Topical TA as an adjuvant demonstrated trends of better outcomes than QSNYL alone for the treatment of melasma.

No abstract

Idiopathic guttate hypomelanosis is a common acquired leukoderma characterized by multiple, discrete round or oval, porcelain-white macules on sun-exposed areas, especially on the extensor surface of forearms and pretibial areas. It usually affects individuals aged over 40 years and the likelihood of acquiring it increases with age. The exact pathogenesis remains controversial. However, there are several factors that are believed to be involved such as aging, ultraviolet exposure, trauma, genetic factors, autoimmunity, and local inhibition of melanogenesis. Despite the benign course of progression, many patients visit medical centers owing to cosmetic concerns and to confirm the natural course of idiopathic guttate hypomelanosis. Because there is no standard therapy for this condition, numerous medical and surgical treatments including intralesional corticosteroids, topical retinoids, topical calcineurin inhibitors, phenol peeling, cryotherapy, superficial dermabrasion, skin grafting, and ablative and non-ablative lasers have been tested with mixed results. This article will thoroughly review the etiology, pathogenesis, clinical presentations, histologic, dermoscopic, and ultrastructural findings, and the treatment of idiopathic guttate hypomelanosis.

No abstract

Excimer light, topical vitamin D analogues, and topical steroids have been reported to be effective treatments for vitiligo. However, monotherapy often demonstrates unfavorable results for acral vitiligo. This study aimed to evaluate the efficacy and safety of combination treatment with 308-nm excimer light and topical calcipotriol or topical clobetasol ointment for acral vitiligo. A prospective, randomized, double-blind, and intraindividual study was conducted. Combination treatment (excimer light and topical medication) was applied in the first 12 weeks, and monotherapy (topical medication alone) was used in the later 12 weeks. Both hands were irradiated with excimer light three times a week for 12 weeks. Calcipotriol ointment was randomly assigned to one hand, whereas clobetasol ointment was assigned to the other hand. The ointments were applied twice daily for a total of 24 weeks. Repigmentation, clinical improvement, and adverse reactions were assessed. A total of 26 hands completed the study. Of the hands treated with excimer light and calcipotriol, approximately 8% achieved excellent repigmentation at the end of the combination treatment period and 23% achieved good to excellent improvement after 12 weeks of calcipotriol monotherapy. More than 85% and 77% of the hands treated with calcipotriol-based and clobetasol-based regimens showed some repigmentation at the end of the study, respectively (P < .05).Nevertheless, no significant difference was found between the treatments. No serious adverse reactions were observed. In conclusion, the combination of excimer light and topical calcipotriol followed by topical calcipotriol alone is effective and might be a promising treatment regimen for acral vitiligo.