Differential Diagnosis of Melasma in Brown Skin

Handog, Evangeline B.; Enriquez-Macarayo, Maria Juliet

doi:10.1007/978-81-322-3664-1_9

Cited by 3 publications

(3 citation statements)

References 15 publications

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“…In particular, our study evaluated treatment responses in melasma using dermoscopic scoring, which visualizes the clinical patterns of skin structures that are not visible to the naked eye. Previous studies have reported that dermoscopic evaluation is superior to other evaluation tools such as Wood's light, in terms of pigmentation and vascularity detection [21,43,44]. Our study found a signifcant improvement in the pseudoreticular network and globular pattern after picosecond ND-YAG laser treatment.…”

Section: Discussionsupporting

confidence: 45%

The Efficacy and Safety of a Low‐Fluence 1064 nm Picosecond ND‐YAG Laser Compared with Those of a Low‐Fluence Photoacoustic Therapy Pulsed (PTP) Mode 1064 nm Q‐Switched ND‐YAG Laser for Treatment of Melasma: A Prospective Split‐Face Study

Lee

Kim

Park

et al. 2023

Dermatologic Therapy

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Melasma is a challenging pigmentation disorder to treat, and although low-fluence 1064 nm picosecond ND-YAG lasers have shown potential for treating benign pigmented disorders, data on the use of this laser for melasma treatment are currently insufficient. In this prospective split-face study, twenty-four patients with melasma on the face were enrolled and randomly assigned to receive treatment on one side of the face either with a low-fluence 1064 nm picosecond ND-YAG laser or with a low-fluence PTP mode 1064 nm Q-switched ND-YAG laser. Laser treatment was performed 5 times at intervals of 2 weeks, with evaluation conducted before each treatment and 2 months after the completion of 5 treatments. Clinical pictures using a standardized, digital photographic system and dermoscopy were taken on each day of the visit. The modified melasma area severity index (mMASI), melanin index (MI), dermoscopic scores of the pigmentary and vascular elements in melasma, pain during laser treatment, and patient satisfaction score were recorded. Twenty-one participants completed the study, and from week 2 in both groups, a significant decrease in mMASI and MI were confirmed. Although no statistically significant difference was observed, the decrease in mMASI and MI were greater in the 1064 nm picosecond ND-YAG laser group than in the 1064 nm Q-switched ND-YAG laser group. The 1064 nm picosecond ND-YAG laser group showed significant improvement in the pseudoreticular network and globular pattern of dermoscopic features between week 0 and week 16, while significant improvement in the globular pattern was shown in the 1064 nm Q-switched ND-YAG laser group. No significant difference was observed between the two groups in terms of the patient satisfaction score and pain during laser treatments. Notably, no adverse events were observed in either group. In conclusion, our study demonstrated that a low-fluence 1064 nm picosecond ND-YAG laser is as effective and safe in the treatment of melasma as a low-fluence PTP mode 1064 nm Q-switched ND-YAG laser.

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Section: Discussionsupporting

confidence: 45%

The Efficacy and Safety of a Low‐Fluence 1064 nm Picosecond ND‐YAG Laser Compared with Those of a Low‐Fluence Photoacoustic Therapy Pulsed (PTP) Mode 1064 nm Q‐Switched ND‐YAG Laser for Treatment of Melasma: A Prospective Split‐Face Study

Lee

Kim

Park

et al. 2023

Dermatologic Therapy

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“…Melasma was classified into [12][13][14] (1.) epidermal, when a regular pigment network with a brownish homogeneous pigmentation is observed; (2.)…”

Section: Assessmentmentioning

confidence: 99%

Tranexamic Acid Microinjection Alone Versus Its Combination With Fractional Carbon Dioxide Laser in Melasma Treatment: A Dermoscopic Evaluation

