جستجوی مقالات مرتبط با کلیدواژه "ملاسما" در نشریات گروه "پزشکی"

Melasma is one of the common dermatologic diseases that has an effect on the patient's quality of life, therefore its treatment is important. Various medicinal and herbal compounds have been used, including creams containing hydroquinone, vitamin C, alfa hydroxy acids, arbutin, tretinoins, and sometimes combination creams are prescribed, and there is still no definite and guaranteed treatment for it. In the present experimental study, the effect of topical medicine Atache Despigman (Atache laboratorios, Spain), which contains 2% hydroquinone, vitamin C and fruit acids) in the treatment of melasma has been investigated. After two months of treatment with this medicine, from the patients' point of view, the results of spot reduction were very good 17%, good 53%, average 25%, and poor 5%, and these percentages from the doctor's point of view were 20%, 52%, 25%, and 3%, respectively. Therefore, the majority observed the effectiveness. With the examination by Dermacatch device, a decrease in pigmentation was also observed.

Melasma is a common disease affecting quality of life. Available treatments result in the gradual and partial clearance of melasma, and are accompanied with high risk of recurrence after discontinuing treatment. Tranexamic acid has been successfully evaluated in several studies. In addition, laser has been proposed as an enhanced drug delivery method. This study is designed to evaluate this enhancing effect.

Twenty-five patients with bilateral epidermal and mixed type melasma were recruited in the study and applied tranexamic 5% gel bilaterally on face two times a day and randomly underwent fractional CO2 laser treatment on one side of the face monthly. They were evaluated before starting treatment and then every 4 weeks by measuring modified melasma area severity index (mMASI) and melanin index by Dermacatch (Colorix, Switzerland). Also, quality of life was measured and compared in a subset of patients with MELAS QoL questionnaire before and after treatment. The results were analyzed by SPSS software version 18 and the results were compared by paired t test. Due to multiple comparisons, p value of 0.0125 was considered significant.

The mMASI and melanin index were not significantly different between two sides in each follow up (P>0.0125). The mMASI and melanin index significantly decreased after treatment with tranexamic acid with or without fractional CO2 laser (P<0.001 and P<0.001, respectively)

Although tranexamic acid 5% gel is effective in the treatment of melasma, however, our study did not show additive therapeutic effect by adding fractional CO2 laser to it.

This is a letter to editor criticizing the paper entitled “Efficacy of licorice extract in the treatment of melasma: A randomized, double-blind, placebo-controlled clinical trial”. We discuss some methodological points on external and internal validity of results. The paper suffers from lack of detailed information on sample size and power calculation to make sure generalisability of results to study population. The paper also did not report blinding procedure and placebo details. The results of the paper also suffer from multiplicity (multiple comparisons) and suitability of data analysis approach. It is recommended to apply either repeated measure ANOVA or a mixed model to consider correlation between repeated measure of outcomes and multiplicity problem.

Melasma is a recurrent, symmetric, and chronic acquired hyperpimentation that presents gray-brown macules and patches with determined margins in areas exposed to light. There are many treatment options with different efficacies and side effects. In this study the therapeutic effect of 20% azelaic acid and 4% hydroquinone in treatment of melasma was assessed.
In this clinical trial, the study population consisted of all patients with clinical diagnosis of melasma, who referred to the outpatient clinic of dermatology of Hamadan, Farshchian Hospital from December 2013 to July 2014. A total of 44 patients were recruited. Patients were randomly divided to two groups and each group was treated with either azelaic acid or hydroquinone for four months. The MASI score was used to evaluate the improvement. P values of ≤ 0.05 were considered significant.
Of 44 patients, 21 received 4% hydroquinone and 23 received 20% azelaic acid, with random allocation. Both groups were similar with respect to gender and age, and there were no significant differences between the two groups. The MASI score in both groups had a decreasing trend over time, and at the end of the fourth month, a significant difference was found between the two groups (P = 0.006). The overall mean MASI score in both groups had a significant difference at different times and during the entire trial period, mean MASI score of 20% azelaic acid was lower than 4% hydroquinone (P = 0.001).
Based on this study, we could conclude that 20% azelaic acid in comparison with 4% hydroquinone had better effects on treatment of melasma. Therefore, 20% azelaic acid is a good alternative for 4% hydroquinone in treatment of melasma.

