Efficacy of Intense Pulse Light Therapy and Tripple Combination Cream Versus Intense Pulse Light Therapy and Tripple Combination Cream Alone in Epidermal Melasma Treatment

强脉冲光联合三联乳膏与单用强脉冲光及单用三联乳膏治疗表皮型黄褐斑的疗效比较

Objective: To compare the efficacy of intense pulse light therapy (IPL) and triple combination cream (TCC) versus intense pulse light therapy and triple combination cream alone in epidermal melasma treatment, downgrading MASI score to more than 10.

Study design: Randomized controlled trial.

Place and duration of study: Dermatology Department, Lady Reading Hospital, Peshawar, from August 2014 to January 2015.

Methodology: Patients of 18-45 years were included in the study with Fitzpatrick skin type II-V. Sample of 96 patients was divided in to three groups of 32 each, through consecutive (non-probability) sampling method. Detailed history was taken, Woods Lamp Examination done, and melasma area and severity index (MASI) score was calculated. TCC had to be applied daily at night for two months by group A patients while group B was consigned for IPL therapy fortnightly, and those in group C were given both for two months. Efficacy was compared by recalculating MASI score at treatment end as well as at follow-up after 4 weeks, using Chi-square test with significance at p < 0.05.

Results: Male and female patients were 10 (31.2%) and 22 (68.8%) in group A, 7 (21.9%) and 25 (78.1%) in group B, while in group C were 12 (37.5%) and 20 (62.5%). The average age was 28.70 +8.70 years. MASI score reduction was achieved in 22 (68.8%) patients in group A; whereas, in 20 (62.5%) and 30(93.8%) patients in group B and C, respectively. Efficacy-wise distribution was significant (p=0.009).

Conclusion: Intense pulse light therapy and triple combination cream are more efficacious in epidermal melasma treatment than intense pulse light therapy and triple combination cream alone.

目的：比较强脉冲光（IPL）联合三联乳膏（TCC）与单用强脉冲光及单用三联乳膏治疗表皮型黄褐斑的疗效，以使MASI评分下降超过10分。

研究设计：随机对照试验。

研究地点和时间：巴基斯坦白沙瓦Lady Reading医院皮肤科，2014年8月至2015年1月。

方法：纳入18-45岁、Fitzpatrick皮肤类型II-V型的患者。通过连续（非概率）抽样方法将96例患者分为三组，每组32例。采集详细病史，进行Wood灯检查，并计算黄褐斑面积和严重程度指数（MASI）评分。A组患者需每晚外用TCC，持续两个月；B组接受每两周一次的IPL治疗；C组同时接受两种治疗，持续两个月。通过在治疗结束时以及随访4周后重新计算MASI评分来比较疗效，使用卡方检验，p < 0.05为有统计学意义。

结果：A组男性和女性患者分别为10例（31.2%）和22例（68.8%），B组为7例（21.9%）和25例（78.1%），C组为12例（37.5%）和20例（62.5%）。平均年龄为28.70±8.70岁。A组有22例（68.8%）患者实现MASI评分下降；B组和C组分别有20例（62.5%）和30例（93.8%）患者实现。疗效分布具有显著性（p=0.009）。

结论：强脉冲光联合三联组合霜治疗表皮型黄褐斑比单用强脉冲光及单用三联组合霜更有效。

Shakeeb N, Noor SM, Ullah G, Paracha MM. Efficacy of Intense Pulse Light Therapy and Tripple Combination Cream Versus Intense Pulse Light Therapy and Tripple Combination Cream Alone in Epidermal Melasma Treatment. J Coll Physicians Surg Pak. 2018 Jan;28(1):13-16.

Efficacy_of_Intense_Pulse_Light_with_Tri.pdf