Trichloroacetic Acid Group Research Articles

Comparative Efficacy of Chemical Peeling Agents in the Treatment of Melasma.

Melasma is a complex skin disorder characterized by brown or dark patches, primarily affecting facial areas. Despite numerous treatment options, the effective management of melasma remains challenging. This study aims to fill a gap in the literature by rigorously comparing the effectiveness of three prevalent chemical peeling agents, 15% trichloroacetic acid (TCA), 15% phenol, and 2% glycolic acid, in treating melasma. A randomized controlled trial was conducted involving patients who were clinically diagnosed with melasma. Participants were divided into three groups, each receiving one of the chemical peeling treatments. The primary measure of efficacy was the Melasma Area and Severity Index (MASI) score, recorded before and after the treatment series. Side effects were also documented and analyzed. Preliminary findings suggest a significant reduction in MASI scores in the group treated with 15% TCA peel. The average MASI score reduction was 8.5 points for the TCA group, 6.0 points for the phenol group, and 5.2 points for the glycolic acid group. Side effects such as redness and mild irritation were noted but were least prevalent in the TCA group. Our study indicates that 15% TCA peel is not only effective but also comparatively safer in treating melasma. It shows a more rapid and significant improvement in reducing melasma symptoms than 15% phenol and 2% glycolic acid peels. However, further research is warranted to validate these findings over a larger population.

Evaluation of the therapeutic efficacy of topical 50% hydrogen peroxide vs. 100% trichloroacetic acid vs. 5% 5-fluorouracil in the treatment of warts

ABSTRACT Background: Warts (verruca) are caused by human papilloma virus (HPV), which is known to affect the skin and mucosae. Over two hundred strains of HPV have been identified to date, among which few strains cause cutaneous lesions. Various treatment modalities have been elucidated in treating verruca lesions, yet the best therapeutic option is yet to be determined. Objectives: To evaluate the efficacy and safety of topical 50% hydrogen peroxide (H2O2), 100% trichloroacetic acid (TCA), and 5% 5-fluorouracil (5-FU) as a topical application in the treatment of warts. Methods: This was a prospective, interventional, clinical trial that included sixty patients with warts randomly allotted into three groups. Group A and group B were treated every week with topical 50% H2O2 and 100% TCA, respectively, and group C with 5% 5-FU under tape occlusion twice a day. The treatment was executed for a maximum period of eight weeks. The patients were evaluated with the Physician Wart Assessment (PWA) every two weeks of treatment and at three months after treatment completion. Results: At the end of the eight weeks of treatment, 13 patients (65%) in the H2O2 group, 11 patients (55%) in the TCA group, and 8 patients (40%) in the 5% 5-FU group displayed complete clearance of warts (PWA grade 0). In our study, side effects were significantly higher in the TCA group (70%) and in the 5% 5-FU group (60%), notably lower in the H2O2 group (30%) (p = 0.011). The most frequent side effect was irritation (25%), which was reported in all groups. No relapse was encountered at three months of treatment completion. Conclusion: According to our study, H2O2 and TCA have the advantage of earlier action over 5% 5-FU. However, H2O2 remarkably stands as a safer therapeutic option concerning the clearance of lesions, patient tolerability, and side effects. Key words: Warts, H2O2, TCA, 5%, 5-FU

A Comparison of Two Treatment Methods, Trichloroacetic Acid, and Laser Therapy, in the Wart Treatment: A Randomized Double-Blind Clinical Trial in a University Hospital in Tehran, Iran

