CONCLUSION

With topical TA treatment for 12 weeks, we demonstrated that the significant improvement of MSS and mMASI scores and subjective satisfaction score, and confirmed by chromameter. With histological analysis, the epidermal pigmentation was decreased significantly in the lesional skin, and even in perilesional normal skin of melasma. With immunohistochemical analysis, only ET-1 and SCF expression of epidermis were reduced significantly after TA treatment. However, dermal vascularity, number of mast cells, and VEGF expression of epidermis showed minimal changes. These findings suggest that the expected mechanism of topical TA might be responsible for modulating epidermal environment rather than dermal environment.

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SUPPLEMENT

Appendix 1. Verhoeff-Van Gieson staining (SA/DA)

Normal Lesion

0 week 0.18±0.06 0.30±0.18

12 week 0.29±0.10* 0.29±0.12

* p < 0.05 compared to 0 week

Appendix 2. MMP2 expression of dermis after topical TA treatment

Normal Lesion

0 week 0.0058±0.0056 0.0090±0.0069

12 week 0.0073±0.0053 0.0097±0.0088

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Appendix 3. Factor XIIIa expression of dermis after topical TA treatment

Normal Lesion

0 week 0.0072±0.0024 0.0063±0.0027

12 week 0.0077±0.0023 0.0094±0.0041

Appendix 4. Vimentin expression of dermis after topical TA treatment

Normal Lesion

0 week 0.0394±0.0185 0.0371±0.0182

12 week 0.0344±0.0131 0.0427±0.0190

Appendix 5. BMP4 expression of epidermis after topical TA treatment

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Normal Lesion

0 week 0.0117±0.0199 0.0043±0.0052

12 week 0.0042±0.0045 0.0123±0.0112*

* p < 0.05 compared to 0 week

Appendix 6. BMP4 expression of dermis after topical TA treatment

Normal Lesion

0 week 0.0016±0.0027 0.0054±0.0075

12 week 0.0009±0.0013 0.0010±0.0006

Appendix 7. BMP6 expression of epidermis after topical TA treatment

Normal Lesion

0 week 0.0216±0.0163 0.0375±0.0304

12 week 0.0207±0.0197 0.0180±0.0315

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Appendix 8. BMP6 expression of dermis after topical TA treatment

Normal Lesion

0 week 0.0002±0.0002 0.0002±0.0003

12 week 0.0025±0.0077 0.0003±0.0003

- 31 - severity scale (MSS), modified melasma area and severity index (mMASI), 그리고 색도계 를 통해 객관적으로 이루어졌으며 피험자 만족도 설문도 기록되었다. 10명의 피