Background: Melasma is a frequently observed dermatological condition. The conventional therapies for melasma improvement established to date are mainly categorized into chemical peeling, topical agents and laser therapy. A new technique to reduce discomfort and post-laser discoloration induced by heat effects is the picosecond laser system. Objective: To find out efficacy of 2% kojic acid containing formulation vs picosecond laser for treatment of melasma Methodology: This was comparative randomized controlled study carried out at the department of dermatology Qazi Hussain Ahmad Medical Complex Nowshera and alshifa clinic and skin aesthetic, Nowshera for duration of one year from July 2020 to July 2021. Totally, 300 patients were included in the study. Each picosecond laser and kojic acid group comprise of 150 patients. All the information was recorded at the baseline and each following visit. Severity Index (MASI) score was calculated and color photographs were taken of all patients. Results: At baseline, the mean MASI scores for picosecond laser and kojic acid group was 10.5±3.5 and 11.2±4.1 respectively (p=0.31). In both the group significant improvement occur in the MASI scores at weeks 12 and week 20. In picosecond laser group, the most remarkable improvement rate (62%) was noted while in kojic acid containing formulation group the rate of improvement was 41.96%. Conclusion: Our study concludes that picosecond Laser device is an efficient and well-tolerated therapeutic option for melasma as compared to kojic acid containing formulation. Keywords: Efficacy; Kojic acid; Picosecond laser; Melasma
Background: Chronic urticaria is defined as a pruritic skin disorder that persists daily or about daily for ˃6 weeks. Chronic urticaria is a common problem in Pakistan. The common treatment method is oral histamine. Currently the important treatment method used is autologous serum therapy. The objective of this study was to determine the efficacy of intramuscular platelet rich plasma versus oral antihistamine in the treatment of chronic urticaria Methodology: This study was randomized controlled clinical trial carried out at the Dermatology Department, Qazi Hussain Ahmad Complex Nowshera and alshifa clinic and skin aesthetic, Nowshera from May 2020 to May 2021. 100 patients were included in this research work. They were randomly divided into two groups of 50 patients each. One group was given autologous serum while the other was given antihistamine. The autologous serum group patients were treated by giving 9 intramuscular injection of autologous serum while the antihistamine group patients were treated with oral antihistamine on routine basis. UAS-7 (Urticaria Activity score-7) was used for measuring the effectiveness of both the treatment methods. Results: At baseline in autologous serum group, the Urticaria activity score was 36.1 (±6.7) while in antihistamine group it was 35.2 (±5.4) respectively. At baseline Urticaria activity score was non-significant (p=0.85). At 4th week the mean Urticaria activity score in autologous serum group and antihistamine group was 18.3(±3.6) and 30.2.1 (±5.1) (p=0.01). At 9th week in autologous serum group, the Urticaria activity score was 11.3 (±6.3) while in antihistamine group it was 22.6 (±4.9). (p=0.04) At 12th week the mean Urticaria activity score in autologous serum group and antihistamine group was 7.1(±5.4) and 20.4 (±7.3) respectively (p=0.01). Conclusion: Our study concludes that autologous serum therapy is more effective as compared to antihistamine in the treatment of chronic urticaria Keywords: Chronic Urticaria; Intramuscular platelet rich plasma; Oral antihistamine
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