Background/Objectives: Melasma is a common pigmentary disorder for which oral tranexamic acid has shown some efficacy in previous studies. The aim of this study was to assess the effectiveness of oral tranexamic acid in combination with hydroquinone cream in the treatment of melasma. Methods: Subjects with moderate-to-severe melasma were enrolled. Group A received hydroquinone 4% cream, sunscreen and oral tranexamic acid, while Group B received hydroquinone 4% cream, sunscreen and placebo capsules for 3 months. All subjects had an additional 3-month follow-up visit on sunscreen alone. The primary outcome measure was change in modified Melasma Area and Severity Index (mMASI) score. In addition, the melanin index was measured using a mexameter. Results: Fifty subjects were enrolled, and all completed the study. There was a 55% reduction in mMASI after 3 months from mean 8.96 (SD 2.45) to 4.0 (SD 1.6) in Group A compared to 10.9% from mean 8.53 (SD 2.04) to 7.6 (SD 2.0) in Group B. Three months after oral and topical therapy was discontinued, there was a 42% decrease in mMASI compared to baseline in Group A (mean 5.1 SD 1.7) vs. 4.7% in Group B (mean 8.1 SD 2.0). No serious adverse events were observed. Conclusions: A combination of oral tranexamic acid and topical hydroquinone is more effective than hydroquinone alone in the treatment of melasma.
Effectiveness of permethrin standard and modified methods in scabies treatment Abstrak Latar belakang: Permetrin adalah obat pilihan untuk terapi skabies tetapi memiliki efek samping eritema, nyeri, gatal dan rasa menusuk. Pengobatan standar dengan mengoleskan permetrin ke seluruh tubuh menimbulkan ketidaknyamanan sehingga timbul pemikiran memodifikasi metode pengobatan skabies dengan cara mengoleskan permetrin di lesi saja diikuti mandi dua kali sehari memakai sabun. Tujuan penelitian ini untuk mengetahui efektivitas permetrin metode standar dibandingkan dengan metode modifikasi dalam pengobatan skabies. Metode: Penelitian eksperimental ini dilakukan di sebuah pesantren, Jakarta Timur dan pengambilan data dilakukan pada bulan Mei-Juli 2012. Diagnosis skabies ditetapkan dengan anamnesis dan pemeriksaan kulit. Subyek positif skabies dibagi menjadi tiga kelompok: satu kelompok metode standar (permetrin dioleskan ke seluruh tubuh) dan dua kelompok modifikasi (permetrin hanya dioleskan di lesi diikuti mandi memakai sabun biasa dan sabun antiseptik). Ketiga kelompok dievaluasi setiap minggu selama tiga minggu berturut-turut. Data diolah dengan SPSS versi 20 dan dianalisis dengan uji Kruskal-Wallis.
Introduction: Seborrheic dermatitis (SD) is a chronic-recidive inflammatory skin disorder with predilection in areas rich of sebaceous gland. The most common clinical manifestations are pruritus and scales. Although SD can be diagnosed without special tools, other examinations may be needed to determine additional specific therapy. Trichoscopy is one of the noninvasive tools which can help to diagnose SD as it can provide the microstructure view of the scalp. Materials and Methods: This descriptive study was conducted to explore the trichoscopic features of SD and its characteristics. There were 96 SD patients enrolled in this study. The scalp was divided into four areas, and each area was scored based on Seborrheic Area Severity Index, comprising erythema, desquamation, number of papules, and percentage of lesion area. The most severe area was examined with a trichoscopy to observe the characteristics of hair and scalp. The association between trichoscopic findings and SD severity was analyzed with Fisher's exact test. Results: Overall, the participants were 36% males and 64% females with the mean age of 30 (13–70) years old. Based on the trichoscopic examination, the most common findings were thick hair shafts (72%), white scales (69%), arborizing thin vessels (38%), yellowish area (36%), and structureless red area (19%). These findings were not significantly different between mild and moderate SD ( P > 0.05). Conclusion: Considering the merits and demerits of trichoscopic examination, it can be helpful to aid the diagnosis of SD. Further studies in Asian population with greater sample size are needed to demonstrate more significant result.
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