{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T01:18:05Z","timestamp":1784423885343,"version":"3.55.0"},"reference-count":12,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T00:00:00Z","timestamp":1553731200000},"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":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Melasma is an acquired hyperpigmentation, often involving the face, and a source of distress for the affected individuals. Although treatment is challenging and frequently a multimodality approach, topical applications are the mainstay of therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Due to the frequent relapses, a therapy both acting rapidly and suitable for long\u2010term use, with fewer adverse effects should be administered. In our outpatient clinic, we treated the melasma patients with a previously unreported triple combination which was empirically formulated with lesser amount of active components, regarding the balance between long\u2010term use and safety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixty\u2010eight female patients with melasma who referred to our hospital dermatology clinic in the years 2016\u20102017 were retrospectively recruited. They all had completed 6\u2010month treatment with a prescribed cream mixture comprised of azelaic acid (4%), hydroquinone (1.6%), methylprednisolone aceponate (0.04%), and salicylic acid (2%). The outcomes were evaluated both instrumentally (Melanin Index\/MI) and by patients (Patient Self\u2010Assessment Scale\/PSAS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Adverse effects declared by the patients were transient irritation in three and mild hypertrichosis in two. Both the MI and PSAS values were found extremely significant at the end of 6th month, compared with initial values. Approximately 62% of total decrease in MI was realized in the first 3\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The triple combination containing active ingredients with lesser concentrations than proposed, and with the addition of 2% salicylic acid, may be promising as a quite effective and safe protocol in treatment of melasma for longer durations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.12904","type":"journal-article","created":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T13:16:40Z","timestamp":1553779000000},"page":"1700-1704","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["A novel triple combination in treatment of melasma: Significant outcome with far less actives"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1469-2557","authenticated-orcid":false,"given":"Erkin","family":"Pekmezci","sequence":"first","affiliation":[{"name":"Dermatology Department Gozde Hospital Malatya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,28]]},"reference":[{"issue":"6","key":"e_1_2_6_2_1","first-page":"578","article-title":"Chemical peels in melasma: a review with consensus recommendations by Indian pigmentary expert group","volume":"62","author":"Sarkar R","year":"2017","journal-title":"Indian J Dermatol"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5154.108070"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-017-0194-1"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5154.57602"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1975.01630130042004"},{"issue":"6","key":"e_1_2_6_7_1","first-page":"558","article-title":"Medical management of melasma: a review with consensus recommendations by Indian pigmentary expert group","volume":"62","author":"Sarkar R","year":"2017","journal-title":"Indian J Dermatol"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.13485"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2012.04711.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2010.03942.x"},{"key":"e_1_2_6_11_1","first-page":"128","article-title":"Salicylic acid: an alternative to alpha\u2010hydroxy acids","volume":"5","author":"Kligman AM","year":"1997","journal-title":"J Geriatr Dermatol"},{"issue":"4","key":"e_1_2_6_12_1","first-page":"7","article-title":"Salicylic acid: not a beta\u2010hydroxy acid","volume":"10","author":"Yu RJ","year":"1997","journal-title":"Cosmet Dermatol"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S84765"}],"container-title":["Journal of Cosmetic Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjocd.12904","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.12904","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocd.12904","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.12904","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T09:20:12Z","timestamp":1694164812000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocd.12904"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,28]]},"references-count":12,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1111\/jocd.12904"],"URL":"https:\/\/doi.org\/10.1111\/jocd.12904","archive":["Portico"],"relation":{},"ISSN":["1473-2130","1473-2165"],"issn-type":[{"value":"1473-2130","type":"print"},{"value":"1473-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,28]]},"assertion":[{"value":"2018-06-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}