Journal
JOURNAL OF COSMETIC DERMATOLOGY
Volume 18, Issue 2, Pages 517-523Publisher
WILEY
DOI: 10.1111/jocd.12751
Keywords
fractional Erbium:YAG laser; melasma; topical steroids
Categories
Ask authors/readers for more resources
BackgroundMelasma is an acquired disorder of symmetrical hyperpigmentation. Several treatment methods are available for patients with melasma, including topical compounds, broad-spectrum photoprotection, camouflage, chemical peels, and laser and light therapies which represent potentially promising options for patients who are refractory to other modalities. ObjectiveTo evaluate and compare the clinical, histopathological, and immunohistochemical changes in melasma after fractional Er:YAG laser versus fractional Er:YAG laser and topical steroids. MethodsTwenty-two patients were treated with fractional Er:YAG laser on both sides of the face with the use of topical steroid only on the left side to make left-to-right-side comparison. Clinical evaluation, histopathological, and immunohistochemical assessment for skin specimens were performed before treatment and 3months after the end of sessions. ResultsTreatment by fractional Er:YAG laser on the right side showed significant decrease in MASI score with clinical outcome which considered as excellent in three patients (13.6%), very good in six (27.2%), good in eight (36.3%), and fair in five (22.7%) with significant decrease in basal pigmentation and reorganization of dermal collagen and decreased number of MART1-positive cells. After combined therapy, the decrease in MASI score was highly significant with the clinical outcome which considered as excellent in six patients (27.2%), very good in 10 (45.4%), good in three (13.6%), and fair in three (13.6%). The histological changes were highly evident and more significant. ConclusionClinical, histopathological, and immunohistochemical improvement was evident on both sides, with more significant better outcome with the use of combined therapy on the left side. However, combined therapy was more beneficial for Fitzpatrick skin type III rather than type IV.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available