Efficacy of Tranexamic Acid Containing Oral Medication on Melasma / 대한피부과학회지

BACKGROUND: Melasma causes considerable cosmetic disfigurement and none of the existing treatment modalities are satisfactory. Recently tranexamic acid has been reported to reduce hyperpigmentation in patients with melasma. OBJECTIVE: The purpose of the study was to evaluate the efficacy and safety of tranexamic acid containing oral medication for the treatment of melasma. METHODS: Forty-five female volunteers who had been diagnosed with melasma were enrolled in the present study. Patients were instructed to take medication for 8 weeks. The melanin index (MI) and erythema index (EI) were measured at baseline, and at 4 and 8 weeks. The melasma area and severity index (MASI) was scored at 0, 4, and 8 weeks. Self-satisfaction and safety evaluations were also performed at each visit. RESULTS: The mean MI measured on the lesional skin was decreased at 4 and 8 weeks compared with baseline (p80% of patients were satisfied with the medication. Adverse effects were minimal and two patients dropped out of the study due to drug-related urticaria and unexpected pregnancy. CONCLUSION: Tranexamic acid-containing oral medication is an effective and safe therapeutic modality for the treatment of melasma.

Changes of skin complexion after ultraviolet A (UVA) and ultraviolet B (UVB) exposure / 中华皮肤科杂志

Objective To observe the alteration of skin complexion after UVA and UVB exposure.Methods The back skin of ten females with skin type Ⅲ was subjected to single exposure to solar-simulated UVA of double minimal persistent pigment darkening (MPPD) or UVB of double minimal erythema dose (MED). Skin reflectance was assessed with clinical grading, spectcolometer and Mexameter MX 18 before irra-diation, 6 hours, 1, 7 and 14 days after the irradiation. Results After UVB irradiation, a~* value and erythema index (EI) abruptly increased at 6 hours and peaked on day 2; L~* value sharply declined on day 1; ITA° markedly decreased on day 7; melanin index (MI) declined within the first 2 days, but notably increased on day 7. After UVA irradiation, a~* and El value experienced no apparent changes; L~* value obviously declined at 6 hours; ITA° reached its lowest value on day 14; MI increased only on day 1. Conclusions There is a significant difference in the kinetics and extent of skin complexion changes after UVA and UVB irradiation. EI and a~* value are sensitive and accurate indices for evaluating sunburn, and MI and ITA ° for analyzing tanning.

Effect of Intradermal Injection of Placenta Hydrolysate to Postburn Hyperpigmented Skin

PURPOSE: The skin hyperpigmentation or hypermelanosis caused by burns results in social withdrawal due to cosmetic problem and depression as a psychiatric aspect. The treatment of the skin hyperpigmentation includes sunscreen, whitening material, skin massage, laser therapy and plastic surgery. Placenta extract can be used to reduce and inactivate the synthesis of the important enzyme (tyrosinase) that compose melanin. This study was performed to estimate the effect of intradermal injection of placenta extract (placenta hydrolysate) for the postburn hyperpigmentation. METHODS: Total 10 subjects who have postburn hyperpigmentation were selected. Two sites of skin area from each subject were randomly selected as possible as symmetrical body area, the one site was to be 'treated site' with placenta extract, the other site was untreated 'control site'. The injection was performed weekly for about 4 weeks only to the 'treated site', not to the control site. The both site were measured by pigment index using Mexameter. The index was also converted to the percentage that indicate a change of after-injection to before-injection. RESULTS: The pigment index of 'treated site' was 399.5+/-63.9 before treatment, and then it had decreased to 333.6+/-59.5 after 4 weeks of injection. The change after injection compared to before injection was significant statistically (p0.05). CONCLUSION: As a result, in the posttburn hyperpigmentation scar, the intradermal injection of placenta extract may be helpful in the management of hyperpigmentation or rehabilitation process of the hypertrophic scar.