Background: Warts are common skin disorders that are treated by a variety of methods. Therefore, researchers are searching for effective and less-complicated methods, especially for treatment-resistant warts. In this regard, the present study compared two methods, CO2 laser and trichloroacetic acid, to treat warts in patients who visited Khanevadeh Hospital from October 2013 to October 2014. Objectives: The present study aimed to compare two treatment methods, trichloroacetic acid, and CO2 laser, in patients with warts who visited Khanevadeh Hospital regarding side effects and efficacy of the treatment. Methods: The present interventional study, which had a randomized, double-blind clinical trial type, examined 60 patients with warts who visited Khanevadeh Hospital from October 2013 to October 2014, and determined and compared the side effects and efficacy of two treatment methods, CO2 laser, and Trichloroacetic acid. Results: The complete treatment effectiveness rate was 20% in the trichloroacetic acid group and 56.7% in the CO2 laser group, indicating a statistically significant difference (P = 0.005). There was no special side effect in any treatment methods. Conclusions: According to research results, the efficacy of CO2 laser was higher in treating warts than trichloroacetic acid; hence, its use is recommended in treating patients with warts because of its efficacy and safety.

Comparison of Effectiveness of Platelet Rich Plasma (PRP) versus 30% Trichloroacetic Acid (TCA) in the Treatment of Acne Scars

Objective: To compare the effectiveness of intradermal platelet-rich plasma with 30% Trichloroacetic acid in treating atrophic acne scars.
 Study Design: Quasi-experimental study.
 Place and Duration of Study: Tertiary Care Hospital of Multan Pakistan, from Aug 2019 to Sep 2020.
 Methodology: A total of 76 patients (38 in each group), were enrolled in the study. Platelet-rich plasma treatment was given to Group-A, and 30% Trichloroacetic acid treatment was given to Group-B patients. Platelet-rich plasma was injected in the dermis with an insulin syringe while 30%Trichloracetic acid was applied with a cotton tip applicator. The effectiveness of treatment was measured by Goodman and Baron quantitative acne scar scale.
 Results: A total of 76 patients with atrophic acne scars were included in the study. The mean age of patients in Plate rich plasma Group was 29.63±5.08 years and 29.92±5.85 years in the 30% Trichloroacetic acid Group. Platelet Rich Plasma was an effective treatment of atrophic acne scar (p= 0.030) with post-procedure improvement in the Goodman and Baron quantitative acne scar scale.
 Conclusion: Atrophic acne scar treatment with intradermal Plate-rich plasma is more effective than 30% Trichloroacetic acid.

Q-switched frequency-doubled Nd:YAG (532 nm) laser versus trichloroacetic acid 35% peeling in the treatment of dorsal hand solar lentigo: An assessor-blind split-hand randomized controlled trial.

Solar lentigo (SL) is a benign hyperpigmented spot occurring due to ultraviolet exposure, most commonly in the elderly. We aimed to compare the safety and efficacy of trichloroacetic acid (TCA) peeling with Q-switched laser in the treatment of SLs. This assessor-blind split-hand randomized controlled trial included 45 patients with symmetric SLs on the back of their hands referred to the dermatology clinics from March 1 to June 24, 2021. TCA 35% was applied to the back of one hand, and the contralateral hand received Q-switched laser. The interventions were repeated for a total of three sessions 4 weeks apart. Eight weeks after the last treatment session, lesion lightening was graded from 1 to 4. Patient satisfaction with treatment was assessed using a visual analogue scale (VAS). Adverse events were also noted. Of the 45 patients included in the current study with a mean age of 52.71 ± 9.73 years, 11 (24.4%) were male. The Fitzpatrick skin type was II in 11 patients (24.4%), III in 23 (51.1%), and IV in 11 (24.4%). Lesion lightening and patient satisfaction were both significantly better with Q-switched laser compared to TCA peeling (standardized mean difference [SMD]=-1.25, 95% confidence interval [CI] -1.69; -0.79, p < 0.001 and SMD=-1.12, 95% CI -1.56; -0.67, p < 0.001, respectively). Overall, post-inflammatory hyperpigmentation (PIH) occurred in one patient in the laser group and for in the TCA group. Also, erythema and pruritus were observed in all patients of both groups after intervention which were treated with topical repair cream. Q-switched laser was superior to TCA peeling for the treatment of SLs in terms of lesion lightening and patient satisfaction with a large effect.

Skin needling with 100% trichloroacetic acid vs. needling with bleomycin in the treatment of recalcitrant cutaneous warts.

