title: Salicylic acid for the treatment of melasma: new acquisitions for monitoring the clinical improvement.
abstract: OBJECTIVE
  The Melasma Area and Severity Index (MASI) and the Melasma Severity Score (MSS) are calculated on the basis of only a subjective clinical assessment. This raises the need to have an objective score, uniform in the evaluation by different clinicians. The purpose of this study was to establish if the images by Canfield Reveal Imager can be correlated to MASI score to better evaluate the clinical efficacy of salicylic acid 33% peeling in the treatment of melasma respect to the clinical observation.
  
  
  METHODS
  The study was a voluntary observational study. Twenty female patients affected with melasma, aged between 30 and 60 years, were included in the study. Treatment with salicylic acid 33% was performed once a month, for a total of four times. The dermatologist (Doc A) examined each patient's melasma areas using MASI score, at the face-to-face observation and at Reveal images evaluation during the first (T0) and the end point time (T4). Digital photographs were also evaluated by another experienced dermatologist (Doc B), who has never seen clinically the patients before and who evaluated MASI score by Reveal images at time T0 and T4.
  
  
  RESULTS
  Student's t-test and linear regression test were performed, showing statistically significant values comparing MASI score obtained by digital photo and MASI score obtained clinically.
  
  
  CONCLUSIONS
  The monitoring of the improvement by Reveal images can optimize the treatment approach and the efficacy of same dermocosmetics procedures can be revised following standard criteria.
authors.affiliation: Department of Clinical Medicine and Surgery, Section of Dermatology, University Federico II of Naples, Naples, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Fabbrocini
authors.forename: Valerio
authors.initials: V
authors.lastname: De Vita
authors.forename: Claudio
authors.initials: C
authors.lastname: Marasca
authors.forename: Franco
authors.initials: F
authors.lastname: Palmisano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Monfrecola
mesh_terms: D000328:Adult; D002615:Chemexfoliation / Q000379:methods*; D016903:Drug Monitoring / Q000379:methods*; D004817:Epidermis / Q000187:drug effects / Q000473:pathology; D005145:Face; D005260:Female; D006801:Humans; D007641:Keratolytic Agents / Q000008:administration & dosage*; D016014:Linear Models; D008548:Melanosis / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D008954:Models, Biological; D010781:Photography / Q000295:instrumentation / Q000379:methods; D020156:Salicylic Acid / Q000008:administration & dosage*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D007641:Keratolytic Agents; D020156:Salicylic Acid
keywords: MASI; chemical peel; digital images; hyperpigmentation; melasma; salicylic acid