A CLINICAL AND HISTOLOGICAL EVALUATION FOR THERAPEUTIC EFFICACY AND SAFETY OF TRANEXAMIC ACID LOCAL INFILTRATION WITH DERMAPEN IN COMBINATION WITH TOPICAL TRANEXAMIC ACID EMUGEL OR KLIGMANâ€™S FORMULA CREAM IN PATIENTS WITH MELASMA: A COMPARATIVE STUDY
Mohamed Abdalmoneim Shoaib M.D, Rehab Samaka M.D, Nada Farag Elnaidany M.D*, Azza Gaber Antar Farag and Mona Saber Aid M.B.B.Ch
Background: Tranexamic acid (TA), an anti-fibrinolytic lysine derivative, seems to be a promising agent for melasma treatment. But, little is known about its optimal administration route, dose, frequency, use duration, or its role in skin whitening of hypermelanotic patches. Aims and Objectives: To evaluate clinical and histological efficacy and safety of TA microinjection plus its topical use in treatment of melasma, and compare this lone use versus TA microinjection plus of Kligmanâ€™s formula. Materials and Methods: Egyptian melasma patients (n=40) were given TA(100 mg/mL per week) using dermapen for 12 weeks. Moreover, some patients used topical TA3% emulgel (group I, n=20), while others used Kligmanâ€™s formula (group II, n=20). Outcome measures were clinical assessment, Melasma Area and Severity Index (MASI) improvement percent, patient satisfaction and histopathological study including immunohistochemical staining. Results: At the end of 12th week, both groups showed a significant decrease in MSAI, that was more pronounced in group I (p=0.04), and significant improvement in pigmentation, solar elastosis, mast cell count and blood vessel density. No significant adverse effects were observed. Conclusion: Tranexamic acid (TA) is an effective and safe therapeutic agent for melasma treatment. Topical use of TA in between dermapen sessions has an improving consequence superior to that of Kligmanâ€™s formula.
Keywords: Tranexamic acid, Melasma, Dermapen, Kligmanâ€™s formula.
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