Evaluation of effectiveness of tranexamic acid as mesotherapy in improvement of periorbital wrinkling in a trial study.

BACKGROUND: Tranexamic acid is used to treat pigmented disorder in dermatology for a long time however there are limited data for effectiveness of tranexamic acid for rejuvenation and improvement of wrinkle. Here we want to find the effectiveness of tranexamic acid as mesotherapy in improvement of periorbital wrinkle in a clinical trial study. METHODS: Patients with melasma who were treated with 4 session of tranexamic acid mesotherapy at intervals on 1 week were evaluated with Visioface device before starting and 1 month after last course of treatment. The outcomes including volume, area, area percent, and depth were measured by Visioface device. RESULTS: Mean of periorbital wrinkles volume before and after procedure were 89 271 and 74 639 pixel3 (px3 ), respectively. Very significant difference with p-value of <0.001 was detected at volume of patient wrinkles before and after treatment. Moreover, the mean of area (and area percent) of their periorbital wrinkles before and after therapeutic method were 8481 Px3 (1.131%) and 7184 Px3 (0.646%), respectively, with significant differences (both have p-value of <0.001).Mean of periorbital wrinkles depth at before and after treatment were 9.8 and 9.6, respectively, without remarkable difference (p-value was 0.257). CONCLUSION: Tranexamic acid mesotherapy significantly leads to reduced volume and area of wrinkles. Injection of tranexamic acid as mesotherapy seems to be effective in improvement of periorbital wrinkling.

Uma revisão sistemática e metanálise sobre a associação entre alopecia androgenética e o risco de síndrome metabólica / A systematic review and meta-analysis on the association between androgenic alopecia and the risk of metabolic syndrome

Este estudo conduziu uma revisão sistemática de estudos sobre a relação entre alopecia androgênica e síndrome metabólica. Realizamos uma revisão abrangente de bancos de dados, incluindo PubMed, Web of Knowledge, Google Scholar, Scopus e Embase, e extraímos artigos relevantes publicados de 2010 a 2018. Os relatos de caso, artigos de revisão ou artigos sem textos completos foram excluídos. Nove estudos foram examinados para a etapa de metanálise. Os resultados mostraram uma relação significativa entre alopecia e síndrome metabólica (OR = 2,81; IC 95% = 2,16-3,66; I2 = 73%; P = 0,0003). Existe uma correlação significativa entre a alopecia androgênica e a síndrome metabólica.

This study conducted a systematic review of studies on the relationship between androgenic alopecia and metabolic syndrome. We performed a comprehensive review of databases including PubMed, Web of Knowledge, Google Scholar, Scopus, and Embase, and extracted relevant articles published from 2010 to 2018. The case reports, review articles, or studies lacking full-text articles were excluded. We examined nine studies for the meta-analysis step. The results showed a significant relationship between alopecia and metabolic syndrome (OR = 2.81; CI 95% = 2.16-3.66; I2 = 73%; P = 0.0003). There is a significant correlation between androgenic alopecia and metabolic syndrome

Comparison of efficacy and safety of tranexamic acid mesotherapy versus oral tranexamic acid in patients with melasma undergoing Q-switched fractional 1064-nm Nd:YAG laser: A blinded RCT and follow-up.

BACKGROUND: Melasma is a common hyperpigmentation disorder. This study aimed to compare the efficacy of Nd-Yag fractional 1064 plus microinjection of tranexamic acid versus Nd-Yag fractional 1064 plus oral tranexamic acid in patients with melasma. MATERIALS AND METHODS: This is a prospective, randomized study with a sample size of 40 patients, 20 in each treatment arm, which was done six times with 2-week intervals. Twenty patients were administered localized microinjections (4 mg/ml) of tranexamic acid and Q-switched 1064 laser every 2 weeks in one arm, while in the other arm, 20 were given oral tranexamic acid 250 mg three times a day and Q-switched 1064 laser every 2 weeks per visit. RESULTS: Twenty-one patients with mean SD 40.52+-4.95 y/o were treated with oral tranexamic acid, and 20 patients with 43.3+-5.87 y/o treated with microinjection of tranexamic acid were analyzed. There was no statistically significant difference between the two groups in terms of demographic and clinical characteristics at the baseline (p > 0.05). The patients MASI score and ∆E decrease over the study period in both treatments significantly (p < 0.001). However, patient's MASI score (p = 0.99) and ∆E (p = 0.53) did not differ significant between the two group over the time. Satisfaction (p = 0.41) and complication during the study period (p = 0.09) were not significantly different between the two group. CONCLUSION: The combination treatment method can be a viable option for Middle Eastern patients having melasma disorder, and tranexamic acid appears to be an effective and safe treatment for melasma, irrespective of its route of administration. Tranexamic acid can increase the permeability locally by non-invasive methods such as microneedling which is less painful than microinjection and can also increase patient satisfaction. Although the oral method is more tolerable for the patient, it may have systemic side effects, and its combination with Q-switch laser increases its effect regardless of the type of prescription. Therefore, it is recommended to use of this drug topically (cream or lotion) by non-invasive methods like microneedling to reduce pain and laser treatment in future studies.

Mycophenolate mofetil treatment of an H syndrome patient with a SLC29A3 mutation.

H syndrome is a complex multi-organ disorder with autosomal recessive inheritance. The skin manifestations include early onset hyperpigmentation and hypertrichosis, followed by skin induration often diagnosed as scleromyxedema and morphea. There is no effective treatment. Our objective was to study the efficacy of mycophenolate mofetil in a patient with genetically confirmed H syndrome. We sought the genetic cause of H syndrome with whole-exome sequencing (WES) of the proband. Genome-wide homozygosity mapping (HM) provided additional evidence for causality of the variant suggested by WES. Here, we report a patient with characteristic clinical features of H syndrome, and the diagnosis was confirmed by identification of a homozygous SLC29A3 mutation (p.Gly437Arg). The patient was initially treated with prednisolone and cyclosporine, but after development of side-effects she was placed on mycophenolate mofetil. After the treatment with mycophenolate mofetil was initiated, resolution of hyperpigmentation was noted, and no new lesions developed during an 18-month follow-up period. Thus, mycophenolate mofetil could be considered as a safe and partially effective treatment of H syndrome.