The treatment of warts has always been a challenging prospect for dermatologists. In some cases, these warts can become resistant or recalcitrant to treatment. Although a plethora of therapeutic and destructive options is available for wart management, to date no treatment has been found to be completely effective because none of the agents induce specific antiviral immunity. We conducted a study to evaluate the efficacy and safety of skin needling with topical 100% trichloroacetic acid (TCA) against the same type of skin needling with bleomycin in patients with recalcitrant cutaneous warts. In total, 33 (63.5%) patients in the TCA group and 35 (81.4%) in the bleomycin group had complete clearance of all the warts, which was not statistically significant (P = 0.13). There was also no statistically significant difference between the treated and untreated warts in the bleomycin group, whereas in the TCA group there was a significantly higher response rate in the treated warts. The most common adverse event (AE) in both groups was transient procedure site pain. We found that the use of needling plus TCA leads to a faster resolution of warts compared with needling plus bleomycin, with a comparable safety profile. Additionally, we found that TCA is superior to bleomycin for management of multiple warts. However, needling with either TCA or bleomycin has excellent and fairly comparable efficacy, and these methods should be used for the management of multiple or recalcitrant warts, as they have minimal AEs and recurrence rates.

Autoinoculation versus 35% trichloroacetic acid for the treatment of molluscum contagiosum: An open-label randomized controlled trial

Background: Despite the availability of different treatment modalities, molluscum is often recurrent after the treatment. Autoinoculation in molluscum is a recently studied modality. Objective: The aim of this article is to evaluate and compare the efficacy of autoinoculation and trichloroacetic acid (TCA) for the disappearance of molluscum contagiosum (MC). Methods: This prospective, randomized controlled trial was done in which a total of 128 patients of molluscum were divided into two groups of 64 patients each: Group A treated with autoinoculation and Group B received TCA application. The patients were followed-up till 6 months for efficacy and safety. Results: At the end of 3 months, a statistically significant (P=0.023) complete clearance of lesions was noted in Group A (80%) when compared with Group B (62%). At the end of 6 months, the recurrence rate was significantly less in the autoinoculation group (3%) than in the TCA group (42%). Conclusion: We conclude that autoinoculation appears to be a safe, simple, and efficacious procedure with better clearance, minimal expertise, recurrence, and complications when compared with TCA.

Molecular mechanisms underlying the effect of diacerein on trichloroacetic acid-induced hepatic pre-neoplastic lesions in rats.

IL-1β mediates angiogenesis indirectly, as it has been shown to induce hypoxia-inducible factor-1α (HIF-1α) which upregulates VEGF.

A Comparative Study of Topical 5% 5-Fluorouracil with Needling versus 30% Trichloroacetic Acid with Needling in the Treatment of Plantar Warts.

Background:Warts are benign proliferations of keratinocytes caused by Human Papilloma Virus (HPV). Plantar warts are caused by HPV types 1, 2, 4, 27 and 57. It is challenging to treat them due to frequent recurrences.Aim:To compare the efficacy and safety of topical 5% 5-Fluorouracil (5-FU) with needling versus 30% Trichloroacetic acid (TCA) with needling in the treatment of plantar warts.Materials and Methods:Sixty consecutive patients of plantar warts were randomly allocated into two groups of 30 each and treated with either 30% TCA with needling or 5% 5-FU with needling once in four weeks, until complete clearance of warts or for a maximum of three sessions. Baseline clinical photographs were taken and subjective response at the end of treatment was recorded. Objective assessment at 4, 8, and 12 weeks was carried out and outcome was evaluated by reduction in number and size of warts. Adverse effects of each group were noted and compared. Follow-up of patients was done at 6 months for clinical assessment of results and to study recurrence.Results:Out of 30 patients in 30% TCA group, 28 patients (93.33%) had complete response and 02 patients (6.66%) had partial response at the end of 12 weeks. In 5-FU group, 26 patients (86.66%) showed complete response, 02 patients (6.66%) had partial response, and 02 patients (6.66%) had no response to treatment. The mean reduction in size and number of warts was better in the TCA group and was significant at 4th week of follow up while at the end of 8th week and 12th week, the response was identical. There was no recurrence of warts in the complete responders at the end of 6 months. The main adverse effect seen in both groups was pain at the needling site.Conclusion:Needling with both topical 5% 5-FU and 30% TCA are highly effective in clearing plantar warts. However, 30% TCA has the advantage of early action and complete clearance of plantar warts with fewer adverse effects.

