fixed triple combination (fluocinolone acetonide 0.01%, hydroquinone 4%, tretinoin 0.05%) compared with hydroquinone 4% cream in Asian patients with moderate to severe melasma. Br J Dermatol 2008; 159(3): 697–703


38.Grimes PE, Bhawan J, Guevara IL et al. Continuos therapy followed by maintenance therapy regimen with a triple combination cream for melasma. J Am Acad Dermatol 2010; 62(6): 962–7


39. Taylor SC, Torok H, Jones T et al. Efficacy


and safety of a new triple-combination agent for the treatment of facial melasma. Cutis 2003; 72(1): 67–72


40.Cook-Bolden FE, Hamilton SF. An


open-label study of the efficacy and tolerability of microencapsulated hydroquinone 4% and retinol 0,15% with antioxidants for the treatment of hyperpigmentation. Cutis 2008; 81(4): 365–71


41. Kang WH, Chun SC, Lee S. Intermittent therapy for melasma in Asian patients with combined topical agents (retinoic acid, hydroquinone and hydrocortisone): clinical and histological studies. J Dermatol 1998; 25(9): 587–96


42.Keeling J, Cardona L, Benitez A, Epstein R,


Rendon M. Mequinol 2%/tretinoin 0.01% topical solution for the treatment of melasma in men: a case series and review of the literature. Cutis 2008; 81(2): 179º83


43.Wang CC, Hui CY, Sue YM, Wong WR, Hong


HS. Intense pulsed light for the treatment of Refractory Melasma in Asian persons. Dermatol Surg 2004; 30(9): 1196–200


44.Chan HH, Kono T. The use of lasers and intense pulsed light sources for the treatment of pigmentary lesions. Skin Therapy Lett 2004; 9(8): 5–7


45. Li YH, Chen JZ, Wei HC et al. Efficacy and


safety of intense pulsed light in treatment of melasma in Chinese patients. Dermatol Surg 2008; 34(5): 693–700


46.Zoccali G, Piccolo D, Allegra P, Giuliani M.


Melasma treated with intense pulsed light. Aesth Plast Surg 2010; 34(4): 486–93


47. Goldman MP, Gold MH, Palm MD et al.


Sequential treatment with triple combination cream and intense pulsed light is more efficacious than sequential treatment with inactive (control) cream and intense pulsed light in patients with moderate to severe melasma. Dermatol Surg 2011; 37(2): 224–33


48.Beylot C. Ablative and fractional lasers.


Ann Dermatol Venereol 2008; 135 Suppl 3: S189–94


49. Tannous ZS, Astner S. Utilizing fractional


resurfacing in the treatment of therapy- resistant melasma. J Cosmet Laser Ther 2005; 7(1): 39–43


50.Karsai S, Raulin C. Fractional


photothermolysis : a new option for treating melasma? Hautarzt 2008; 59(2): 92–100


51. Kroon MW, Wind BS, Beek JF et al.


Nonablative 1550-nm fractional laser therapy versus triple topical therapy for the treatment of melasma: a randomized controlled pilot study. J Am Acad Dermatol 2011; 64(3): 516–23


52. Ilknur T, Biçak MU, Demirtaşoğlu M, Ozkan


S. Glycolic acid peels versus amino fruit acid peels in the treatment of melasma. Dermatol Surg 2010; 36(4): 490–5


53. Kumari R, Thappa DM. Comparative study


of trichloroacetic acid versus glycolic acid chemical peels in the treatment of melasma. Indian J Dermatol Venereol Leprol 2010; 76(4): 447


54. Sharquie KE, Al-Tikreety MM, Al-Mashhadani SA. Lactic acid chemical peels as a new therapeutic nodality in nelasma in comparison to Jessner’s solution chemical peels. Dermatol Surg 2006; 32(12): 1429–36


55. Ejaz A, Raza N, Iftikhar N, Muzzafar F.


Comparison of 30% salicylic acid with Jessner’s solution for superficial chemical peeling in epidermal melasma. J Coll Physiciancs Surg Pak 2008; 18(4): 205–8


56. Ghersetich I, Troiano M, Brazzini B,


Arunachalam M, Lotti T. Melasma: treatment with 10% tretinoin peeling mask. J Cosmet Dermatol 2010; 9(2): 117–21


57. Ghersetich I, Brazzini B, Lotti T. Chemical


peeling. In: Lotti TM, Katsambas AD. eds, European handbook of dermatological treatments. 2nd edn. New York: Springer, 2003


58.Lee JH, Park JG, Lim SH et al. Localized intradermal microinjection of tranexanic acid for treatment of melasma in Asian patients: a preliminary clinical trial. Dermatol Surg 2006; 32(5): 626–31


prime-journal.com | July 2011 ❚ Physical treatment with lasers (especially IPl) should be


limited to those patients who do not respond to the primary topical and cosmetic treatment. However, in the authors’ opinion only transient results can be obtained, with the possible reappearance of hyperpigmented lesions. Physical modalities like lasers sometimes yield rebound hyperpigmentation. the role of vascularisation in the pigmentation processes must be studied further. this field of research may provide new therapeutic options such as vascular lasers or anti-angiogenic agents, but future work is needed to identify this treatment option.


Declaration of interest The authors have no significant financial involvement with any organisation or entity with a direct financial interest in the subject matter or materials discussed in this article


27


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84