24684165
BACKGROUND	Post-inflammatory hyperpigmentation is a frequent concern when treating solar lentigines .
OBJECTIVE	To assess the safety and efficacy of a triple combination cream with fluocinolone acetonide 0.01 % , hydroquinone 4 % and tretinoin 0.05 % as adjuvant to cryotherapy in the treatment of solar lentigines in hands dorsum , and in the prevention of post-inflammatory hyperpigmentation after cryotherapy .
METHODS	This prospective , randomized , controlled , investigator-blinded , single-centre study enrolled 50 patients .
METHODS	Twenty-five patients received a 2-week daily triple combination cream plus sunscreen pre-treatment and 25 received sunscreen alone .
METHODS	After that , cryotherapy was performed in all patients followed by a 3-week recovery period .
METHODS	After this period , patients received the same initial treatment and were followed up for 8weeks .
METHODS	Melanin and erythema levels of a target and a control lentigo were objectively measured using a narrowband reflectance spectrophotometer .
METHODS	Lentigines count , colour homogeneity and global improvement were also assessed .
RESULTS	The number of solar lentigines reduced in the first 2weeks only in patients who used the triple combination 257 vs. 228 ( P < 0.0001 ) , and reduced at the end of the study for both groups ( P < 0.0001 ) .
RESULTS	The melanin levels also reduced in the first 2weeks only in patients who used the triple combination 29769 vs. 27366 ( P < 0.0001 ) and reduced at the end of the study for both groups ( P < 0.0001 ) .
RESULTS	Erythema and residual blisters from cryotherapy were the reported adverse reactions .
CONCLUSIONS	Triple combination cream can be used to enhance the resolution of solar lentigines , and to significantly reduce melanin levels and lentigines count , improving treatment results .
CONCLUSIONS	It was well-tolerated and did not increase the occurrence of neither erythema nor other side-effects after the cryotherapy .

