IntroductionFew studies have focused on therapeutic as well as side effects of tranexamic acid (TXA) as a topical drug compared to other topical drugs in treating melasma. The present study aimed to assess and compare the beneficial therapeutic effects and also side effects of local TXA in comparison with hydroquinone in treating women with melasma.MethodsThis randomized double-blinded clinical trial was performed on 60 women who suffered from melasma and were referred to the skin disorders clinic at the Rasoul-e-Akram hospital in Tehran in 2015. The patients were then randomly assigned via computerized randomization to two groups: group A received TXA%5 (topically twice a day for 12 weeks in the location of the melasma) and group B (received hydroquinone 2% with the same treatment order). Prior to intervention and at 12 weeks after intervention, the intensity and extension of melasma were assessed based on the Melasma Area and Severity Index (MASI) scoring method.ResultsThe mean MASI score in both treatment groups decreased considerably after completion of treatment and was not significant between the two groups. No side effects were detected in group A, but 10% of those in group B complained of drug-related side effects including erythema and skin irritation (p = 0.131). Regarding the level of patient satisfaction, the patients in group A had a significantly higher level of satisfaction level of 33.3% compared with 6.7% in group B (p = 0.015) (Fig. 9). Multivariate linear regression modeling with the presence of age, history of systemic disorder, drug history, and family history of melasma demonstrated no difference in the mean MASI between the two groups.ConclusionTopical use of TXA significantly reduced both melanin level and MASI score. Given its high efficiency and low drug side effects, this regimen results in high patient satisfaction compared with topical hydroquinone. IRCT code: IRCT2016040627220N2.
Background: Role of insulin-like growth factor 1 (IGF1) and contributing cancer risk has been shown in many studies. Hence, this study was performed to determine the serum level of IGF-1 in patients with acne vulgaris in comparison with healthy subjects. Methods: The current study was a case-control assessment performed on a sample of 102 subjects, including 51 known cases of acne and 51 healthy subjects (without acne as controls). Serum IGF-1 level was assessed and compared across the two groups. Results: Both groups were matched for age and gender (P > 0.05). The mean IGF-1 level was significantly (P = 0.0001) higher in the case group. There was a significant reverse correlation between age and serum IGF-1 level (P = 0.002, r =-0.417). Also, the mean serum IGF-1 level was significantly higher in males compared with females in the case group (P = 0.006). The severity and location of acne had no association with serum IGF-1 level (P > 0.05). Conclusions: Overall, according to the obtained results in this study, it may be concluded that rate of metabolism is increased in patients with acne. This finding suggests that nutrition-related lifestyle factors play a role in acne pathogenesis. Hence, modifications in these styles are recommended to control acne formation. Also, use of IGF-1-reducing drugs, such as metformin, may be useful for treatment of acne. However, this matter may be confirmed by future studies.
Hypomelanosis is a prevalent skin disorder in individuals with dark skin. Numerous inflammatory skin disorders cause hypomelanosis, even depigmentation. Its pathogenesis remains unknown, but it can be attributed to changes in melanin production in response to inflammation. The clinical manifestations, often including lesions with ill-defined borders limited to the site of inflammation, mostly appear in individuals with dark skin. The most important way to manage PIH is to effectively treat the underlying skin disorder that has led to it, however, medical therapy and phototherapy can be helpful, as well.
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