{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T17:00:36Z","timestamp":1784912436656,"version":"3.55.0"},"reference-count":8,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Dermatol"],"abstract":"<jats:p>Introduction: Melasma is a chronic, relapsing hyperpigmentation disorder and may remain refractory despite multiple topical agents and procedural approaches. Case Presentation: We report a case series of six women with Fitzpatrick skin types III\u2013V and longstanding, treatment-resistant facial melasma managed with a multimodal protocol consisting of (1) a 16-week home regimen (twice-daily depigmenting cosmeceutical serum and daily high-protection sunscreen) and (2) two sessions of low-energy, low-density 1,927-nm fractional thulium laser at 4-week intervals, immediately followed by laser-assisted delivery of a compounded depigmenting mask (hydroquinone, retinoic acid, kojic acid, triamcinolone acetonide, vitamins C and E). Clinical response was assessed using the Melasma Severity Scale (MSS), standardized photography, and patient satisfaction. At week 16, all patients improved: 4 achieved &gt;75% clinical improvement and 2 achieved 50\u201375% improvement, with high satisfaction and no significant adverse events beyond transient darkening and mild desquamation. Clinical benefits remained stable 12 weeks after the final laser session. Conclusion: This case series suggests that 1,927-nm fractional thulium laser-assisted delivery of a high-potency depigmenting compound, supported by topical priming and strict photoprotection, may be a feasible option for selected patients with refractory melasma.<\/jats:p>","DOI":"10.1159\/000552673","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T16:04:00Z","timestamp":1780934640000},"page":"438-444","source":"Crossref","is-referenced-by-count":0,"title":["High-Potency Depigmenting Mask Delivered via 1,927-nm Fractional Laser in Refractory Melasma: A Pilot Case Series"],"prefix":"10.1159","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4481-5602","authenticated-orcid":false,"given":"Jaime","family":"Piquero-Casals","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1450-697X","authenticated-orcid":false,"given":"Juan Francisco","family":"Mir-Bonafe\u0301","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7435-7868","authenticated-orcid":false,"given":"Eduardo","family":"Rozas-Mun\u0303oz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0661-6178","authenticated-orcid":false,"given":"Vanesa","family":"Piquero-Casals","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4704-6132","authenticated-orcid":false,"given":"Daniel","family":"Morgado-Carrasco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2024.12419"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/pcmr.12684"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-019-00488-w"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S242180"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.3390\/cosmetics9050108"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2009.06.023"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics14122738"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.13817"}],"container-title":["Case Reports in Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000552673","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T16:01:42Z","timestamp":1784908902000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000552673"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000552673","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.32541711","asserted-by":"subject"}]},"ISSN":["1662-6567"],"issn-type":[{"value":"1662-6567","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]}}}