Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(23), P. 7483 - 7483

Published: Dec. 9, 2024

Background: Melasma is a challenging, acquired hyperpigmentary disorder. The gold standard treatment Kligman's formulation, which contains hydroquinone, tretinoin, and dexamethasone, but its long-term use limited by the risk of exogenous ochronosis. Cysteamine, tyrosinase inhibitor, reduces melanocyte activity melanin production, showing strong depigmenting effects in patients resistant to formulation. Nonetheless, clinical studies have yielded inconsistent efficacy results. This meta-analysis aimed assess cysteamine treating melasma identify potential factors that may impact therapeutic outcomes. Methods: A systematic search PubMed, Embase, Web Science, CENTRAL, from earliest record until August 2024, was conducted. Randomized controlled trials quasi-randomized design related topical on were included. primary outcome MASI or mMASI assessment after treatments. current conducted with random-effects model. Subgroup analyses meta-regressions performed based baseline MASI, disease duration melasma, patient age, sample size included studies. Funnel plots Duval Tweedie's trim fill method adopted publication bias. Results: Eight for quantitative analysis. analysis demonstrated significant decrease compared placebo (p = 0.002). Compared other treatments, did not show superior 0.277). modified formula, tranexamic acid mesotherapy statistically different when 0.434). Further showed no benefit allowing extended application time < 0.0001). meta-regression revealed decreased as increased (coefficient 0.38, p 0.0001, R2 0.99). funnel plot displayed some asymmetry. suggested adjusted effect 0.607 (95% CI -0.720 1.935). Conclusions: Cysteamine exhibited patients; however, depigmentation comparable hydroquinone-based regimens, mesotherapy, formula. Using short result better efficacy.

Language: Английский