Inflammation in Melasma: Study of Its Infiltrate and the Expression of Acute and Chronic Mediators
NCT ID: NCT01952379
Last Updated: 2014-11-25
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
20 participants
OBSERVATIONAL
2013-07-31
2014-11-30
Brief Summary
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Using histological, histochemistry, immunohistochemistry, and quantitative real-time PCR, we evaluated melasma lesions from 20 healthy female patients with malar melasma without specific solar exposure or photoprotection measures within the previous 3 weeks and compared them to non lesional skin.
Detailed Description
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Previous reports in lesional skin have described increased mast cell infiltration in elastotic areas, presence of a moderate lymphohistiocytic infiltrate, increased vascularity, and up-regulation of proangiogenic factors. This histological evidence of skin inflammation is also supported clinically by colorimetry and thermography, and by the improvement of pigmentation with topical anti-inflammatories.
Photoinduced dermal inflammation might be related to epidermal hyperpigmentation through the production of melanogenic cytokines, and growth factors, and through the secretion of COX-2 induced prostaglandins by keratinocytes, a mechanism involved in the pathogenesis of postinflammatory hyperpigmentation which has not been evaluated in melasma.
The aim of this study is to describe the ongoing characteristics of inflammation in this condition by measuring the cellular infiltrate, the expression of acute and chronic immune inflammatory mediators, and non-immune inflammation mechanism such as COX-2, as well as to explore its relationship with severity of disease, elastosis, and melanin staining.
Twenty healthy female patients with malar melasma without specific solar exposure or photoprotection measures within the previous 3 weeks were enrolled. Disease severity was estimated using the Melasma Area and Severity Index (MASI). Histological, histochemical, immunohistochemistry, and quantitative real-time PCR were used to evaluate the presence of these markers in melasma lesions and compare them to nonlesional skin.
Conditions
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Study Design
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CASE_CROSSOVER
CROSS_SECTIONAL
Study Groups
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Melasma
Women affected by symmetric facial malar melasma.
No interventions assigned to this group
Eligibility Criteria
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Inclusion Criteria
* Symmetrical and bilateral lesions.
* Melasma with MASI scores greater than 12 points.
Exclusion Criteria
* Pregnant women or nursing.
* Miscarriage or labor in the last 12 months.
* Menopause
* Coexistence of other pigmentation disorders.
* Infrared radiation exposure.
* Regular exercise or diet restriction.
* Consumption of food supplements.
* Any type of drugs consumption in the last 2 months (i.e anti-inflammatories and hormonal treatments)
* Personal history of keloid or hypertrophic scars.
* Lidocaine allergy.
18 Years
50 Years
FEMALE
Yes
Sponsors
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Hospital Central "Dr. Ignacio Morones Prieto"
OTHER
Universidad Autonoma de San Luis Potosí
OTHER
Responsible Party
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Juan Pablo Castanedo-Cazares
Dermatology department research director
Principal Investigators
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Juan P Castanedo-Cazares, MD
Role: STUDY_DIRECTOR
Hospital Central "Dr. Ignacio Morones Prieto"
Bertha Torres-Alvarez, MD
Role: STUDY_CHAIR
Hospital Central "Dr. Ignacio Morones Prieto"
Adriana Rodriguez-Arambula, MD
Role: PRINCIPAL_INVESTIGATOR
Hospital Central "Dr. Ignacio Morones Prieto"
Locations
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Hospital Central Dr. Ignacio Morones Prieto
San Luis Potosí City, San Luis Potosí, Mexico
Countries
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References
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Navarrete-Solis J, Castanedo-Cazares JP, Torres-Alvarez B, Oros-Ovalle C, Fuentes-Ahumada C, Gonzalez FJ, Martinez-Ramirez JD, Moncada B. A Double-Blind, Randomized Clinical Trial of Niacinamide 4% versus Hydroquinone 4% in the Treatment of Melasma. Dermatol Res Pract. 2011;2011:379173. doi: 10.1155/2011/379173. Epub 2011 Jul 21.
Torres-Alvarez B, Mesa-Garza IG, Castanedo-Cazares JP, Fuentes-Ahumada C, Oros-Ovalle C, Navarrete-Solis J, Moncada B. Histochemical and immunohistochemical study in melasma: evidence of damage in the basal membrane. Am J Dermatopathol. 2011 May;33(3):291-5. doi: 10.1097/DAD.0b013e3181ef2d45.
Moncada B, Sahagun-Sanchez LK, Torres-Alvarez B, Castanedo-Cazares JP, Martinez-Ramirez JD, Gonzalez FJ. Molecular structure and concentration of melanin in the stratum corneum of patients with melasma. Photodermatol Photoimmunol Photomed. 2009 Jun;25(3):159-60. doi: 10.1111/j.1600-0781.2009.00425.x.
Hernandez-Barrera R, Torres-Alvarez B, Castanedo-Cazares JP, Oros-Ovalle C, Moncada B. Solar elastosis and presence of mast cells as key features in the pathogenesis of melasma. Clin Exp Dermatol. 2008 May;33(3):305-8. doi: 10.1111/j.1365-2230.2008.02724.x.
Espinal-Perez LE, Moncada B, Castanedo-Cazares JP. A double-blind randomized trial of 5% ascorbic acid vs. 4% hydroquinone in melasma. Int J Dermatol. 2004 Aug;43(8):604-7. doi: 10.1111/j.1365-4632.2004.02134.x.
Other Identifiers
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mel-Infla1
Identifier Type: -
Identifier Source: org_study_id