Comparison of the efficacy and safety of intralesional injection of tranexamic acid and the topical application ofKligmancombination drug in the treatment of macular amyloidosis

Abstract

Macular amyloidosis (MA) is a common form of cutaneous amyloidosis that manifests as dark spots consisting of brown pigments with a rippled pattern on the skin, and the treatment of this condition is highly challenging. The aim of this study was to compare the efficacy and safety of intralesional injection of tranexamic acid (TXA) and topical application of Kligman combination drug in the treatment of macular amyloidosis. In this double-blind clinical trial, a total of 43 patients, who were diagnosed with MA, were treated with two different methods of intralesional injection of tranexamic acid and topical application of Kligman combination drug. Both therapeutic methods were effective in improving MA and significantly reduced hyperpigmentation of the treated areas, but tranexamic acid was significantly more effective than the Kligman combination drug.Significantly, greater improvements were observed in the group of patients treated with tranexamic acid. In the tranexamic acid treatment group, ΔE was reduced from 11.39 in the first session to 8.53 in the third session, and in the Kligman treatment group, it was reduced from 8.79 in the first session to 6.32 in the third session (p < 0.05). In addition, the pruritus score in patients treated with topical tranexamic acid injection was lower compared to the patients treated with the topical application of the Kligman combination drug. The results of this study demonstrated the significant positive effects of both treatment methods, but in terms of reducing melanin content, intralesional injection of tranexamic acid was a more effective method. Both treatments considered safe for MA. In tranexamic acid group, patients logically experienced a tolerable pain during injection but they significantly had significantly lower local pruritic discomfort during study.So, based on the positive findings of this study we suggest to use tranexamic acid in combination with other effective therapeutic methods for treatment of MA especially use of its topically applied form in combination with non-aggressive needling that results in better drug delivery without the experience of injection pain. Selection of the best administration route of tranexamic acid for hyper-Mohammadreza Ghassemi and Masoumeh Roohaninasab equally contributed to this study.

Association between the Expression Levels of MicroRNA-101, -103, and -29a with Autotaxin and Lysophosphatidic Acid Receptor 2 Expression in Gastric Cancer Patients

“…There is accumulating data that increased ATX has been detected in malignancies such as breast, pancreatic, non-small-cell lung, colorectal, and thyroid cancers [ 51 – 53 ]. In following with our findings, it has been demonstrated that serum activity of ATX enhanced in pancreatic cancer patients but not in GC ones [ 54 , 55 ]. Nonetheless, related to the ATX protein, it was higher in GC tissue samples than the paired nontumor tissue specimens.…”

Systematic review of clinical studies assessing the needling for treatment of melasma: Focusing on efficacy, safety, and recurrence rate

“…Minor side effects reported in this article were hypomenorrhea, mild abdominal discomfort, and transient skin irritation. They stated that tranexamic acid had good efficacy and safety, either alone or as an adjunct to conventional melasma treatments 27‐32 . However, based on the present systematic study, an average decrease of 3.72 was observed in MASI score.…”

“…They stated that tranexamic acid had good efficacy and safety, either alone or as an adjunct to conventional melasma treatments. [27][28][29][30][31][32] However, based on the present systematic study, an average decrease of 3.72 was observed in MASI score.…”

Evaluation of effectiveness of tranexamic acid as mesotherapy in improvement of periorbital wrinkling in a trial study

“…Research has shown the effectiveness of tranexamic acid in treating pigmented diseases such as amyloidosis and melasma. 15,16 The rejuvenating effects of tranexamic acid have been less studied. Since the authors of this article also used transamic acid to treat scars and its acceptable results, they also paid attention to the rejuvenating effects of tranexamic acid, and there was little literature at the beginning of this trial.…”

“…Local tranexamic acid and mesotherapy are effective in treating melasma by inhibiting these mechanisms. Research has shown the effectiveness of tranexamic acid in treating pigmented diseases such as amyloidosis and melasma 15,16 . The rejuvenating effects of tranexamic acid have been less studied.…”