Preventing melasma recurrence: prescribing a maintenance regimen with an effective triple combination cream based on long-standing clinical severity

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP ARELLANO, I.
ALMEIDA, A. R. Trindade de
dc.identifier.citation JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY, v.26, n.5, p.611-618, 2012
dc.identifier.issn 0926-9959
dc.description.abstract Background The relapsing nature of melasma emphasizes the need to maintain efficacy achieved after acute treatment. Objective To compare clinical efficacy and safety of two 6-month Triple Combination (TC; containing fluocinolone acetonide, hydroquinone and tretinoin) maintenance regimens in subjects with moderate to severe melasma, after daily treatment up to 8 weeks. Methods This randomized, investigator-blinded, controlled study had a maintenance phase of 6 months. Sixteen centres in Brazil and Mexico enrolled 242 subjects 18 years or older attaining no or mild melasma after 8 weeks of daily TC applications. Subjects were randomized to receive TC in a twice weekly or tapering regimen [3/week (1st month), 2/week (2nd month), 1/week (4th month)]. Efficacy and safety measurements included median time to relapse and relapse-free rate, Global Severity Score, Melasma Area and Severity Index score (MASI), subject's assessment, quality of life questionnaire (MelasQol), and adverse events. Results The majority (78.8%) had no or mild melasma (GSS <= 1) at week 8 and entered maintenance phase. After 6 months, 53% of patients remained relapse-free with improved quality of life, and time to relapse was similar between groups (about 190 days). Melasma severity at study entry, not maintenance baseline, influenced relapse rate. The twice weekly regimen tended to show better effectiveness in postponing relapse in severe melasma. Both regimens were safe. Conclusions After resolution of melasma with TC, maintenance therapy over 6 months was successful in preventing relapse in over half of the patients who entered maintenance phase. Prescribing medicines should be adapted to patients based on melasma severity.
dc.language.iso eng
dc.publisher WILEY-BLACKWELL
dc.relation.ispartof Journal of the European Academy of Dermatology and Venereology
dc.rights restrictedAccess
dc.subject.other of-life questionnaire; retinoic acid; validation; tretinoin; therapy; skin; hydroquinone; efficacy; language; safety
dc.title Preventing melasma recurrence: prescribing a maintenance regimen with an effective triple combination cream based on long-standing clinical severity
dc.type article
dc.rights.holder Copyright WILEY-BLACKWELL
dc.identifier.doi 10.1111/j.1468-3083.2011.04135.x
dc.identifier.pmid 21623930
dc.type.category original article
dc.type.version publishedVersion RIVITTI-MACHADO, M. C.:HC:ICHC · ARELLANO, I.:Hosp Gen Mexico OPD, Mexico City, DF, Mexico
· CESTARI, T.:Univ Rio Grande Sul, Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil
· OCAMPO-CANDIANI, J.:Hosp Univ Jose E Gonzalez, Monterrey, Mexico
· AZULAY-ABULAFIA, L.:Inst Dermatol & Estet Rio de Janeiro, Rio De Janeiro, Brazil
· TRINDADE NETO, P. Bezerra:Hosp Univ Onofre Lopes, Petropolis, Brazil
· SITTART, A.:Hosp Servidor Publ Estado Sao Paulo, Sao Paulo, Brazil
· ALMEIDA, A. R. Trindade de:Hosp Servidor Publ Municipal Sao Paulo, Sao Paulo, Brazil
· REGO, V.:Univ Fed Bahia, BR-41170290 Salvador, BA, Brazil
· MARQUES-HASSUN, K.:Univ Fed Sao Paulo, Sao Paulo, Brazil 2-s2.0-84860224279 WOS:000303051300011 MALDEN USA
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dc.description.index MEDLINE
hcfmusp.citation.scopus 13
hcfmusp.citation.wos 6 Brasil México

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