Melasma is a common acquired disorder characterized by symmetric, hyperpigmented patches with an irregular outline, occurring most commonly on the face. The goal of this study was to evaluate the efficacy of a cream containing 4% licorice extract with a novel formulation based on solid lipid nanoparticles technology in the treatment of melasma. To the best of our knowledge, it is the first study designed to investigate the efficacy of this novel formulation in the treatment of melasma all over the world.
In this randomized, double-blind, placebo-controlled clinical trial, 44 women with clinical diagnosis of melasma referred to the Afzalipour hospital dermatology clinic were randomly allocated into two treatment groups of equal size. All the patients were interviewed and examined every four weeks during the trial and their Modified Melasma Area and Severity Index (MMASI) score were evaluated at 4, 8 and 12 weeks. The efficacy of the interventions were classified in four levels: complete response, significant response, partial response and no response.
Forty patients were enrolled in the study. At the end of the study (12 weeks), mean± standard deviation of MMASI score changed from 11.03±2.7 to 1.41±0.6 in the intervention group and from 11.25±2.9 to 2.37±1.2 in the placebo group, respectively (P Licorice extract can be used as a skin-lightening agent with minimal side effect in the treatment of melasma. Nano/micro solid lipid particles are used as carriers with unique properties like size, surface electrical bar. Moreover, a large amount of the drug might be loaded to increase the efficacy and decrease the adverse events.

Melasma is an acquired pigmentation disorder in all types of skin especially in women. Researchers are certain to find effective and less recurrence rate treatment. This study compared the effectiveness of Kligman formula alone and its combination therapy with fractional Q switched Nd: YAG laser in the treatment of melasma. In this clinical trial، 50 patients with melasma were randomly divided into two groups of 25. The first group treated with Kligman formula and the second group treated with combination of Kligman formula and fractional Q switched Nd: YAG laser. Area expansion، pigmentation and melasma uniformity، melasma area and severity index score (MASI) score، patient opinion immediately after the completion of treatment and 6 months after starting it، were recorded. The results were analyzed using ANOVA test. In both methods، there were significant differences after treatment in the development of pigmentation and MASI score compared to before it; but no significant differences were observed between the two methods. The inverse relation was observed between the age and the result of treatment and recurrence of melasma in both groups. Dry skin was occurred in one case of combination therapy. In this study، significant improvement was seen in both groups; but، there was no significant difference between the two approaches. It seems that increasing the number and reducing the time between laser sessions can create a more appropriate response. In addition، due to the recurrence of melasma after the end of treatment، there is a need for continuation the treatment using lightening compounds as Kligman formula and Peel felt.

Background and Melasma is a pigmentation of facial area that is seen mostly in women. Endocrine disorders are involved in development of melasma. This study was designed to evaluate the topical effect of a triple combination therapy in patients with melasma. This clinical trial was conducted in 70 patients with melasma attending a Dermatology Clinic. All patients with melasma received triple combination (hydroquinone 5%, salicylic acid 4%, and fluocinolone 0.01%) and vitamin C 2% for 6 months. The efficacy of treatment was evaluated based on Melasma Area and Severity Index (MASI) Score and patients’ satisfaction was evaluated according to a questionnaire based on Satisfaction Index (SI). Data analysis was performed applying qui square test, binomial test, and repeated measures ANOVA. Among the patients 93% were women and the mean age of participants was 35.21±7.5. Mean MASI Score was 27.07±10.24 at the beginning of the treatment and a significant decrease was seen at the end of first month (7.17±3.64), second (6.97±2.97), third (8.64±3.77), fourth (8.96±4.77), and sixth months (7.77±4.86). Triple combination therapy (hydroquinone 5%, salicylic acid 4%, and fluocinolone 0.01%) was found effective in treatment of melasma and could be used as a new protocol.

