Rosalie Tzu-Li Liu

Background: Refractory melasma remains a challenge in dermatology, necessitating the exploration of innovative treatments. Aims: This study aims to evaluate the efficacy and safety of combining radiofrequency microneedling (RFM) with Cysteamine cream, applied both in‐office and as a part of a home‐care regimen, to treat refractory melasma. Patients/Methods: A vehicle‐controlled, split‐face trial was conducted on 30 Fitzpatrick skin types III and IV participants. Subjects received RFM and Cysteamine serum on one side of the face and RFM with saline on the contralateral side. Additionally, a random half‐added Cysteamine cream was applied at home. The modified Melasma Area and Severity Index and VISIA skin analysis were used for assessment. Results: Significant improvement in melasma severity and skin texture was noted on the sides treated with RFM and Cysteamine, including observable benefits from both in‐office and home‐based Cysteamine use with minimal adverse effects. Conclusions: The combined approach of RFM with Cysteamine provides a promising and safe modality for managing refractory melasma, showing notable improvements.

Vitiligo, a psychologically distressing pigmentary disorder characterized by white depigmented patches due to melanocyte loss, necessitates non-invasive tools for early detection and treatment response monitoring. High-cellular-resolution full-field optical coherence tomography (CRFF-OCT) is emerging in pigmentary disorder assessment, but its applicability in vitiligo repigmentation after tissue grafting remains unexplored. To investigate the feasibility of CRFF-OCT for evaluating vitiligo lesions following tissue grafting, our investigation involved ten vitiligo patients who underwent suction blister epidermal grafting and laser ablation at a tertiary center between 2021 and 2022. Over a six-month period, clinical features, dermoscopy, and photography data were recorded. Utilizing CRFF-OCT along with artificial intelligence (AI) applications, repigmentation features were captured and analyzed. The CRFF-OCT analysis revealed a distinct dark band in vitiligo lesion skin, indicating melanin loss. Grafted areas exhibited melanocytes with dendrites around the epidermal-dermal junction and hair follicles. CRFF-OCT demonstrated its efficacy in the early detection of melanocyte recovery and accurate melanin quantification. This study introduces CRFF-OCT as a real-time, non-invasive, and in vivo evaluation tool for assessing vitiligo repigmentation, offering valuable insights into pigmentary disorders and treatment responses.