Efficacy of ultrapulse carbon dioxide laser ablation versus 30% trichloroacetic acid in xanthelasma palpebrarum - A randomised controlled trial

Context: Xanthelasma palpebrarum (XP) is the most common cutaneous xanthoma that develops around the eyes. A number of treatment modalities have been tried for its removal, but none are truly satisfactory. Trichloroacetic acid (TCA) is commonly used in Indian setting as it is easily available and cost-effective whereas carbon dioxide (CO2) laser has been tried increasingly due to its favorable cosmetic outcome. Aims: This study aims to compare the efficacy of ultrapulse CO2 laser ablation with 30% TCA in the treatment of XP. Setting and Design: Prospective, interventional, randomized study at a Dermatology Centre of a Tertiary Level Hospital from January 2017 to June 2018. Methods: Seventy-four patients with 100 lesions of XP were divided into two groups of flat and elevated lesions. Each group was further randomly divided into two subgroups and administered CO2 laser once a month and 30% TCA once in 2 weeks respectively for 3 months. Patients were clinically assessed at baseline and then at monthly intervals using visual analog scale (VAS), patient satisfaction score (PSS), and standardized photographs. The follow-up was done at the end of 3 and 6 months. Statistical Analysis and Results: Mean PSS and VAS score of TCA and laser in flat and elevated lesions were compared using independent group Student's t-test. Response to laser in elevated lesions was found to be statistically better whereas in flat lesions the response to TCA and laser were similar. Recurrence was 17% and 6% at 3 months' follow-up and 24% and 11% at 6 months' follow-up in TCA and laser groups, respectively. Conclusions: The end results of ultrapulse CO2 laser and 30% TCA are comparable in flat lesions of XP. In elevated lesions, laser has better efficacy, requires fewer sittings with lesser chance of recurrence.

Chemical Regeneration of Wound Defects: Relevance to the Canine Palatal Mucosa and Cell Cycle Up-Regulation in Human Gingival Fibroblasts.

Trichloroacetic acid (TCA) is an agent widely applied in dermatology for skin regeneration. To test whether TCA can offer an advantage for the regeneration of oral soft tissue defects, the cellular events following TCA application were explored in vitro and its influence on the oral soft tissue wound healing was evaluated in a canine palate model. The cytotoxicity and growth factor gene expression in human gingival fibroblasts were tested in vitro following the application of TCA at four concentrations (0.005%, 0.05%, 0.5% and 1%) with different time intervals (0, 3, 9 and 21h). One concentration of TCA was selected to screen the genes differentially expressed using DNA microarray and the associated pathways were explored. TCA was injected in open wound defects of the palatal mucosa from beagle dogs (n = 3) to monitor their healing and regeneration up to day 16-post-administration. While the 0.5-1% concentration induced the cytoxicity, a significantly higher expression of growth factor genes was observed after 3 and 9h following the 0.5% TCA application in comparison to other groups. DNA microarray analysis in 0.5% TCA group showed 417 genes with a significant 1.5-fold differential expression, involving pathways of cell cycle, FoxO signaling, p53 signaling, ubiquitin mediated proteolysis and cAMP signaling. In vivo results showed a faster reepithelialization of TCA-treated wounds as compared to spontaneous healing. TCA promoted the healing and regeneration of oral soft tissue wound defects by up-regulating the cell cycle progression, cell growth, and cell viability, particularly at a concentration of 0.5%.

