ABSTRACT
BACKGROUND: Melasma is an acquired hypermelanosis that is often recalcitrant to treatment with hypopigmenting agents. OBJECTIVE: To assess the efficacy of 4% hydroquinone cream vs 4% hydroquinone cream combined with glycolic acid peels as treatment for melasma. METHODS: Twenty-one Hispanic women with bilateral epidermal and mixed melasma were enrolled in a split-faced prospective trial lasting 8 weeks. Patients underwent 20% to 30% glycolic acid peels every 2 weeks to one side of the face only in addition to twice-daily full-face application of 4% hydroquinone cream and sun protective factor 25 UV-B sunscreen each morning. Pigmentation was measured objectively using a mexameter and the Melasma Area and Severity Index and subjectively using a linear analog scale and physician and patient global evaluation. RESULTS: Hydroquinone treatment alone and treatment with the combination of hydroquinone and glycolic acid had a significant effect in reducing skin pigmentation compared with baseline (P<.001). However, no significant difference was found using combination therapy compared with hydroquinone alone (P =.75). CONCLUSIONS: Use of 4% hydroquinone and a daily sunscreen is effective in the treatment of melasma; however, the addition of 4 glycolic acid peels did not enhance the hypopigmenting effect of hydroquinone treatment alone.
Subject(s)
Chemexfoliation/methods , Facial Dermatoses/drug therapy , Glycolates/therapeutic use , Keratolytic Agents/therapeutic use , Melanosis/drug therapy , Adolescent , Adult , Aged , Esthetics , Facial Dermatoses/diagnosis , Female , Follow-Up Studies , Humans , Melanosis/diagnosis , Middle Aged , Patient Satisfaction , Prospective Studies , Statistics, Nonparametric , Treatment OutcomeABSTRACT
Proximal femoral valgus osteotomy for Legg-Calvé-Perthes disease was evaluated at an average 5 years postoperatively in 31 consecutive patients. The indications for osteotomy were hinge abduction and pain. The Iowa hip scores at follow-up for 21 patients averaged 93 points. Combined clinical and radiographic review for these patients yielded 6 (29%) excellent, 7 (33%) good, 5 (24%) fair, and 3 (14%) poor results. The 10 remaining patients had good pain relief and were satisfied but were unable to return for hip scale evaluation.