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.authorArellano, I.
dc.contributor.authorCestari, T.
dc.contributor.authorOcampo-Candiani, J.
dc.contributor.authorAzulay-Abulafia, L.
dc.contributor.authorBezerra Trindade Neto, P.
dc.contributor.authorHexsel, D.
dc.contributor.authorMachado-Pinto, J.
dc.contributor.authorMunoz, H.
dc.contributor.authorRivitti-Machado, M. C.
dc.contributor.authorSittart, A.
dc.contributor.authorTrindade de Almeida, A. R.
dc.contributor.authorRego, V.
dc.contributor.authorPaliargues, F.
dc.contributor.authorMarques-Hassun, K. [UNIFESP]
dc.contributor.institutionHosp Gen Mexico OPD
dc.contributor.institutionUniv Rio Grande Sul
dc.contributor.institutionHosp Univ Jose E Gonzalez
dc.contributor.institutionInst Dermatol & Estet Rio de Janeiro
dc.contributor.institutionHosp Univ Onofre Lopes
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionHosp Servidor Publ Estado São Paulo
dc.contributor.institutionHosp Servidor Publ Municipal São Paulo
dc.contributor.institutionUniversidade Federal da Bahia (UFBA)
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T14:27:13Z
dc.date.available2016-01-24T14:27:13Z
dc.date.issued2012-05-01
dc.description.abstractBackground 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.en
dc.description.affiliationHosp Gen Mexico OPD, Mexico City, DF, Mexico
dc.description.affiliationUniv Rio Grande Sul, Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil
dc.description.affiliationHosp Univ Jose E Gonzalez, Monterrey, Mexico
dc.description.affiliationInst Dermatol & Estet Rio de Janeiro, Rio de Janeiro, Brazil
dc.description.affiliationHosp Univ Onofre Lopes, Petropolis, Brazil
dc.description.affiliationHosp Clin FMUSP, São Paulo, Brazil
dc.description.affiliationHosp Servidor Publ Estado São Paulo, São Paulo, Brazil
dc.description.affiliationHosp Servidor Publ Municipal São Paulo, São Paulo, Brazil
dc.description.affiliationUniv Fed Bahia, BR-41170290 Salvador, BA, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, EPM, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent611-618
dc.identifierhttp://dx.doi.org/10.1111/j.1468-3083.2011.04135.x
dc.identifier.citationJournal of the European Academy of Dermatology and Venereology. Hoboken: Wiley-Blackwell, v. 26, n. 5, p. 611-618, 2012.
dc.identifier.doi10.1111/j.1468-3083.2011.04135.x
dc.identifier.issn0926-9959
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/34877
dc.identifier.wosWOS:000303051300011
dc.language.isoeng
dc.publisherWiley-Blackwell
dc.relation.ispartofJournal of the European Academy of Dermatology and Venereology
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://olabout.wiley.com/WileyCDA/Section/id-406071.html
dc.titlePreventing melasma recurrence: prescribing a maintenance regimen with an effective triple combination cream based on long-standing clinical severityen
dc.typeinfo:eu-repo/semantics/article
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