Button graft and trichloroacetic acid for repair of small and medium-sized ear drum perforations

Introduction: Several techniques have been used for repairing tympanic membrane perforations starting from chemical cauterization of the edges of the perforation to the use of autologous graft materials such as temporalis muscle fascia, perichondrium and cartilage. Aim: To present our approach of combined use of cartilage perichondrium graft (button graft) and chemical cauterization with trichloroacetic acid (TCA) for repair small and medium sized perforations. Materials and Methods: In this study 80 patients with small and medium sized TM perforations included and divided into two groups. In the study group button graft (BG) combined with TCA cauterization was performed while conventional temporalis fascia graft (TFG) underlay myringoplasty was used in the control group. We compared the operative time, time needed for resuming usual physical activity, time needed for graft epithelialization and postoperative anatomical and functional restoration. Results: Mean operative time was 13.70±2.30 minutes in BG with TCA group and 42.40±6.45 minutes in TFG group (P value <0.001). Time needed for complete epithelization of the graft was (12.00±1.50 days) in BG with TCA approach and (21.40±2.20 days) in TFG myringoplasty (P value <0.001). There was no significant difference between both techniques as regard anatomical and functional restoration. Conclusion: Combined use of cartilage perichondrium graft and chemical cauterization with TCA is an effective technique which decreases operative time, allow for rapid postoperative healing with comparable anatomical and functional results.

Evaluation the efficacy of trichloroacetic acid (TCA) 33% in treatment of oral retinoid-induced cheilitis compared with placebo (Vaseline): a randomized pilot study

Background: Oral Isotretinoin (13-cis-retinoic acid) is a gold standardtreatment for severe forms of acne with cheilitis as a most frequent complication. We designed this novel study to investigate the therapeutic effect of trichloroacetic acid (TCA) 33% as compared with placebo to treat cheilitis.Methods: In this pilot study, 90 acne vulgaris patients between 18 and 50 years, who referred dermatologic clinic with cheilitis, were assigned to either case (TCA) or control (Vaseline) group using permuted-block randomization from 2013 to 2015 with data analysis in 2016. Patients had follow-up visits after 2 and 6 weeks, at which their lesions were photographed. Two blinded expert dermatologists recorded physician International global score for each image.Results: Ninety eligible patients were randomly allocated into two groups. This included 45 patients in each group. At the end of follow-up, 44 patients in the intervention group and 37 patients in control group completed the final assessment. Compared to the control group, the TCA group had a greater reduction in the mean ICGS value from baseline to Week 6 (mean difference 2.59 points, p < .0001).Conclusions: TCA can be considered as a good strategy in improvement of cheilitis to isotretinoin therapy.

Surface plasmon resonance based fiber optic trichloroacetic acid sensor utilizing layer of silver nanoparticles and chitosan doped hydrogel

In this study, we report a silver nanoparticles/chitosan doped hydrogel-based fiber optic sensor for the detection of trichloroacetic acid (TCA). The sensor is based on the combined phenomenon of localized and propagating surface plasmons. The sensing relies on the interaction of TCA with silver nanoparticles (AgNP) which results in the electron transfer between the negative group of TCA and positive amino group of AgNP stabilizer (chitosan). This alters the mechanical properties/refractive index of the AgNP embedded hydrogel matrix as well as the refractive index of the AgNP. The change in refractive index of both in turn changes the effective refractive index of the nanocomposite hydrogel layer which can be determined using the Maxwell–Garnet Theory. Four stage optimization of the probe fabrication parameters is performed to obtain the best performance of the sensing probe. The sensor operates in the TCA concentration range 0–120 μm which is harmful for the humans and environment. The shift in peak extinction wavelength observed for the same TCA concentration range is 42 nm. The sensor has the linearity range for the TCA concentration range of 40–100 μm. The sensor possesses high sensitivity, selectivity and numerous other advantages such as ease of handling, quick response, modest cost and capability of online monitoring and remote sensing.

