Treatment of Acquired Dermal Macular Hyperpigmentation With Oral Isotretinoin: A Multi-Institutional Retrospective Study of 121 Cases

IF 2.6 3区 医学 Q2 CELL BIOLOGY
Zhongyi Xu, Yuecen Ding, Chengfeng Zhang, Davinder Parsad, Michelle Rodrigues, Muthu Sendhil Kumaran, Nawaf Almutairi, Iltefat Hamzavi, Jharna Amin, Houda Hammami Ghorbel, Leihong Xiang, Thierry Passeron
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Abstract

The term acquired dermal macular hyperpigmentation (ADMH) was introduced to unify Riehl's melanosis (RM), lichen planus pigmentosus (LPP), and related entities. These are cosmetically distressing pigmentary disorders that pose therapeutic challenges. To investigate the efficacy and safety of oral isotretinoin in treating ADMH, we conducted a muticenter retrospective study of patients with ADMH treated with oral isotretinoin between 2014 and 2024. Patients from Australia, China, Europe, India, Middle East, North America, and North Africa were included. Patients lost to follow-up before two visits were excluded. The response was graded by a 5-point Investigator's Global Assessment (IGA) scale. A total of 121 patients were included. Most patients (64.5%) were treated with a dose of 20 mg/d for an average of 8 months. Oral isotretinoin improved the severity of pigmentation in all RM and 85 (90.4%) LPP patients, with 17 (63.0%) RM and 31 (33.0%) LPP patients achieving marked improvement. RM patients responded better than LPP patients (p = 0.005). Patients with localized lesions (p = 0.0012), disease duration of less than 5 years (p = 0.046 for RM, p = 0.0272 for LPP), Fitzpatrick skin phototypes III-VI (p = 0.0081), or longer duration of treatment (p = 0.0178) responded better. Oral isotretinoin appears to be a promising treatment modality for ADMH.

Abstract Image

口服异维甲酸治疗获得性皮肤黄斑色素沉着:121例多机构回顾性研究
获得性皮肤黄斑色素沉着症(ADMH)一词的引入是为了统一Riehl's melanosis (RM), planenus pigmentosus (LPP)和相关实体。这些都是困扰美容的色素紊乱,给治疗带来挑战。为了研究口服异维a酸治疗ADMH的有效性和安全性,我们对2014年至2024年口服异维a酸治疗ADMH的患者进行了多中心回顾性研究。包括来自澳大利亚、中国、欧洲、印度、中东、北美和北非的患者。排除两次就诊前未能随访的患者。根据5分的研究者全球评估(IGA)量表对反应进行评分。共纳入121例患者。大多数患者(64.5%)以20mg /d的剂量治疗,平均治疗8个月。口服异维甲酸改善了所有RM和85例(90.4%)LPP患者的色素沉着严重程度,其中17例(63.0%)RM和31例(33.0%)LPP患者的色素沉着明显改善。RM患者的疗效优于LPP患者(p = 0.005)。局部病变(p = 0.0012)、病程小于5年(RM = 0.046, LPP = 0.0272)、Fitzpatrick皮肤光型III-VI (p = 0.0081)或治疗时间较长(p = 0.0178)的患者疗效更好。口服异维甲酸似乎是ADMH的一种有希望的治疗方式。
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来源期刊
Pigment Cell & Melanoma Research
Pigment Cell & Melanoma Research 医学-皮肤病学
CiteScore
8.90
自引率
2.30%
发文量
54
审稿时长
6-12 weeks
期刊介绍: Pigment Cell & Melanoma Researchpublishes manuscripts on all aspects of pigment cells including development, cell and molecular biology, genetics, diseases of pigment cells including melanoma. Papers that provide insights into the causes and progression of melanoma including the process of metastasis and invasion, proliferation, senescence, apoptosis or gene regulation are especially welcome, as are papers that use the melanocyte system to answer questions of general biological relevance. Papers that are purely descriptive or make only minor advances to our knowledge of pigment cells or melanoma in particular are not suitable for this journal. Keywords Pigment Cell & Melanoma Research, cell biology, melatonin, biochemistry, chemistry, comparative biology, dermatology, developmental biology, genetics, hormones, intracellular signalling, melanoma, molecular biology, ocular and extracutaneous melanin, pharmacology, photobiology, physics, pigmentary disorders
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