Melasma is a common acquired hypermelanosis in areas exposed to sunlight, which exacerbates with sunlight, pregnancy, and endocrine diseases. Melasma is problematic regarding cosmetic especially in women. Many drugs have been used for its treatment, but regarding side effects, they have limited relative usage. Therefore, testing a new drug with higher effectiveness and fewer side effects is necessary. This study attempted to evaluate the effectiveness of kojic acid on melasma. In this study double-blind clinical trial study, 40 patients with melasma were enroled. One group of 20 people received kojic acid cream 2%, and the other used glycolic acid 10% and hydroquinone cream 2%. In the first group, 43 pigmented macules and in the second group, 21 pigmented macules existed. The changes of pigments in terms of recovery time, color tone and size of the pigments over a three-month treatment period was evaluated with clinical assessment, completing monthly questionnaire, and in a few cases with the aid of Wood's lamp. After the three-month treatment period, the collected data using the Friedman test, t-test were analyzed. In total, 79% of the patients were cured after 3 months. According to Friedman test, regarding healing time of the pigment, there was a significant difference between the groups (P = 0.008). Regarding the color tone changes of the pigment at the end of the second and third months, there was a significant difference between the two groups.Conclousion: Kojic acid 2% cream has a good efficacy in the treatment of melasma with no serious complications.

Skin disease is one of the important parts of Iranian Traditional Medicine. There are multiple and no expensive therapies for each of them. one of the most popular skin disease in Iranian Traditional Medicine named Kalaf which is a skin hyper pigmentation of the face. It is caused by different factors such as pregnancy، menstrual disorders، gastric disease، hepatic failure and…. On the other hand etiologies and clinical manifestations of Melasma are very similar to Kalaf disease. Based on the fact that Melasma treatment is not so effective and also has many complications، the main goal of this systematic review is to study Iranian Traditional Medicine books and make a comparison between Melasma and Kalaf in order to find their similarities. So if they were the same in general، on the next step we can use simple and easy and more effective remedies of Kalaf disease in treatment of Melasma patients.

Quality of life is a broad concept that reflects an individual’s perspective on the level of life satisfaction experienced in a variety of situations including housing, recreation, environmental conditions, health and job. In this way it is a subjective measure that is affected by factors well beyond health status. To evaluate quality of life in patients with common pigmentation disorders such as vitiligo, melasma, and freckles refer to dermatologic clinics of Kashan University of medical sciences during 2010 and 2011. In this cross sectional study, 142 patients with pigmentation disorders, older than 18 years old filled out Dermatology Life Quality Index (DLQI) questionnaire. DLQI questionnaire includes 10 questions regarding feelings, daily activities, leisure, job and education, personal relationship and treatment. Scoring was performed according to Finlay's guidelines. The data were analyzed with t, ANOVA and Pearson correlation tests. The higher the score, the greater the impairment of quality of life. The mean DLQI score was 5.64 (±5.03). The mean DLQI score in vitiligo was higher than other diseases. In this study score of quality of life in women, patients younger than 25 years old, patients with lesions on exposed areas, and single patients was higher than others, but there was not any significant relationship between quality of life and duration of disease, job, education level and place of residence. This study showed that skin pigmentation disorders had a significant impact on all aspects of the quality of life, especially on socio-psychological aspect. Therefore, dermatologists should pay attention to the psychological effects of those diseases and try to decrease their extensions and disfigurating effects by various treatment modalities.

Melasma is a brown hyperpigmentation that involves face and neck of women. The aim of this study was to investigate the Iron deficiency anemia, folate and Vitamin B12 deficiency among these patients. In a cross-sectional descriptive study 70 females who were diagnosed with melasma were included and Hemoglobin, Hematocrit, Serum Iron and Ferritin Levels, Folate and VitB12 were measured in all of them. Mean age of patients was 33.42±7.35. Family history of melasma was positive in 30% of them. Abnormal Uterine Bleeding (AUB) was reported in 40%. The recruits had mean hemoglobin level of 11.2±1.63 g/dl. (14.3%) had low serum iron levels 8/6% of patients abnormal ferritin levels. Low levels of serum folate and serum Vitamin B12 were observed in 3 patients and 1 patient succedingly. This preliminary study showed that prevalence of Iron deficiency and float and vitamin B12 deficiency among a group of patient with melasma but larger studies with control group are needed.

Introduction & Melasma is an acquired hypermelanosis disease and can cause superficial problems in women if left untreated. The objective of this study was to compare the efficacy of 2% hydroquinone and Melfade in the treatment of Melasma. This is a randomized clinical trial study conducted at Kurdistan University of Medical Sciences in 2008. Sixty two women with Melasma disease were recruited and randomly assigned to two groups. Two percent hydroquinone was prescribed for the first group (n=31) and Melfade for the second group. After 12 weeks of daily drug consumption by the patients, they were examined by a dermatologist for assessment of recovery. The collected data was analyzed by the SPSS software. Response to treatment with hydroquinone and Melfade- was the same and no significant differences were found between the two groups. (P>0.05) Results of this study demonstrated that topical Melfade is as effective as 2% hydrquinone in treatment of Melasma, Therefore it can be considered as an alternative drug in the treatment of Melasma.