Histological evaluation of the effect of trichloroacetic acid and mineral trioxide aggregate on human teeth pulp

Objective: The objective of this study was to compare between the effects of two medicaments [trichloroacetic acid (TCA) and mineral trioxide aggregate (MTA)] on the remaining pulp tissue of the young permanent teeth after pulpotomy. Materials and methods: The present study comprised 30 premolars. Pulpotomy procedure was performed. The radicular pulp was capped with MTA in premolar in one side and with TCA in those of the other side. Premolars were reviewed after successive periods (1 week, 1, and 3 months). Teeth were extracted after examination periods. Sections was then stained by standard hematoxylin and eosin stain. Results and conclusion: Bridge formation was seen in TCA group after 3 months which is a desirable finding in pulpotomy procedures, whereas MTA is superior to TCA in treating pulps in human teeth.

Comparative Study to Evaluate the Efficacy of Radiofrequency Ablation versus Trichloroacetic Acid in the Treatment of Xanthelasma Palpebrarum.

Background:Xanthelasma palpebrarum (XP) is a metabolic disorder involving the eyelids. Radiofrequency(RF) surgery and trichloroacetic acid (TCA) applications have been listed among the procedures for XP, but comparative studies are not available.Aim:To compare the efficacy of radiofrequency surgery versus trichloroacetic acid application in the treatment of XP.Settings and Design:20 consecutive cases of XP attending dermatology, medicine and endocrinology out-patient departments of M.S. Ramaiah teaching hospital were enrolled for the study. It was an open-label clinical trial conducted in our hospital for a duration of 1 year.Materials and Methods:20 consecutive patients conforming to inclusion criteria were selected for the study. For each patient, lesions were treated with radiofrequency ablation on one side and TCA application on the other side.Results:RF ablation was done for 12 patients over right eye lesions and 8 patients over the left eye lesions. TCA applications were done for 8 patients over right eye lesions and 12 patients over left eye lesions. 70% of lesions treated with RF ablation had a score of improvement of 4 and 70% of lesions treated with TCA application had a score of improvement of 4, at 4 weeks of follow-up. At four weeks of follow-up 40% in RF group and 15% in TCA group had scarring and 45% in RF group and 30% in TCA group had pigmentation.Conclusion:RF ablation as compared to TCA application, required fewer sessions for achieving more than 75% clearance of lesions. However, TCA applications were associated with fewer complications comparatively.

Comparison of efficacy of chemical peeling with 25% trichloroacetic acid and 0.1% retinoic acid for facial rejuvenation.

IntroductionSkin aging is a problem which negatively affects the psyche of the person, social relations, as well as work life and health and which compels the patients to find appropriate treatment methods. Numerous treatment methods have been developed in order to delay aging and to reduce the aging effects in addition to having a younger, healthier and more beautiful facial appearance.AimTo compare the efficiency, cosmetic results and possible adverse effects of the peeling treatment with 25% trichloroacetic acid (TCA) and 0.1% retinoic acid for facial rejuvenation in patients presenting with skin aging.Material and methodsFifty female patients in total presenting with medium and advanced degree skin aging were subject to this study. Two separate treatment groups were formed; the first group underwent chemical skin treatment with 25% TCA while the other group was applied with 0.1% retinoic acid treatment. Following the 4 months’ treatment the patients were controlled three times in total for post lesional hypopigmentation, hyperpigmentation, scars, skin irritation and other possible changes per month. The pretreatment and first follow-up visit, and final control images were comparatively evaluated by three observers via specific software.ResultsThe healing rates of the group subject to retinoic acid were statistically higher (p < 0.05) compared to patients in the TCA group in the final follow-up visit following the treatment according to the first and second observers. On the other hand, according to the third observer, patients applied with retinoic acid presented with higher healing rates compared to those treated with TCA, however; this rate was not statistically significant (p > 0.05). The frequency of TCA- and retinoic acid-associated adverse effects was similar in both groups (p > 0.05). As a result of both treatments, a reduction in the quality of life scores as well as a pronounced recovery (p = 0.001) in the quality of life of those patients with skin aging was observed.ConclusionsThe photo aging treatment option with 0.1% retinoic acid is cheaper and more feasible for patients compared to 25% TCA, and it is also as reliable and effective as TCA.

