title: Topical tretinoin (retinoic acid) treatment of hyperpigmented lesions associated with photoaging in Chinese and Japanese patients: a vehicle-controlled trial.
abstract: BACKGROUND
  Hyperpigmented lesions are a predominant component of photoaging in Chinese and Japanese persons. Topical 0.1% tretinoin cream improves the hyperpigmentation associated with photoaging in Caucasian persons.
  
  
  OBJECTIVE
  Our purpose was to assess the efficacy of 0.1% tretinoin cream treatment of hyperpigmented lesions associated with photoaging in Chinese and Japanese patients.
  
  
  METHODS
  Forty-five photoaged patients (23 Chinese, 22 Japanese) completed a double-blind, randomized study in which 21 applied 0.1% tretinoin cream and 24 applied vehicle cream once daily to face and/or hands for 40 weeks. Patients' hyperpigmented lesions were evaluated clinically and by colorimetry throughout the study and by histologic analysis of skin biopsy specimens taken before therapy and at the end of treatment.
  
  
  RESULTS
  At the end of treatment, hyperpigmented lesions of the face and hands were lighter or much lighter in 90% of patients receiving tretinoin compared with 33% receiving vehicle (p < 0.0001). Colorimetry demonstrated significant lightening of lesions after tretinoin compared with vehicle (p < 0.05). Histologic analysis of hyperpigmented lesions demonstrated a statistically significant 41% decrease in epidermal pigmentation with tretinoin therapy as compared with a 37% increase in the vehicle group (p = 0.0004). No patient withdrew for adverse effects.
  
  
  CONCLUSIONS
  By clinical, colorimetric, and histologic evaluation, 0.1% tretinoin cream significantly lightens the hyperpigmentation of photoaging in Chinese and Japanese patients.
authors.affiliation: Department of Dermatology, University of Michigan Medical Center, Ann Arbor 48109-0314.
authors.forename: C E
authors.initials: CE
authors.lastname: Griffiths
authors.forename: M T
authors.initials: MT
authors.lastname: Goldfarb
authors.forename: L J
authors.initials: LJ
authors.lastname: Finkel
authors.forename: V
authors.initials: V
authors.lastname: Roulia
authors.forename: M
authors.initials: M
authors.lastname: Bonawitz
authors.forename: T A
authors.initials: TA
authors.lastname: Hamilton
authors.forename: C N
authors.initials: CN
authors.lastname: Ellis
authors.forename: J J
authors.initials: JJ
authors.lastname: Voorhees
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D001213:Asian; D001706:Biopsy; D002681:China / Q000208:ethnology; D004311:Double-Blind Method; D005148:Facial Dermatoses / Q000188:drug therapy / Q000208:ethnology / Q000473:pathology; D005260:Female; D006229:Hand Dermatoses / Q000188:drug therapy / Q000208:ethnology / Q000473:pathology; D006801:Humans; D017495:Hyperpigmentation / Q000188:drug therapy* / Q000208:ethnology / Q000473:pathology; D007564:Japan / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D010781:Photography; D015595:Skin Aging / Q000187:drug effects*; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D014212:Tretinoin