RESUMO
BACKGROUND: Melasma is a common pigmentary disorder among Asians and treatment is challenging. Oral tranexamic acid (TA) has emerged as a potential treatment for refractory melasma. Large-scale studies on its use, outcomes, and safety are limited. OBJECTIVE: We sought to evaluate treatment outcomes and adverse effects of oral TA in melasma in an Asian population. METHODS: We conducted a retrospective analysis of patients who received oral TA for melasma in a tertiary dermatologic center from January 2010 to June 2014. RESULTS: In all, 561 patients (91.4% female, 8.6% male) were enrolled. Median duration of treatment was 4 months. The majority (503 [89.7%]) improved, 56 (10.0%) had no improvement, and 2 (0.4%) worsened. Patients without family history of melasma had better response rates than those with family history (90.6% vs 60.0%, P = .01). Of the 503 who improved, response was seen within 2 months of TA initiation, with a relapse rate of 27.2%. Adverse events occurred in 40 (7.1%). Most were transient, but 1 developed deep vein thrombosis requiring prompt discontinuation. She was later given the diagnosis of familial protein S deficiency. LIMITATIONS: This was a retrospective study. CONCLUSION: Oral TA may be an effective adjunct for refractory melasma. Careful screening for personal and familial risk factors for thromboembolism should be done before initiation.
Assuntos
Fármacos Dermatológicos/uso terapêutico , Dermatoses Faciais/tratamento farmacológico , Melanose/tratamento farmacológico , Ácido Tranexâmico/uso terapêutico , Administração Oral , Adulto , Povo Asiático , Fármacos Dermatológicos/efeitos adversos , Dermatoses Faciais/etnologia , Feminino , Gastroenteropatias/induzido quimicamente , Cefaleia/induzido quimicamente , Humanos , Masculino , Melanose/etnologia , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Fatores de Risco , Singapura , Ácido Tranexâmico/efeitos adversos , Resultado do Tratamento , Trombose Venosa/induzido quimicamenteRESUMO
When two or more cutaneous tumours coexist in a single lesion, it is known as a cutaneous collision or contiguous tumour. Various combinations of collisions have been described. Collision tumours often have misleading clinical and histological presentations, and can be a diagnostic challenge. Chondroid syringomas are mixed cutaneous tumours of dual origin, and like collision tumours, are often confused with the more commonly seen cutaneous lesions. As chondroid syringomas are rare, their involvement in collision tumours is an even more peculiar occurrence. We report an unusual case of a cutaneous collision tumour on the nose involving an intradermal naevus and chondroid syringoma. To the best of our knowledge, this is the first time such a combination is reported.
