皮膚科および皮膚科疾患ジャーナル

Background: Melasma is a chronic skin problem that causes dark, discolored patches on the skin and therefore can have adverse effects on quality of life. Recently, a novel complex was shown to decrease melasma. Specifically, the goal of the study was to prove that the formula can reduce melasma, overall hyperpigmentation and nontransient erythema.
Objectives: The primary efficacy outcome measure was a minimum of 50% improvement of the modified melasma area and severity index (mMASI) score from the baseline at the 90 day follow-up visit. Secondary outcomes were overall hyperpigmentation score collection and analyses, patient’s self-assessment regarding their non-transient erythema score when evaluated across the whole patient population at the baseline and at 90 days and the analyses of adverse events.
Methods: Forty subjects with Fitzpatrick skin types III-V were enrolled in the double-blinded, randomized, placebo controlled trial: 20 were treated over 90 days with the oral supplement and 20 received a placebo over 90 days. Subjects were assessed at onset and re-assessed at 60 and 90 days by the Modified Melasma Area and Severity Index (mMASI), photographic documentation, hyperpigmentation tool, erythema index and client satisfaction. Subjects used the product or a placebo (in tablet form) orally once a day.
Results: At 90 days, the modified melasma area and severity index score (mMASI) improved by more than 50% in 75% of cases (p<0.001), thus indicating treatment efficacy. There was a greater decrease in mMASI for the supplement group vs placebo (-3.28 for the active arm vs. -0.73 for the placebo arm, p<0.001). Furthermore, at the 90-day follow-up visit, the overall hyperpigmentation and non-transient erythema scores (p<0.001) improved significantly: by 55% and 38%, respectively. Results obtained from patients showed overall satisfaction with the therapy course and results. The product was well tolerated, with no reports of adverse events or side effects.
Conclusion: Consistent, statistically significant reductions in melasma, as measured by mMASI scores, overall hyperpigmentation and non-transient erythema scores were achieved while meeting patient expectations at the 90 day follow-up evaluation point when compared to placebo. Results from this clinical trial suggest that this oral supplement is an effective treatment for melasma and may provide an alternative treatment for overall hyperpigmentation and non-transient erythema, while meeting expectations of patients. The product was well tolerated, with no reports of adverse events or side effects.

Objective: The objective of this study is to provide the clinical features of infantile hemangiomas and their associated risk factors. Method: The study included patients who have been diagnosed with infantile hemangiomas, who were identified from a logbook in the Dermatology Department of Hera General Hospital, Makkah, Saudi Arabia. Demographic, prenatal, perinatal, and clinical data, along with complications and treatment modalities, were included on the data sheet. Result: The medical records of 61 patients were examined. Most of our patients were female (69.9%) and the maternal age of their mothers ranged from 22 to 43 years, with a mean maternal age of 28.8 years and a median age of 28 years. A positive family history of vascular anomalies in first-degree relatives was reported in 11.5% of patients. In 58 patients (95.1%), the age of onset for lesions was before two weeks (86.2%) and over two weeks (13.8%). Complications were noted in eight patients (13.3%). Most of our patients were treated by topical betablockers (39.7%), followed by pulsed-dye laser (10.3%) and systemic propranolol (10.3%). Observation of the hemangioma progression was seen in 57.6% of our patients. Conclusion: Hemangiomas more commonly occur in premature, female infants, who are more likely to be born as a product of single gestation. Further studies are needed to define other risk factors and to understand the relationship between potentially confounding factors.

Aims and objective: The aim of this study was to assess the clinical and demographic features of a rare cutaneous condition, angiolymphoid hyperplasia with eosinophilia (ALHE), and compare them with those previously reported. ALHE is a benign vascular proliferation of unknown etiology and its treatment is unclear. Methods: A 29 year old woman visited the Hospital of Skin and Venereal diseases for pruritic lesion in the ear. She presented with a reddish papulonodular rash. Laboratory tests showed no abnormalities. She was diagnosed with ALHE based on clinical, histological, and immunological features. Treatment with injectable prolonged systemic glucocorticoid and topical prednisolone was initiated. The rash and pruritic sensation improved within one week in the hospital, and the reddish infiltration and nodules had dramatically decreased at the 6 month follow-up. Continuous topical application resulted in no recurrence at the 6 month follow-up. Results and conclusion: Management of ALHE is still poorly standardized and poorly understood due to uncertainties concerning its pathophysiology and development and the small number of available studies. Establishing the final clinical diagnosis is difficult owing to the absence of subjective sensations. ALHE can persist for years but serious complications like cancer transformation do not occur.

Combination of hormonal change, ultraviolet radiation and genetics are the most responsible factors in melasma. One of pigmentation change caused by pregnancy is melasma. The critical key to describe hyperpigmentation process is increased levels of estradiol and estriol. This study is aimed to determined correlation of serum levels of estradiol and estriol to melasma severity in pregnant women. This cross-sectional study was conducted with consecutive sampling in pregnant women with melasma. This study was conducted from June to July 2017 at Dr. Saiful Anwar Regional Hospital, Malang, East Java, Indonesia. Pregnant woman with melasma (15-49 years) was included and pregnant women with the history of melasma not caused by pregnancy, which used hormonal contraception or oral hormone therapy containing estrogen and took oral phototoxic drugs, were excluded. Anamnesis, physical examination, Wood Lamp, MASI (Melasma Area and Severity Index) Score and blood was drawn to measure serum levels of estradiol and estriol by using ELISA to 25 pregnant women with melasma. Data analysis was done with Pearson correlation test and multiple linear regressions. The result showed serum levels of estradiol was significantly positive correlated with MASI Score (r=0.462; p<0.05), but serum levels of estriol was not significantly correlated with MASI Score (r=0.301; p>0.05). Multiple linear regression revealed R2=0.244 (p<0.05), which means that serum levels of estradiol and estriol had 24.4% effects to MASI Score, while the rest 75.6% was influenced by others variables that were not included in this study. The conclusion is that there is a positive correlation between serum levels of estradiol with melasma severity in pregnant women, but serum levels of estriol are not correlated with melasma severity. Another factor besides serum levels estradiol and estriol might influence melasma severity.