Comparison of therapeutic efficacy of intralesional platelet-rich plasma and topical alpha-glucoside derivative of trihydroxy benzoic acid in melasma

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Background: Melasma is the most common cause of facial melanosis and presents with a complex therapeutic problem. Intralesional platelet-rich plasma (PRP) has shown promising results in hyperpigmentation, whereas alpha-glucoside derivative of trihydroxy benzoic acid (THBG) is a newer molecule for the management of pigmentation. Aims and objective: To compare therapeutic effects of PRP and THBG in facial melasma, note any untoward side effects of therapy and evaluate dermoscope as a tool for therapeutic prognosis. Methods: A total of 60 patients were enrolled based on inclusion and exclusion criteria after due written informed consent. After clinical, dermoscopic, and Wood lamp examination with relevant blood investigations, group P was treated by three sittings of intralesional injection of PRP at monthly interval, whereas group B was subjected to local application of THBG twice a day. Intergroup as well as intragroup comparative analyses were performed by subjective scores and dermoscope. Results: The mean of difference between modified melasma area and severity index (mMASI) score at the end of the study (i.e., difference mMASI at 12 and 0 weeks) was 2.21 for group P and 0.18 for group B and on comparison, the P-value was <0.0001 which is considered statistically significant. The average %mMASI improvement in group P was 35.05%, whereas in group B, it was 3.18%. On analysis of other parameters, physician global assessment, patient global assessment, and melasma quality of life scale patients of group P showed higher and significant improvements in comparison with group B. Changes in dermoscopic parameters could be appreciated in patients with significant improvement only. Conclusion: There is mild–moderate improvement in melasma (average 35.05%) with PRP with no untoward side effects, whereas THBG did not show any promising result in the treatment of melasma in FT grade IV/V.