Moin-Ul Haque1, V Ramesh. 1. Department of Dermatology, Venereology and Leprosy, Deendayal Upadhyay Hospital, Govt. of NCT of Delhi, Harinagar, New Delhi, India. runamoin@indiatimes.com
Abstract
BACKGROUND: Xanthelasma is a common cutaneous condition that presents in the periocular region. Essentially benign, treatment is of cosmetic importance. OBJECTIVE: Evaluation of varying strengths of trichloroacetic acid (TCA) in xanthelasma palpebrarum. METHODS: Three strengths of TCA were used on 51 patients randomly after categorizing their xanthelasma into papulo-nodular, flat plaques and macular lesions. The average number of sittings was calculated in each category and patients were reviewed fortnightly. RESULTS: Papulo-nodular lesions required an average of two applications with 100%, 2.67 with 70% and 4.16 with 50% TCA. Flat plaques responded to an average of 1.43, 1.50 and 3.55 sittings with 100%, 70% and 50% TCA, respectively. Macular lesions responded to only one application of all strengths of TCA applied. Eleven patients developed hypopigmentation, five had hyperpigmentation and one developed mild scarring. CONCLUSION: 100% TCA gives the best results in papulo-nodular lesions, 100% or 70% TCA give similar results in flat plaque xanthelasma and in macular lesions 50% is sufficient. Hypopigmentation is the commonest side effect, followed by hyperpigmentation. Scarring is a minor problem.
RCT Entities:
BACKGROUND: Xanthelasma is a common cutaneous condition that presents in the periocular region. Essentially benign, treatment is of cosmetic importance. OBJECTIVE: Evaluation of varying strengths of trichloroacetic acid (TCA) in xanthelasma palpebrarum. METHODS: Three strengths of TCA were used on 51 patients randomly after categorizing their xanthelasma into papulo-nodular, flat plaques and macular lesions. The average number of sittings was calculated in each category and patients were reviewed fortnightly. RESULTS: Papulo-nodular lesions required an average of two applications with 100%, 2.67 with 70% and 4.16 with 50% TCA. Flat plaques responded to an average of 1.43, 1.50 and 3.55 sittings with 100%, 70% and 50% TCA, respectively. Macular lesions responded to only one application of all strengths of TCA applied. Eleven patients developed hypopigmentation, five had hyperpigmentation and one developed mild scarring. CONCLUSION: 100% TCA gives the best results in papulo-nodular lesions, 100% or 70% TCA give similar results in flat plaque xanthelasma and in macular lesions 50% is sufficient. Hypopigmentation is the commonest side effect, followed by hyperpigmentation. Scarring is a minor problem.