We found kinetin and niacinamide exert a synergistic anti-aging effect. Our data suggest that these compounds have multiactive, multifunctional, and pluripotent effects on skin. They are also both promising to be included in the cutaneous anti-aging cosmeceuticals in the future.
Background
Recent evidence suggests melasma to be a photoaging disorder. Triple combination creams (TCC: fluocinolone acetonide 0.01%, hydroquinone 4% and tretinoin 0.05%) remain the gold standard treatment. Picosecond alexandrite laser treatment using a diffractive lens array (DLA) has been identified to be effective for improving photoaging conditions.
Objective
We aimed to compare the efficacy and tolerance of the picosecond alexandrite laser with those of DLA and TCC in female Asian patients with melasma.
Methods
Twenty‐nine patients were randomly assigned to group A1 (3 laser sessions at 4‐week intervals), A2 (5 laser sessions at 4‐week intervals) or B (TCC daily for at least 8 weeks and then tapered until the final evaluation). The Melasma Area, Severity Index (MASI) score and VISIA were assessed at baseline, week 12 and week 20. By week 20, the follow‐up periods for groups A1 and A2 were 3 months and 1 month, respectively.
Results
Nine, 11 and 6 participants in groups A1, A2 and B completed the study, respectively. MASI scores were significantly improved in all 3 groups at weeks 12 and 20. In groups A1, A2 and B, the improvement rates at week 20 were 53%, 38% and 50%, respectively. VISIA® analysis additionally revealed a significant improvement in spots, porphyria, pores and brown spots after 3 laser sessions (P < 0.05). Group A2 showed greater improvements than group A1 in terms of spots, wrinkles and pores; however, only red areas were significantly different (P < 0.001). All side‐effects in the 3 groups were transient and gradually subsided after 1–3 months.
Conclusion
Picosecond alexandrite laser treatment using DLA showed comparable efficacy with TCC for the treatment of melasma. Improvements in texture, spots, wrinkles and pores were observed in the laser groups. Patients with melasma lesions that exhibit telangiectasia may benefit from additional laser treatment sessions.
This study demonstrated that VCDDSS increases diagnostic accuracy by 18.75%, which means we can avoid possible misdiagnosis, provide better treatment, and avoid waste of medical resources. The user satisfaction is high. We expect wider application of this kind of decision support system in clinical practice, medical education, residency training, and patient education in the future. Further large-scale studies should be planned to confirm its application.
Pulmonary hemorrhage (PH) is an uncommon clinical manifestation of patients with systemic lupus erythematosus (SLE). In this report, we describe a 14-year-old male with PH as the sole clinical manifestation of his SLE. Kidney biopsy was performed and the report revealed lupus nephritis class IVb. He demonstrated a rapid clinical response to the therapy of intravenous pulse methylprednisolone. Awareness of the possibility of PH as a sole clinical presentation of SLE may aid in the diagnosis and early aggressive management of this condition.
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