Hong Kong - Members of the Pigmentary Disorders Academy (PDA)discussed a spectrum of topical issues, finalized revisions tomanuscripts for a supplement to the Journal of the American Academyof Dermatology, and decided to undertake a global, community-basedsurvey investigating the natural history of melasma as the nextmajor project when the group convened its third annual meetinghere.
"We expect to develop a cross-culturally validated survey instrument that will allow us to collect quality, robust, global data on a topic that is underexplored but of critical importance," said Jean-Paul Ortonne, M.D. Dr. Ortonne is chairman of the PDA and is professor and chairman, department of dermatology, University of Nice, Sophia Antipolis, France.
The PDA comprises 16 dermatologist members representing 11 countries in North America, South America, Europe and Asia. It was established in 2003 through an unrestricted grant from Galderma Laboratories, Paris, and has continued to operate thanks to the generous support of that company.
New research directions
At past meetings, members of the PDA worked to develop a common lexicon for pigmentary disorders, guidelines for best practices in conducting clinical trials for various pigmentary disorders, and critical evaluations of treatment options for melasma, solar lentigines and post-inflammatory hyperpigmentation. Meeting discussions included a review of a variety of topics to explore new areas where the group can play an active role in advancing research and knowledge.
The decision to undertake a survey of melasma epidemiology was based on recognition that accurate information is lacking regarding disease associations, chronicity, recurrence and social implications.
Presentations by various PDA members during the meeting highlighted the paucity of information about melasma epidemiology and management. For example, while melasma is considered a relapsing disorder, based on her personal literature review, Dr. Taylor reported there have been no published studies designed specifically to examine chronicity.
Marta Rendon, M.D., undertook an in-depth literature review of studies investigating concomitant use of topical therapy and procedural modalities for the management of melasma. Her conclusions were that while information about mechanisms of action provides a plausible basis for combining different approaches, an evidence base conclusively demonstrating benefits is lacking.
Recognizing the lack of evidence-based research, several members of the group suggested different studies with clearly designed objectives that might be undertaken to obtain more definitive information on the safety and efficacy of combination topical/procedural therapy.