An open, comparative clinical study on the efficacy and safety of 10% trichloroacetic acid, 25% trichloroacetic acid and cryotherapy for verruca plana

Objective: Although there are several methods to treat Verruca plana, warts do not respond well to the common therapeutic options. In this study, we compared the safety and efficacy of 10% trichloroacetic acid, 25% trichloroacetic acid, and cryotherapy for the treatment of warts caused by Verruca plana.Methods: Ten percent and 25% trichloroacetic acid were applied to warts weekly until all lesions cleared. Cryotherapy was performed by liquid nitrogen spray for 5–10 seconds for each lesion per week until the lesions cleared. The number of Verruca plana lesions and adverse effects were evaluated five times during the treatment (the initial visit, week 2, week 4, week 6, and week 8).Results: The number of lesions decreased through week 8 for all three treatments, and the reductions in the mean numbers of lesions were statistically similar (p > 0.05). Those in the cryotherapy group exhibited more erythema, pain, erosions, bullae, and hyperpigmentation (p < 0.001, p < 0.001, p < 0.001, p < 0.05, and p = 0.001, respectively) than those in either TCA group. Itching was more common among those in the trichloroacetic acid groups than in the cryotherapy group (p < 0.05). Additionally, hyperpigmentation, erythema, pain, and itching were more frequent in the 25% trichloroacetic acid group than in the 10% trichloroacetic acid group (p < 0.001), (p < 0.05), (p < 0.05), (p < 0.05).Conclusion: Ten percent trichloroacetic acid, 25% trichloroacetic acid, and cryotherapy are effective methods to treat Verruca plana. 10% trichloroacetic acid offers a safer and easier treatment than either 25% trichloroacetic acid or cryotherapy.

Novel Panel of Early Diagnostic Markers for Experimental Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) accounts for 80% to 90% of primary liver cancer and it is a major health problem worldwide, ranking the fifth most common cancer in the world. In the present study we aimed to explore new or highly pertinent rapid and sensitive markers for early diagnosis of hepatocellular malignant changes. Two groups of rats were used in this study, one served as control, the second as trichloroacetic acid (TCA) challenged group (0.5 g/kg/d for 5 days, sacrificed after 4 weeks). The results showed that TCA group had a significant increase in blood alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase ( ALP), and acetyl CoA synthase (ACAS) activities, total bilirubin, triglycerides, total glycosaminoglycans (TGAGs), parallel with alpha-fetoprotein (AFP). On the other hand, it induced a significant reduction in serum total lipoprotein lipase (TLPL) activity. The histopathological investigations of hepatic tissue confirmed these neoplastic changes induced by TCA. The three parameters (TGAGs level, TLPL and ACAS activities) can be added as new markers for early diagnosis of hepatocellular carcinoma and elevation of the sensitivity and specificity of AFP.

The comparison between trichloroacetic acid 50% and CO2laser in the treatment of cutaneous leishmaniasis scar

Background:The scars of the cutaneous leishmaniasis and psychological problems of this disease need different interventions for its correction.Aim:Our objective in this study was to compare the efficacy of 50% trichloroacetic acid (TCA) solution and CO2 laser for treatment of the atrophic scars due to leishmaniasis.Materials and Methods:This was a randomized clinical trial performed in 92 patients. Patients were randomized into two groups: the first group was treated with 50% TCA solution, once monthly and for a maximum of 5 months, and the second group was treated with CO2 laser which was performed for only one time. Patients were followed-up at 3 and 6 months after starting the treatment. The improvement of scar was graded by a 6-point scale using digital camera and the collected data were analyzed using SPSS software.Results:In this study, 74 females and 18 males were enrolled. The improvement of scar was 48.13% in the TCA group and 44.87% in the CO2 laser group. This difference was not statically significant (P = 0.55). There was also no significant difference regarding side effects between these two groups.Conclusion:The results of our study showed that efficacy of focal with 50% TCA solution is compared with CO2 laser in treatment of leishmaniasis scar. Because of the low cost and simple application of TCA solution in comparison with CO2 laser, we suggest use of this treatment for correction of leishmaniasis scar or the atrophic scars.