【 文献重点摘要 】

Objective

To evaluate treating epidermal melasma using a 4% hydroquinone skin care system plus tretinoin 0.05% cream.

Design

Multicenter open-label study, with all patients receiving above-mentioned treatment for up to 24 weeks.

Setting

Private dermatology and plastic surgery clinics and clinical research facilities.

Participants

Thirty-seven adult females with moderate or marked epidermal melasma, melasma pigmentation of mild-to-marked intensity, and Fitzpatrick skin type III to VI.

Measurements

Melasma severity, melasma pigmentation intensity, melasma improvement, patient satisfaction, quality-of-life measures, erythema, dryness, peeling, burning/stinging.

Results

No patient discontinued due to lack of efficacy or treatment-related adverse events. Treatment was associated with a significant reduction from baseline in melasma severity and melasma pigmentation intensity from Week 4 onward (P≤0.001), and 100 percent of patients showed improvement from Week 8 onward. At Week 24, 100 percent of patients were “satisfied” or “very satisfied” with the overall effectiveness of their treatment. Patients’ quality of life also improved (e.g., the proportion of patients feeling embarrassed or self-conscious about their skin “a lot” or “very much” declined from 78 percent at baseline to four percent at Week 24). Mean and median scores for erythema, dryness, peeling, and burning/stinging did not exceed trace levels.

Conclusion

Treating moderate-to-severe melasma using the 4% hydroquinone skin care system plus 0.05% tretinoin can significantly reduce the severity of melasma and the intensity of melasma pigmentation within four weeks. Treatment was generally well tolerated and associated with an improved quality of life and high levels of patient satisfaction.

目的

评价4%氢醌护肤液加0.05%维甲酸乳膏治疗表皮黄褐斑的疗效。

设计

多中心开放研究，所有患者均接受上述治疗，疗程长达24周。

设置

私人皮肤科和整形外科诊所和临床研究设施。

研究对象

37名成年女性，患有中度或明显的表皮黄褐斑，黄褐斑色素沉着轻度至明显，Fitzpatrick皮肤类型III至VI型。

测量

黄褐斑严重程度、黄褐斑色素沉着强度、黄褐斑改善程度、患者满意度、生活质量指标、红斑、干燥、脱皮、灼热/刺痛。

结果

无1例患者因疗效不佳或治疗相关不良事件而停药。从第4周开始，治疗与黄褐斑严重程度和黄褐斑色素强度较基线显著降低有关(P≤0.001)，从第8周开始，100%的患者表现出改善。在第24周，100%的患者对他们治疗的总体效果“满意”或“非常满意”。患者的生活质量也有所改善(例如，对自己的皮肤感到“非常”或“非常”难堪的患者比例从基线的78%下降到第24周的4%)。红斑、干燥、脱皮和灼热/刺痛的平均和中位数得分均未超过痕量水平。

结论

4%氢醌护肤液加0.05%维甲酸治疗中重度黄褐斑，四周内可明显减轻黄褐斑严重程度，减轻黄褐斑色素沉着强度。治疗总体上耐受性良好，并与生活质量的改善和患者满意度的高水平相关。