Melasma is an acquired hypermelanosis skin disorder that commonly affects women than men. It is characterized by irregular light to dark brown macules occurring in the sun-exposed areas of the face, neck and arms.
It occurs most commonly with pregnancy and with the use of contraceptive pills.
Other factors implicated in the etiopathogenesis are photosensitizing medications, mild ovarian or thyroid dysfunction and certain cosmetics.
Solar and ultraviolet exposure is the most common important factor in its development.
Taking the oral extract product of the fern Polypodium leucotomos (PLE) on top of the standard topical hydroquinone cream and sunscreen reduces the severity of melasma to a greater extent compared with the standard treatment alone in Asian patients, a pilot study has shown.
Tranexamic acid shows potential in the treatment of melasma, demonstrating efficacy when used alone or in combination with other modalities while inducing relatively few side effects, according to a literature review.
In patients with atrial fibrillation (AF) and stable coronary artery disease (CAD), rivaroxaban monotherapy is noninferior to combination treatment with an antiplatelet therapy in terms of cutting the risk of cardiovascular events and mortality, according to data from the AFIRE trial.
Many patients with nonvalvular atrial fibrillation (NVAF) in Thailand use anticoagulants, but the uptake of nonvitamin-K oral anticoagulants remains suboptimal despite showing an upward trend, according to data from the COOL-AF registry presented at the European Society of Cardioloy (ESC) Asia Congress 2019 with APSC and AFC.