Efficacy and safety of intralesional steroid injection in the treatment of melasma.
BACKGROUND
The etiopathogenesis of melasma is not yet completely elucidated; however, certain inflammatory cytokines are involved in its pathogenesis as interleukin (IL) 1a, IL 1b, IL6, prostaglandin (PG) D2and PGE2. Corticosteroid suppressive effect on these cytokines may explain its therapeutic effect in the treatment of melasma.


AIMS
To assess the efficacy and safety of intralesional triamcinolone versus Kligman's formula in treatment of melasma.


METHODS
This study included 2 groups of female patients with melasma; group1 (treatment group) included 22 patients who were treated by intralesional injection of triamcinolone acetonide at a concentration of 4 mg/mL once monthly for four sessions as a maximum and group 2 (control group), included 22 patients who were treated by Kligman's formula once daily for 3 months. All patients were evaluated by dermoscope before treatment and at each follow-up visit to record any adverse effects of treatment.


RESULTS
The severity of melasma, assessed by MASI score, significantly decreased in both groups at the end of third month. There was no statistically significant difference in the therapeutic response between both groups. No side effects were reported with triamcinolone injection except for mild pain during injection, while Kligman's formula was associated with dermatitis, irritation, and burning sensation.


CONCLUSIONS
Triamcinolone injection at low concentration could be an effective treatment modality of melasma.
['Nassar|Amany Abd Elrahman|AAE|', 'Ibrahim|Al-Shimaa M|AM|https://orcid.org/0000-0002-9674-4703', 'Mahmoud|Asmaa Atef|AA|']
D005260:Female D006801:Humans D015552:Injections, Intralesional D008548:Melanosis D012720:Severity of Illness Index D016896:Treatment Outcome D014221:Triamcinolone
melasma cytokines Melanin