Efficacy of trichloroacetic acid peel in the treatment of facial melasma

Modern medical exfoliation with trichloroacetic acid [TCA] formulas began in 1926, today TCA peels are used to treat a multitude of cutaneous disorders. Melasma is a common pigmentary disorder characterized by the development of slowly enlarging tan-brown macules and patches. Thirty female patients with moderate to severe facial epidermal melasma were included in the present study. Patients' melasma was treated by application of 35% trichloroacetic acid peel once which may be repeated for the second time after 3 months depending on the clinical results after peeling. All patients were followed up once weekly during the first month, then monthly for a total of 6 months. Improvement ranged between excellent to fair, 20% of patients required second [TCA] application after 3 months from the first

Treatment of ear lobe keloids by combined intralesional surgical excision followed by intralesional corticosteroid injection

Keloids are defined as dermal fibrotic lesions which are considered an aberration of wound healing process. Their etiology and pathogenesis are poorly understood. Different treatment modalities are described in literature and no one method has been found completely successful. In the present work we combined intralesional surgical excision followed by in-tralesional corticosteroid injections to improve the therapeutic outcomes. Thirty female patients with ear lobe keloids due to ear piercing, burn and trauma were included in this study. Keloids were excised intralesionaly followed by adjuvant intralesional injection of triamcinolone acetonide 3 weeks after excision. Injections were done once / week for 3 weeks, followed by another course of injections 6 weeks later. Cases were followed up every 2 months for one year: 2 cases [6.6%] had relapsed after 4 and 6 months post-operative respectively. Our results confirm the effectiveness of this technique in reducing the rate of recurrence of ear lobe keloids