Melasma is an acquired symmetrical brown hyperpigmentation of the face or neck. Melasma has been shown to have a significant emotional and psychologic distress on affected patients. Although this pigmentary disorder is more prevalent among women of reproductive age, the effect of melasma on quality of life in this population is unknown. The aim of this study was to evaluate health-related quality of life in patients with melasma attending to dermatology clinics in Kerman city, Iran A cross-sectional study was carried out by clinical examination and questionnaire on 200 patients with melasma. Melasma area and severity index (MASI), Dermatology Life Quality Index (DLQI) and Melasma Quality of Life Scale (MELASQOL) were used to assess melasma severity and quality of life. There were 200 women with mean age 31.86±6.42 years old (range: 18-55 years). The mean score of DLQI and MELASQOL were 6.90±4.48 and 40.24±14.95, respectively. In 113 (56.5%) patients, melasma had very large effect on their quality of life. There was a significant correlation between the scores of quality of life questionnaires and MASI (P<0.001). In DLQI scale the most frequent impairment was related to emotional well-being and based on MELASQOL questionnaire, embarrassment due to skin appearance had an important impact on quality of life. This study revealed that physicians must consider the devastating psychosocial impact of pigmentary imperfections in addition to pharmacological and physical treatment.

Melasma is a common acquired cutaneous hyperpigmentation involving sunexposed areas of face predominantly in women: several treatment modalities including topical depigmenting agents are being used in management of this condition with varying results. Hydroquinon is the gold standard in treatment of melasma. Liquorice extract contains natural ingredients such as glabridin and Liquiritin which collectively have multiple effects on skin including skin lightening effect. This study was conducted to compare the clinical efficacy of 4% Hydroquinon and 4% Licorice extract creams in the treatment of melasma.

This clinical trial study was carried out on 38 women who had melasma with bilateral symmetrical hyperpigmentation of malar areas. The hydroquinone and licorice extract creams were applied to the opposite sides of the face once a day at night for 8 weeks. Mmasi scores were separately measured for each side of the face at the base line and every 2 weeks thereafter. The data were analyzed using the SPSS software and Friedman and Wilcoxon signed rank tests.

27 of the patients used the drugs regularly until the end of the study.The mmasi score decreased from 10.59±6.10 to 2.59±2.17 in the treatment (licorice) group and from 0.81±6.34 to 1.63±1.55 in the control (hydroquinone) group after 8 wks. The data showed that a significant decrease in mmasi occurred on the side treated with liquorice after the 8 weeks (P<0.001), while the decrease in mmasi was significantly higher on the side treated with hydroquinone(P=0.002).

Although a significant decrease in mmasi from the baseline occurred on the side treated with 4% liqurice extract cream at the end of the study (P<0.001), 4% hydroquinone cream was significantly more effective in this respect than 4% licorice cream (P=0.002).

Melasma is an acquired hyper pigmentation on the face which generally happens in women between the ages of 30 to 35. If there is no timely treatment, it can cause a lot of cosmetic problems. The aim of this study was to compare the effect of kojic acid cream and hydroquinone 2% in treatment of melasma. This clinical trial was done on 100 women who had epidermis melasma and were referred to the dermatology department of the 22 Bahman Hospital in mashhad, Iran. Each patient had at least two melasma scars with similar severity and size on both sides of the face. For each of the patient, kojic acid cream on one side of the face and hydroquinone 2% cream on the other side of the face was prescribed. The researchers assessed the rate of improvement during a three month period. Data were analyzed using Wilcoxon test. One month after the start of treatment there was a positive response of both applications, 7% from Koji acid treatment and 10% from hydroquinone treatment. Two months after the treatment there was a positive response of 24% from kojic acid and 22% from hydroquinone. In both treatments, there was no statistical significance but there was a statistical significance after 3 months of treatment which was 58% in kojic acid and 30% in hydroquinone, group. Based on the length of the treatment during the trial, kojic acid was found to be more suitable in the treatment of melasma. Therefore, it should be considered in the protocol of treatment for this pigmentation disorder.