女性黄褐斑102例临床分析及血清性激素水平检测

目的探讨女性黄褐斑患者的临床特点及血清性激素水平。方法对102例女性黄褐斑患者进行临床资料分析,并检测了40例女性黄褐斑患者和38例正常对照组的血清性激素水平。结果黄褐斑发病与日晒、遗传、内分泌因素等相关;病例组血清雌二醇、促卵泡素、黄体生成素水平与对照组差异有统计学意义(P<0.05)。结论日晒是黄褐斑发病最重要的危险因素,部分黄褐斑患者可存在性激素水平的异常。     

外用0.5% MITF-siRNA霜治疗黄褐斑临床疗效及安全性观察

目的观察MITF-siRNA霜外用治疗黄褐斑的临床疗效及安全性。方法经临床诊断为黄褐斑的33例患者给予外用MITF-siRNA霜治疗,2次/d,并用MicroskinⅡ多功能偏振光皮肤镜图像分析系统对治疗前后黄褐斑皮损进行客观测量,通过测量L×,A×,B×值并计算ITAo值以评价局部外用siRNA霜的治疗效果。结果经MITF-siRNA霜外用治疗12周后,有效率90.3%,治疗前后ITAo值显著改善(P0.01)。观察过程中仅有1例局部出现红斑,停用至红斑消退后,继续外用siRNA霜后达到显效。结论局部外用MITF-siRNA霜可以显著淡化色斑,疗效确切且安全性好。     

Dermabrasion: A Curative Treatment for Melasma

Melasma is fairly common in Asian patients with a dark skin tone. It has long been known for its recalcitrance to any form of treatment. The objective of this article is to propose mechanical dermabrasion as a curative treatment for this entity. Five hundred and thirty-three patients with melasma were treated by mechanical dermabrasion using a rotatory diamond fraise. Four hundred and ten patients were available for long-term follow-up (mean follow-up time 5 years, range 1–9 years). Out of 410 patients, 398 (97%) achieved persistent clearance of melasma; in the remaining cases, there was partial recurrence after initial clearance. The common temporary sequelae were postoperative erythema or hyperpigmentation, pruritus, and milia formation. Two patients developed hypertrophic scars, one on the upper lip and one on the jawline, and one patient had permanent hypopigmentation on the forehead. In conclusion, mechanical dermabrasion is a relatively safe and highly effective means for curing melasma.     

IgM Chlamydia Trachomatis Antibodies in Cases of Melasma

Background

Melasma is an acquired photosensitive hypermelanosis in sun-exposed areas, especially seen in females. The exact cause of this disorder is not known. Association of melasma with chronic pelvic inflammatory disease (PID) has been described earlier. Chlamydia trachomatis is an important etilogical agent in acute and chronic PID and photosensitivity has been described in almost 50% cases of chronic lymphogranuloma venereum caused by 1.1, 1.2 and 13 serovars of C. trachomatis.

Method

Blood of 38 cases of melasma in women and 31 healthy females was tested for the presence of C. trachomatis IgM antibodies by ELISA.

Results

The average age of the patients was 35.6(range 19-51) years and that of controls was 38(range 24-55). 7(18.42%) and 5 (13.16%) of the patients of melasma were positive and borderline positive for IgM antibodies respectively. None of the healthy controls were positive. The difference was statistically significant.

Conclusion

Melasma in women is most likely due to photosensitivity to C.trachomatis in cases of chronic pelvic inflammatory disease.Key Words: Melasma, Chlamydia trachomatis infection     

Therapeutic Effect of Microneedling with Platelet-rich Plasma Versus Microneedling with Tranexamic Acid for Melasma

BackgroundMelasma is a chronic acquired focal pigment disorder showing symmetrical hyperpigmentation or hypermelanosis of photoexposed areas on the face. Tranexamic acid (TXA) is a treatment for melasma. The regression of melasma after platelet-rich-plasma (PRP) treatment is an interesting finding.ObjectiveWe investigated the effect of microneedling followed by PRP versus microneedling followed by tranexamic acid in the treatment of patients with melasma. MethodsThe study included 26 patients with melasma divided into two groups of 13 patients each. Group 1 was treated with microneedling and PRP, and Group 2 was treated with microneedling and tranexamic acid.ResultsThe response to treatment was assessed using the Melasma Area and Severity Index scoring system before and after treatment. At the start of the study and at the first session, there were no statistically significant differences (p>0.05). At the second and third treatment sessions, there were statistically significant differences (p<0.05). There were no statistically significant differences between the two groups regarding side effects of pain, erythema and postinflammatory hyperpigmentation.ConclusionMicroneedling with PRP offers better results than microneedling with TXA in treating melasma.     

黄褐斑病因探赜

黄褐斑的病因病机复杂,至今真正发病机制尚不明确。南宋陈言据张仲景"千般疢难,不越三条"的论点,结合临床实践与《内经》有关论述,将病因归纳为三大类:内因;外因;不内外因。本文就黄褐斑其发病病因作一概述。     

150例黄褐斑患者发病因素的统计分析

目的：探讨黄褐斑的主要病因。方法：采用问卷调查150例门诊黄褐斑患者，并就相关因素进行二值多元Logistic回归分析。结果：统计分析表明有显著性意义的发病因素相继是家族史、日晒和睡眠不佳。结论：黄褐斑患者的预防和诊治应注意防晒及调节睡眠。     

从瘀论治黄褐斑临证心得

作者结合黄褐斑的传统理论、发病特点及西医发病机制,阐述了黄褐斑与血瘀病机的相关性,并介绍了活血化瘀治疗黄褐斑的临床经验。