To compare the efficacy and safety of trichloroacetic acid peel with topical tretinoin in the treatment of acanthosis nigricans: A randomized controlled study

Harish Muddanahalli Rajegowda, Deepadarshan Kalegowda, Shashikumar Basavapura Madegowda, Kavya Manjunath, Thabassum A

Abstract


Background Acanthosis nigricans (AN) is a common pigmentary disorder with several therapeutic modalities to treat. Topical tretinoin is the first drug of choice in the treatment of acanthosis nigricans, however, trichloroacetic acid (TCA) peel has also shown efficacy in the treatment of AN recently.

 

Objective The study aimed to compare the efficacy & safety of trichloroacetic acid peel versus topical tretinoin in the treatment of acanthosis nigricans.

 

Material and Methods Fifty patients with acanthosis nigricans were selected and randomly allocated into two groups, where group A was treated with topical tretinoin 0.025% daily and group B with 15% trichloroacetic acid peel once in 15 days. Patients were assessed every fortnight for the improvement for 2 months. The degree of improvement was assessed using a grading system i.e., upto 25% - minimal, 26-50% - moderate, 51-75% - good and >75% - excellent improvement.

 

Results A total of 41 patients completed the study. At the end of treatment period 47.62% (n=10) patients in group A and 85% (n=17) patients in group B showed moderate improvement and 23.81% (n=5) in group A and 5% (n=1) in group B showed good improvement (p=0.0395). Side effects like erythema, burning sensation were more with topical tretinoin compared to TCA.

 

Conclusion Topical tretinoin 0.025% cream is more efficacious than 15% TCA. Though TCA is less efficacious, it is safe and well tolerated. Hence 15% TCA peel can be considered as a second line therapy in management of acanthosis nigricans.

 


Keywords


Acanthosis nigricans, tretinoin cream, trichloroacetic acid peel

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