Melasma
Conditions
Keywords
Epigenetics, Malar melasma,
Brief summary
BACKGROUND: Malar melasma has a chronic and recurrent character that may be related with epigenetic changes.
Detailed description
OBJECTIVE: Recognize the DNA methylation status of the malar melasma and perilesional skin, and its change after treatment with 50 SPF sunscreen (S), 4% niacinamide (N), or 0.025% retinoic acid (RA). METHODS: Fifty-six lesion of 28 female patients without treatment were clinically evaluated, as also the expression of DNA methyl transferases 1 and 3 by real time-PCR (polymerase chain reaction amplification), immunohistochemistry and immunofluorescence. It was initially quantified and after 8 weeks of treatment with S, RA and N. RESULTS: Relative expression of DNA methyl transferases were significantly elevated compared with unaffected skin in all subjects indicating hypermethylation of DNA. Hypermethylation decreased by S (7 vs 3 times relative expression, p\<0.05), RA (7 vs 2 times relative expression p\<0.05), and N (7 vs 1 relative expression p\<0.01) correlated with clinical improvement, this was also supported by immunohistochemistry and immunofluorescence. CONCLUSIONS: The investigators found hypermethylation of DNA in melasma lesions. Environmental factors such as sun radiation may induce DNA hypermethylation triggering hyperpigmentation trough the activation of pathways regulated by epigenetic modifications. Thus, decreasing methylation by sunscreen protection and the genetic transcription modification through N and RA, may allow their clinical improvement regardless its depigmenting effect.
Interventions
DRUGNiacinamide
topical administration in melasma lesions
DRUGRetinoic acid
topical administration in melasma lesions
DEVICEcolorimetry measurement
Measurement of erythema and luminosity through a colorimeter
DRUGsunscreen
topical administration in melasma lesions
Sponsors
Universidad Autonoma de San Luis Potosí
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
DOUBLE (Subject, Investigator)
Masking description
double bind
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
Clinical diagnosis of malar melasma by a specialist. No previous treatment at the beginning of the study.
Exclusion criteria
Use of medications associated with the development of melasma. Pregnant or lactating patients. Presence of concomitant diseases associated with the development of melasma. or other facial hyperpigmentations (thyroid, liver). Have received treatment in the last 2 months. Regular use of sunscreen.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| improve in the level of DNA methylated | 8 weeks | Decrease in levels of expression of DNA methyl transferases |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| improve in the clinical severity of melasma | 8 weeks | decrease in the MASI score |
Outcome results
None listed