Benzoyl peroxide/clindamycin/UVA is more effective than fluticasone/UVA in progressive macular hypomelanosis: a randomized study.

There is no effective treatment for progressive macular hypomelanosis. Recent findings indicate that Propionibacterium acnes may play a role in the pathogenesis.
We sought to compare the effectiveness of antimicrobial therapy with anti-inflammatory therapy in patients with progressive macular hypomelanosis.
A total of 45 patients were randomized to a within-patient left-right comparison study of benzoyl peroxide 5% hydrogel/clindamycin 1% lotion in combination with UVA irradiation versus fluticasone 0.05% cream in combination with UVA irradiation. Repigmentation was determined by photometric measurements of changes in skin color and by patient and dermatologist assessment using before and after photographs.
Benzoyl peroxide 5% hydrogel, clindamycin 1% lotion, and UVA led to better repigmentation than fluticasone 0.05% cream in combination with UVA irradiation in all measurements. (Photometric measurements P = .007, patient assessment P < .0001, and dermatologist assessment P < .0001.)
There was difficult objective color measurement. Therefore, subjective assessment has important additional value. Right-left comparisons have certain inherent limitations.
Antimicrobial therapy in conjunction with light was more effective in repigmentation in patients with progressive macular hypomelanosis than a combination of anti-inflammatory therapy and light.
AuthorsGermaine N Relyveld, Melanie M Kingswijk, Johannes B Reitsma, Henk E Menke, Jan D Bos, Wiete Westerhof
JournalJournal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 55 Issue 5 Pg. 836-43 (Nov 2006) ISSN: 1097-6787 [Electronic] United States
PMID17052490 (Publication Type: Journal Article, Randomized Controlled Trial)
Chemical References
  • Androstadienes
  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents
  • Hydrogels
  • Clindamycin
  • Fluticasone
  • Benzoyl Peroxide
  • Administration, Topical
  • Adult
  • Androstadienes (adverse effects, therapeutic use)
  • Anti-Bacterial Agents (administration & dosage, adverse effects, therapeutic use)
  • Anti-Inflammatory Agents (adverse effects, therapeutic use)
  • Benzoyl Peroxide (administration & dosage, adverse effects, therapeutic use)
  • Clindamycin (administration & dosage, adverse effects, therapeutic use)
  • Disease Progression
  • Female
  • Fluticasone
  • Humans
  • Hydrogels
  • Hypopigmentation (drug therapy, pathology, therapy)
  • Male
  • Treatment Outcome
  • Ultraviolet Therapy

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