الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 146 |  |  |
| | | from | 146 | | |
Abstract
Melasma is a common skin condition characterized by irregular light brown to dark brown patches on sun-exposed areas of the skin, it is more prevalent in women with darker skin types; however its incidence in men is considerable. Although its pathogenesis is not clearly defined, some etiological factors have been identified, including exposure to ultraviolet light, genetic influences, hormones associated with pregnancy, oral contraceptives, phototoxic drugs. Melasma is cosmetic condition; and patients with melasma report that their appearance affects their social life, emotional well being and leisure activities.
Although multiple therapeutic modalities have previously been tried and touted as being successful, truly efficacious treatment options for this condition have been few and quite elusive. Such treatment approaches include; numerous topical agents, chemical peels, dermabrasion, and a variety of lasers and light-based devices.
In this study we used microneedling to deliver the study drug TXA to evaluate the clinical, histopathological and immunohistochemical changes in melasma patients treated with topical TXA application.
Our study included twenty one cases of melasma , each one received 6 sessions of skin microneedling and topical TXA application with 2 weeks interval between sessions.
Our study has demonstrated that there was clinical improvement after treatment. Also a 62 % decrease in MASI score after treatment when compared with that before treatment.
As regard histiopathological changes of treated patients, H&E microscopic examination of biopsies taken from melasma showed basal hyperpigmentation in all cases which showed significant decrease after treatment. Also by Masson-Fontana stained sections, we have demonstrated decrease of density of melanin in basal layer after treatment.
Immunohistochemical staining using MART-1 antibody revealed a significant quantitative decrease in the number of melanocytes after treatment.
In conclusion, on the basis of the findings, topical TXA can be used as potentially a safe, effective, and promising therapeutic agent for the treatment of melasma. The medication is easily available and affordable. Microneedling can significantly increase the effectiveness of topical TXA in treating melasma, and the combined therapy is safe and painless, without significant side effects and almost no downtime.