{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T03:06:08Z","timestamp":1787972768053,"version":"build-2784847793"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T00:00:00Z","timestamp":1614816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust J Dermatology"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Literature on treating acquired dermal macular hyperpigmentation is sparse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims and objectives<\/jats:title><jats:p>To assess treatment response of mycophenolate mofetil in patients having acquired dermal macular hyperpigmentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>In this open\u2010label, pilot study, patients of acquired dermal macular hyperpigmentation affecting <jats:italic>at least<\/jats:italic> the face and\/or neck were included. Each participant was treated with mycophenolate mofetil 2\u00a0g\/day for 24\u00a0weeks, with a follow\u2010up of 12\u00a0weeks. Two aspects of disease severity were measured: activity (appearance of new lesions\/extension of existing lesions), and degree of hyperpigmentation (measured using \u2018<jats:italic>dermal pigmentation area and severity index<\/jats:italic>\u2019). Patient satisfaction was assessed on a scale of 0\u201310.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010three of 46 patients who were prescribed mycophenolate, completed the study (40 females, 6 males; mean disease duration 2.8\u00a0\u00b1\u00a01.4\u00a0years). Amongst 20 (43.5%) patients with active disease, stability was achieved in 17, after a mean duration of 6.1\u00a0\u00b1\u00a02.5\u00a0weeks (range 4\u201312\u00a0weeks; median 4; IQR 4\u00a0weeks). Mean <jats:italic>dermal pigmentation area and severity index<\/jats:italic> at baseline was 18.8\u00a0\u00b1\u00a07.1 and decreased to 13.7\u00a0\u00b1\u00a06.3 at 24th week (27.5\u00a0\u00b1\u00a014.7%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). A significant decreasing trend in <jats:italic>dermal pigmentation area and severity index<\/jats:italic> (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) was observed, and first significant difference from baseline was noted at the 16th week (<jats:italic>P<\/jats:italic> 0.008). Less than 10%, &gt;10\u201320%, &gt;20%\u201330%, &gt;30%\u201340%, &gt;40%\u201350%, and &gt;50% reduction in <jats:italic>dermal pigmentation area and severity index<\/jats:italic> was observed in 8, 5, 4, 15, 10 and 1 patients\/patient respectively. The maximum mean grade of pre\u2010treatment dermatoscopic severity was 3\u00a0\u00b1\u00a00.7, and decreased to 2.1\u00a0\u00b1\u00a00.8 on the face (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and 2.4\u00a0\u00b1\u00a00.7 on the neck (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) post\u2010treatment. There were 9 (20.1%) non\u2010responders. Self\u2010assessment scores of the rest of the patients fell in the range of moderate\/fair improvement (&gt;5 to 7). No significant correlation was seen between patient satisfaction score and degree of reduction in <jats:italic>dermal pigmentation area and severity index<\/jats:italic> (<jats:italic>r<\/jats:italic> \u22120.39). Three developed adverse effects (leucopenia, <jats:italic>n<\/jats:italic>\u00a0=\u00a01; transaminitis and hyperbilirubinemia, <jats:italic>n<\/jats:italic>\u00a0=\u00a02) that resolved following discontinuation of mycophenolate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Mycophenolate mofetil appears to be a promising treatment option in acquired dermal macular hyperpigmentation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajd.13567","type":"journal-article","created":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T12:29:20Z","timestamp":1614860960000},"page":"278-285","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Oral mycophenolate mofetil in the treatment of acquired dermal macular hyperpigmentation: An open\u2010label pilot 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