Benzoyl peroxide/clindamycin/UVA is more effective than fluticasone/UVA in progressive macular hypomelanosis: a randomized study.
BACKGROUND
There is no effective treatment for progressive macular hypomelanosis. Recent findings indicate that Propionibacterium acnes may play a role in the pathogenesis.


OBJECTIVE
We sought to compare the effectiveness of antimicrobial therapy with anti-inflammatory therapy in patients with progressive macular hypomelanosis.


METHODS
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.


RESULTS
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.)


CONCLUSIONS
There was difficult objective color measurement. Therefore, subjective assessment has important additional value. Right-left comparisons have certain inherent limitations.


CONCLUSIONS
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.
Relyveld
Germaine N
GN
Netherlands Institute for Pigment Disorders, Amsterdam, The Netherlands.
Kingswijk
Melanie M
MM
Reitsma
Johannes B
JB
Menke
Henk E
HE
Bos
Jan D
JD
Westerhof
Wiete
W
D000287:Administration, Topical; D000328:Adult; D000730:Androstadienes / Q000009:adverse effects / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001585:Benzoyl Peroxide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002981:Clindamycin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D000068298:Fluticasone; D006801:Humans; D020100:Hydrogels; D017496:Hypopigmentation / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D008297:Male; D016896:Treatment Outcome; D014467:Ultraviolet Therapy
D000730:Androstadienes; D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D020100:Hydrogels; D002981:Clindamycin; D000068298:Fluticasone; D001585:Benzoyl Peroxide