Efficacy of Hydroquinone (2%) Versus Tretinoin (0.025%) as Adjunct Topical Agents for Chemical Peeling in Patients of Melasma
Efficacy of Hydroquinone (2%) Versus Tretinoin (0.025%) as Adjunct Topical Agents for Chemical Peeling in Patients of Melasma
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功效%20of%20对苯二酚%20(2%)%20对比%20维A酸%20(0.025%)%20as%20辅助%20外用%20药剂%20for%20化学%20脱皮%20in%20患者%20of%20黄褐斑
DOI：
10.1111/j.1524-4725.2004.30106.x
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发表时间：
2004
影响因子：
2.4
通讯作者：
B. S. Reddy
中科院分区：
文献类型：
--
作者：
C. Grover;B. S. Reddy
近年来，化学换肤在黄褐斑的治疗中变得越来越流行。然而，果皮后色素沉着过度是一种常见的副作用，特别是在深色皮肤的人。预充剂在预防这种并发症中的作用尚未得到充分评价。因此，我们在一项50例黄褐斑患者的双盲、随机临床试验中研究了氢醌与维甲酸作为预充剂在最大限度地减少这种副作用发生率方面的作用。方法将50例患者中，25例皮肤光型相似，黄褐斑性质和严重程度相似的患者分为I组和II组。在开始三氯乙酸脱皮前2周，I组患者用2%对苯二酚预处理，II组患者用0.025%维甲酸每日一次（夜间）预处理。随后，所有受试者每隔2周接受三氯乙酸剥离，持续12周，随后在随访期间每月进行剥离，持续12周。在随访期间，患者继续使用SPF大于15的防晒霜和推荐的底漆。根据患者的印象、医生的临床检查和照片分析，在6个月时进行最终评估。结果共50例患者（每组25例）参加了研究。观察到的主要菲茨帕特里克皮肤类型为IV型（56%），黄褐斑类型为混合型（44%）。12周时两组的最终结果相当。然而，在随访期间，两组之间存在显著差异，I组患者中24%的患者持续改善，28%的患者恶化，而II组患者中仅16%的患者持续改善，40%的患者恶化。结论：氢醌作为预充剂，在维持去死皮效果和降低去死皮后反应性色素沉着发生率方面优于维甲酸，其效果上级。
BACKGROUND AND OBJECTIVES In recent years, chemical peels have become increasingly popular in the treatment of melasma. However, postpeel hyperpigmentation is a frequently encountered side effect, especially in dark-skinned individuals. The role of priming agents in preventing this complication has not been adequately evaluated. Hence, we studied the effect of hydroquinone versus tretinoin as priming agents in minimizing the incidence of this side effect in a double-blind, randomized clinical trial of 50 patients with melasma. METHODS Of a total of 50 patients, 25 patients each with a similar skin phototype, the nature and severity of melasma were assigned to groups I and II. The patients were primed with 2% hydroquinone in group I, and in group II with 0.025% tretinoin once daily (night time) 2 weeks before starting trichloroacetic acid peels. Subsequently, all of them received trichloroacetic acid peels at intervals of 2 weeks for 12 weeks, followed by monthly peels for next 12 weeks during the follow-up period. Patients continued to use a sunscreen with an SPF of greater than 15 and the recommended priming agent during the follow-up. Final assessment was made at 6 months, based on the impression of the patient, clinical examination by the physician, and photographic analysis. RESULTS A total of 50 patients (25 in each group) participated in the study. The predominant Fitzpatrick skin type observed among them was type IV (56%), and the type of melasma was mixed (44%). The final results at 12 weeks were comparable in two groups. However, a significant difference was seen in the two groups during the follow-up period, with continued improvement in 24% and worsening in 28% of patients in group I and continued improvement in only 16% and worsening in 40% in group II patients. CONCLUSIONS Hydroquinone is superior to tretinoin as a priming agent in maintaining the results achieved with peels and in decreasing the incidence of postpeel reactive hyperpigmentation.
DOI：
10.1016/s0190-9622(81)70071-9
发表时间：
1981-01-01
影响因子：
13.8
作者：
SANCHEZ, NP;PATHAK, MA;MIHM, MC
通讯作者：
MIHM, MC