Microsoft PowerPoint - Poster Lentigo_20210218 • Cysteamine is an aminothiol derived from coenzyme A degradation in mammalian cells and is naturally found in human breast milk.1 Serving as intracellular anti- oxidant, Cysteamine has anti-carcinogenic effect.1 • Chavin first discovered the potent depigmenting effect of Cysteamine in vivo in 1966.2 But its topical use was historically prohibited due to a very offensive odor and rapid oxidation. • Scientis developed in 2012 a unique stabilization method that allowed the use of Cysteamine topically. • Multiple studies have demonstrated the significant efficacy in the treatment of melasma3-8 and PIH10, with comparable or better results than Hydroquinone5-6, Kligman’s Formula7-8 and mesotherapy with Tranexamic acid.9 • Cysteamine has a broad action in the regulation of melanogenesis: o Enzymatic effect: inhibition of tyrosinase and peroxidase. o Chemical effect: chelation of mineral ions, preventing Fenton-type reactions. o Antioxidant: lightening of dark melanin in stratum corneum. o Cascade reaction: increase of intracellular glutathione, amplifying natural depigmenting effects. What is Cysteamine ?What is Cysteamine ? • Solar lentigines are macules and hyperpigmented patches ranging from a few millimeters to a few centimeters.11 • The prevalence of solar lentigo is associated with aging, in which 90% of white-skinned people over the age of 60 years have these lesions. 12 • In 2008, a study shows the impact on Quality of life of lentigo : >40% of 105 US patients with lentigo were embarrassed because of their skin. • Topical depigmenting products are usually ineffective for the treatment of lentigines. Lentigines are also resistant to Triple Combination therapy, as indicated by Dr Kligman.14 Why focus on Lentigo ?Why focus on Lentigo ? Results with Cysteamine 5%Results with Cysteamine 5% • Significant improvement of senile lentigos after 12 weeks • 40% reduction of colorimetry • Topical Cysteamine (Cyspera®) is one of the first monotherapy treatments demonstrating significant efficacy in reduction of dorsal hand lentigines by all evaluation methods. ConclusionConclusion 1. Besouw, M, and al. (2013). "Cysteamine: an old drug with new potential". Drug Discovery Today. 18 (15-16): 785–792. https://doi.org/10.1016/j.drudis.2013.02.003 2. Chavin, W.; Schlesinger, W. (1966). "Some potent melanin depigmentary agents in the black goldfish". Die Naturwissenschaften 53(16): 413–414. https://doi.org/10.1007/BF00625789 3. Mansouri, P and al. (2015)."Evaluation of the efficacy of cysteamine 5% cream in the treatment of epidermal melasma: a randomized double-blind placebo-controlled trial". The British Journal of Dermatology. 173 (1): 209–21. https://doi.org/10.1111/bjd.13424 4. Farshi et al. (2018). ”Efficacy of cysteamine cream in the treatment of epidermal melasma, evaluating by Dermacatch : a randomized double blind placebo controlled study”. J. Dermatol. Treat. 29:2, 182- 189. https://doi.org/10.1080/09546634.2017.1351608 5. Fitzpatrick and al. (1968). "Selective action of mercaptoethylamines on melanocytes in mammalian skin: experimental depigmentation". Arch Dermatol 97:465–77 10. 6. Nguyen et al. (2020). “Evaluation of the efficacy of cysteamine cream compared to hydroquinone in the treatment of melasma: A randomised, double-blinded trial” Aust. J. Dermatol. https://doi.org/10.1111/ajd.13432 7. Kasraee et al. (2019). “Significant therapeutic response to cysteamine cream in a melasma patient resistant to Kligman's formula”. J Cosmet Dermatol. 18(1):293-295. https://doi.org/10.1111/jocd.12837 8. Karrabi et al. (2020). “Clinical evaluation of efficacy, safety and tolerability of cysteamine 5% cream in comparison with modified Kligman’s formula in subjects”, Skin Res Technol. https://doi.org/10.1111/srt.12901 9. Karrabi, and al. (2020). ”Clinical evaluation of efficacy and tolerability of cysteamine 5% cream in comparison with tranexamic acid mesotherapy in subjects with melasma: a single-blind, randomized clinical trial study”. Arch Dermatol Res. https://doi.org/10.1007/s00403-020-02133-7 10. Mathe, Balogun, Yoo. (2021). “A case report on the use of topical cysteamine 5% cream in the management of refractory postinflammatory hyperpigmentation (PIH) resistant to triple combination cream (hydroquinone, topical corticosteroids, and retinoids)”. J Cosmet Dermatol. ; 20: 204- 206. https://doi.org/10.1111/jocd.13755 11. James WD and al. (2011). “Andrew’s Diseases of the Skin E-Book: Clinical dermatology” Elsevier Health Sciences 12. Šitum M and al. (2010). “Senile lentigo–cosmetic or medical issue of the elderly population”. Collegium antropologicum. 34(2):85-8. 13. Taylor A and al. (2008). “Prevalence of pigmentary disorders and their impact on quality of life: a prospective cohort study”. J Cosmet Dermatol. Sep;7(3):164-8. https://doi.org/10.1111/j.1473- 2165.2008.00384.x 14. Kligman, A. M., & Willis, I. (1975). “A new formula for depigmenting human skin. Archives of dermatology, 111(1), 40-48. doi:10.1001/archderm.1975.01630130042004 ReferencesReferences • Randomized, double-blinded; 30 subjects with dorsal hand lentigines • Cyspera® Cysteamine 5% from Scientis vs vehicle, 15-minutes daily short contact; Sunscreen daily • Colorimetry and visual analogue scale (VAS) at baseline, 4-weeks, 8-weeks and 12-weeks • Mean age 49.5; Gender 8:22 M:F distributed equally Material & MethodsMaterial & Methods Vehicle Cysteamine 0 50 100 150 200 250 300 350 400 450 500 387 294 397 481 COLORIMETRY Vehicle Cysteamine 0 1 2 3 4 5 6 7 8 9 7.46 5.09 7.33 8.27 VAS Subject 1 Baseline week-12 Subject 2 Baseline week-12 40% reduction in colorimetry (p<0.002) vs 2% reduction in non-treatment arm (p<0.405) 40% reduction In VAS (p<0.001) vs 2% reduction in non-treatment arm p<0.245) Learn more about the product: Stabilized Cysteamine 5% Cream for the Treatment of Senile Lentigo Nasrin Saki, MD, Shiraz University of Medical Sciences Stabilized Cysteamine 5% Cream for the Treatment of Senile Lentigo Nasrin Saki, MD, Shiraz University of Medical Sciences