et al. 2022

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BACKGROUND Melasma is a challenging pigmentation disorder. OBJECTIVE To assess and compare the efficacy of tranexamic acid (TXA) intradermal microinjection alone versus its combination with low-power, low-density fractional CO 2 laser in a sequential pattern in melasma.Patients and Methods This study included 29 patients with melasma. Half of the face was randomly assigned to fractional CO 2 laser; the other half to TXA. This split-face session was repeated every 6 weeks for 3 sessions. In between, TXA was applied to the full face every 2 weeks. Treatment duration was 4 months. Dermoscopy, melanin index (M.I), and erythema index (E.I) were evaluated at baseline and 4 weeks after the last session. RESULTS Melanin index, E.I, total dermoscopic score and different dermoscopic patterns of pigmentation, and vascular features showed significant reduction posttreatment on both sides of the face. No statistically significant difference was found regarding the degree and percentage of improvement in M.I, E.I, and total dermoscopic score between both sides. CONCLUSION Tranexamic acid microinjection alone or combined with low-power, low-density fractional CO 2 laser in a sequential pattern are comparatively effective and safe for melasma treatment; however, combined treatment is recommended. Dermoscopy is an essential noninvasive tool in the assessment of melasma and monitoring patients' response to treatment. Patients and MethodsThis randomized, split-face, comparative study included 29 patients with bilateral symmetrical facial melasma older than 18 years after being approved by the Dermatology Research Ethics Committee during the period from January 2019 to January 2020. Informed written consent was obtained from the patients before the study.Exclusion criteria included pregnancy, lactation, use of oral contraceptive pills or hormonal replacement therapy at

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“…Non-segmental vitiligo is the most common type in both children and adults. [1], [6], [7] The etiopathogenesis of vitiligo is still not fully elucidated. [1], [8], [9] Vitiligo significantly affects patients cosmetically and psychosocially.…”

Section: Introductionmentioning

confidence: 99%

Retrospective evaluation of epidemiological and clinical data of patients diagnosed with vitiligo in our outpatient clinic

Mert Baran,

Alper Alyanak,

İlgül Bilgin

2024

World J. Adv. Res. Rev.

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Objective: It was aimed to evaluate retrospectively the epidemiological and clinical data of patients who applied to our clinic and were diagnosed with vitiligo. Epidemiological and clinical evaluation guide the progression, choice of treatment, and diagnosis of the comorbidities of the disease. Methods: 327 patients evaluated as non-segmental vitiligo were included in the study. Demographic characteristics of the patients (age and gender), age at onset of vitiligo, treatments used for vitiligo, clinical type of vitiligo, location of lesions, and accompanying autoimmune thyroid disease data were evaluated. Results: Of 327 patients, 169 (51.7%) were male and 158 (48.3%) were female. The male/female ratio was found to be 1,1:1. The mean age of the patients was 37.26±18.07 years, and the mean age according to gender was 37.44±18.19 years in females and 37.08±18 years in males. The mean age of onset of the disease was 29.17±15.79 years, and the mean age of onset by gender was 29.13±16.46 years in females and 29.2±15.15 years in males. Regarding onset of the disease, 54% of the patients were <30 years old, and 46% of the patients were 30 years or older. Generalized vitiligo (58.8%) and acrofacial vitiligo (29.9%) were the most common clinical types. Head and neck (68.9%) and extremities (64%) were the most common locations of the lesions. Concomitant autoimmune thyroid disease was seen in 13.5% of the patients. Accompanying autoimmune thyroid disease according to gender was 19.5% in females and 7.4% in males, and there was a statistically significant difference between the groups. It was observed that 89.5% of the patients received treatment for vitiligo, and 10.5% did not receive any treatment. The most commonly used treatments were found to be topical treatment (76.1%) and topical treatment+phototherapy (14.6%). Conclusion: The epidemiological and clinical characteristics of the patients in our study were similar to other studies in the literature. Concerning the highest prevalence of generalized vitiligo in our study, phototherapy and/or systemic therapy use should have been considered when their use was indicated, and factors precluding their more widespread use could be investigated in other studies.

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Differential Diagnosis of Melasma in Brown Skin

Cited by 3 publications

References 15 publications

The Efficacy and Safety of a Low‐Fluence 1064 nm Picosecond ND‐YAG Laser Compared with Those of a Low‐Fluence Photoacoustic Therapy Pulsed (PTP) Mode 1064 nm Q‐Switched ND‐YAG Laser for Treatment of Melasma: A Prospective Split‐Face Study

The Efficacy and Safety of a Low‐Fluence 1064 nm Picosecond ND‐YAG Laser Compared with Those of a Low‐Fluence Photoacoustic Therapy Pulsed (PTP) Mode 1064 nm Q‐Switched ND‐YAG Laser for Treatment of Melasma: A Prospective Split‐Face Study

Tranexamic Acid Microinjection Alone Versus Its Combination With Fractional Carbon Dioxide Laser in Melasma Treatment: A Dermoscopic Evaluation

Retrospective evaluation of epidemiological and clinical data of patients diagnosed with vitiligo in our outpatient clinic

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