口服氨甲環酸（TA）治療白斑症合併黃褐斑的可行性

摘 要：

雀斑和白斑症都是常見的色素性疾病，其治療具有挑戰性。口服氨甲环酸（TA）對難治性雀斑有效；然而，對於合併雀斑的白斑症患者的TA的可行性尚未研究。為評估口服TA治療白斑症患者雀斑的治療結果和不良反應。我們對2017年1月至2020年8月間在三級皮膚科中接受口服TA治療雀斑的白斑症患者進行了回顧性分析。我們納入了32名同時患有白斑症和面部雀斑的患者。患者報告的雀斑改善的平均持續時間約為1.64個月的治療。白斑症病灶再色素沉著的首次跡象發生在治療1個月時。84.38%的患者在醫師全球評估中達到了輕度至良好程度的雀斑改善（0%–75%改善），而81.25%的患者通過醫師全球評估達到了中度至優良程度的白斑症改善（25%–100%改善）。未觀察到明顯的不良事件。在TA治療期間，未有患者出現白斑症疾病惡化。口服TA可能是白斑症患者雀斑治療的可行選擇。

Melasma and vitiligo are both common pigmentary disorders, and the treatment is challenging. Oral tranexamic acid (TA) is effective for refractory melasma; however, the feasibility of TA in vitiligo patients with melasma was not studied. To evaluate the treatment outcomes and adverse effects of oral TA in vitiligo patients with melasma. We conducted a retrospective analysis of vitiligo patients who received oral TA for melasma in a tertiary dermatologic center from January 2017 to August 2020. We enrolled 32 patients with concomitant vitiligo and melasma on the face. The mean duration of the improvement of melasma that patients reported is around 1.64 months of treatment. The first sign of repigmentation of the vitiligo lesions occurred at 1 month of treatment. 84.38% of the patients achieved a mild to good degree of improvement of melasma (0%–75% improvement), whereas 81.25% of the patients achieved a moderate to excellent degree of improvement of vitiligo (25%–100% improvement) via physician global assessments. No significant adverse event was noted. No patients experience vitiligo disease deterioration during TA treatment. Oral TA may be a feasible option for melasma in vitiligo patients.