【 文献重点摘要 】

Background

Melasma, a common acquired disorder of hyperpigmentation, especially in women, is often resistant to therapy. This study was aimed to evaluate the efficacy and safety of azelaic acid, resorcinol and phytic acid solution in chemical peeling of melasma in comparison to 50% glycolic acid.

Materials and Methods

This clinical trial was performed, on 42 female patients with bilateral melasma. Severity of melasma was assessed by melasma area and severity index (MASI). Combination of (20% azelaic acid + 10% resorcinol + 6% phytic acid) was used as a new peeling agent on the right side of the face and 50% glycolic acid on the left side every 2 weeks for 6 times. Follow-up was carried out for 3 months after the last session. Any decrease in MASI score and unwanted complications following peeling were evaluated and compared during the trial.

Results

Patients showed marked improvement as calculated with MASI score before and after treatment in both sides of the face. The efficacy of combination formula (azelaic acid, resorcinol and phytic acid) was similar to glycolic acid, but with fewer complications. There was no statistically difference in improvement between two groups (P > 0.05). However, the patient's discomfort following procedures was significantly lower with azelaic acid, resorcinol and phytic compared with the glycolic acid peels (P < 0.05) and there was the same duration in the beginning of the therapeutic response in both groups.

Conclusion

Results showed that triple-combination was found to be an effective and safe peeling agent in the treatment of melasma and it was as effective as 50% glycolic acid peel.

背景

黄褐斑是一种常见的获得性色素沉着障碍，尤其是在女性中，往往对治疗有抵抗力。本研究以50%羟基乙酸为对照，评价杜鹃酸、间苯二酚和植酸溶液化学去皮治疗黄褐斑的疗效和安全性。

材料和方法

对42例女性双侧黄褐斑患者进行临床研究。用黄褐斑面积和严重程度指数(MASI)评估黄褐斑的严重程度。采用20%杜鹃酸+10%间苯二酚+6%植酸(20%杜鹃酸+10%间苯二酚+6%植酸)和50%乙醇酸(50%乙醇酸)组合，每2周1次，共6次。最后一次治疗后随访3个月。在试验期间评估和比较MASI评分的任何下降和剥离后不希望出现的并发症。

结果

治疗前后患者双侧面部MASI评分均有明显改善。复方(杜鹃酸、间苯二酚、植酸)的疗效与乙醇酸相似，但并发症较少。两组改善情况差异无统计学意义(P>0.05)。而杜鹃酸、间苯二酚和植酸的术后不适感明显低于乙醇酸脱皮(P<0.05)，且两组的起效时间相同。

结论

三联用治疗黄褐斑安全有效，与50%乙醇酸剥脱剂疗效相当。