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 KLIGMAN’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
ABSTRACT
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 Kligman’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 Kligman’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 Kligman’s formula.
Keywords: Tranexamic acid, Melasma, Dermapen, Kligman’s formula.
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