A Study of Skin Color by Melanin Index According to Site, Gestational Age, Birth Weight and Season of Birth in Korean Neonates

Human skin color shows variations throughout life and influenced by various factors such as race, sex, age and hormones. Since the development of spectrophotometer, many studies on human skin color have been done. However, few studies have been carried out to measure the skin color of neonatal infants. The aim of our study was to assess the variations in skin color according to site, gestational age, birth weight and season of birth in Korean neonates. A total of 447 healthy neonates (3 days after birth, 213 males and 234 females) were enrolled in the present study. Skin pigmentation was measured by reflectance spectrophotometer (Derma-Spectrophotometer(R), Cortex technology, Hadsund, Denmark) at four different sites (forehead, upper arm, abdomen, and inguinal area). The forehead showed highest melanin index in all sites measured (p<0.05). There was no significant difference according to gestational age, birth weight, and season of birth. This result imply that the skin color in neonates is mainly determined genetically.

A Study of Skin Color by Melanin Index according to Sex, Age, Site and Skin Phototype in Koreans

BACKGROUND: Skin color is determined by many factors including melanin and nonmelanin pigments like hemoglobin and extraneous chemicals. Various factors such as race, sex, and age have been reported to have an influence on skin color. METHODS: Measurement of malanin index (M-index) was made by reflectance spectropho-tometer at three different sites including forehead, abdomen and forearm in total 800 healthy subjects consisting of 100 males and 100 females of neonates (three days after birth) and children (male:8.08±0.84, female:8.03±0.80, total :8.06±0.82 years of age), ado-lescence (mate:13.89± 0.76, female:13.96±0.79, total:13.93±0.78 years of age), and adults(male:24.26±0.82, female:24.40±0.89, total:24.33±0.86 years of age). We also investigated the change of M-index by each skin phototype of college students determined by Fitzpatrick classification. RESULTS: From the birth to the puberty, sex difference of melanin index was generally not not-ed, but adult females showed lower levels of melanin index in all sites measured. M-index in-creased from birth to adolescence, and decreased after adulthood. Forehead showed highest melanin index compared with other sites. Increase of M-index was noted as skin phototype goes from III to V. CONCLUSIONS: Factors including sex, age, body sites and skin phototype have a significant in-fluence on the changes of skin color in humans.

Reflectance Spectrophotometry for the Evaluation of Therapeutic Effect of Falshlamp - pumped Pulsed Dye Laser for Nevus Flammeus / 대한피부과학회지

BACKGROUND: At present, flashlamp-pumped pulsed dye lasers are treatment of choice for the treatment of congenital capillary malformations like nevus flammeus. Clinical methods have been generally used to evaluate their effectiveness in many papers. OBJECTIVE: To evaluate the effectiveness of the laser therapy in nevus flammeus patients, we used reflectance spectrophotometry as a supportive objective method in addition to the clinical evaluation. METHODS: Thirty-two patients with definite nevus flammeus skin lesion, mainly on head and neck, were treated with flashlamp-pumped pulsed dye laser(SPTL-1b) at 8 week interval. Patients without previous treatment and the others with previous treatments were grouped separately to compare the influence of previous treatment to laser therapy. Erythema/Melanin indices were measured before and after laser therapy in both normal and lesional skin. Based on these indices, relative blanching effect were calculated. RESULTS: Clinically, they showed 58.6% improvement in their skin color in average and Erythema/Melanin indices measured on normal skins were 13.09+/-3.91 a.u. and 34.65+/-2.82 a.u.. Erythema indices measured on lesional skins were 26.07+/-10.26 a.u. and 20.73+/-8.81 a.u. in non-treated group and 2453+/-6.14 a.u. and 21.18+/-5.47 a.u. in pre-treated group, alternatively. Relative blanching effect in both groups were calculated as 35.9% and 31.6%, meaning no significant difference(p>0.3). Clinical evaluation and relative blanching effect showed good correlation(r=0. 691). CONCLUSION: Reflectance spectrophotometry can be useful in evaluating successful laser treatments in nevus flammeus patients. Reflectance measurements, an objective estimate of blanching, correlate well with the clinical results, and are helpful in monitoring and predicting the therapeutic outcome in dye laser treated patients.