Abstract: Huang Jun, Hu Wenting, Zhang Lingling, Xu Ai′e Department of Dermatology, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medicine University, Hangzhou 310009, China Corresponding author: Xu Ai′e, Email: xuaiehz@msn.com 【Abstract】 Objective To evaluate the clinical efficacy of compound glycyrrhizin injection in the treatment of melasma. Methods A total of 30 melasma patients with blood vessel scores of ++ or +++ and melanin scores of ++ or +++, which were evaluated by dermoscopy and reflectance confocal microscopy （RCM） respectively, were collected from the Department of Dermatology of Hangzhou Third Hospital between May 2015 and July 2016. All the patients were randomly divided into 2 groups by drawing lots: treatment group treated with intravenous drips of compound glycyrrhizin injection at a dose of 40 ml once every three days for 8 sessions, oral vitamin C tablets at a dose of 0.2 g thrice a day, and oral vitamin E tablets at a dose of 0.1 g once a day, and control group treated with oral vitamin C and vitamin E tablets at the same dose as the treatment group. Three months after starting the treatment, the therapeutic effect was evaluated using melasma area and severity index（MASI）. Meanwhile, RCM, dermoscopy and VISIA skin detector were used to detect skin lesions, and the melanin score, blood vessel score and brown spot and erythema indices were calculated. Results For the treatment group, the melanin score and blood vessel score were both significantly decreased at 3 months after starting the treatment compared with those before the treatment （Z =2.773, 3.135, P = 0.006, 0.002, respectively）, so were the brown spot index （38.3 ± 3.1 vs. 43.9 ± 5.8, Z = 3.091, P = 0.002）and erythema index （26.5 ± 5.6 vs. 33.3 ± 7.7, t = 2.752, P = 0.010）. For the control group, the melanin score significantly decreased at 3 months after starting the treatment compared with those before the treatment （P = 0.023）, while no significant differences were observed in the blood vessel score or VISIA indices （P > 0.05）. Three months after starting the treatment, 9 cases showed marked improvement, and 6 showed improvement in the treatment group; 3 cases showed marked improvement, 11 improvement, and 1 showed no improvement in the control group. The therapeutic effect in the treatment group was significantly superior to that in the control group （Z = 2.276, P = 0.029）. Conclusion Compound glycyrrhizin injection is effective for the treatment of melasma, and RCM, dermoscopy and VISIA skin detector can be used to assist efficacy evaluation in melasma.

Key words: Chloasma, Glycyrrhizic acid, Microscopy, confocal, Dermoscopy, Treatment outcome, Compound glycyrrhizin injection