array:22 [
  "pii" => "S2666275224001838"
  "issn" => "26662752"
  "doi" => "10.1016/j.abdp.2024.07.028"
  "estado" => "S300"
  "fechaPublicacion" => "2024-11-01"
  "aid" => "1010"
  "copyrightAnyo" => "2024"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "en" => array:17 [
      "pii" => "S0365059624001685"
      "issn" => "03650596"
      "doi" => "10.1016/j.abd.2023.10.005"
      "estado" => "S300"
      "fechaPublicacion" => "2024-11-01"
      "aid" => "1010"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:1 [
        "total" => 0
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Letter - Research</span>"
        "titulo" => "Lack of efficacy of oral N-acetylcysteine &#8203;&#8203;in the treatment of facial melasma in women&#58; a randomized&#44; double-blind&#44; placebo-controlled clinical trial"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "928"
            "paginaFinal" => "931"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:8 [
            "identificador" => "fig0005"
            "etiqueta" => "Fig&#46; 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 2310
                "Ancho" => 3008
                "Tamanyo" => 329629
              ]
            ]
            "detalles" => array:1 [
              0 => array:3 [
                "identificador" => "at0085"
                "detalle" => "Fig&#46; "
                "rol" => "short"
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Graphs of the variation in mMASI &#40;A&#41;&#44; MELASQoL &#40;B&#41;&#44; colorimetry &#40;Dif-&#42;L - C&#41;&#44; and assessment of improvement between the studied groups &#40;GAIS &#8210; Global Aesthetic Improvement Scale - D&#41;&#44; at T8&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Melissa de Almeida Corr&#234;a Alfredo, Ingrid Rocha Meireles Holanda, Daniel Pinho Cassiano, Ana Cl&#225;udia Cavalcante Esp&#243;sito, Paula Basso Lima, H&#233;lio Amante Miot"
            "autores" => array:6 [
              0 => array:2 [
                "nombre" => "Melissa de Almeida Corr&#234;a"
                "apellidos" => "Alfredo"
              ]
              1 => array:2 [
                "nombre" => "Ingrid Rocha Meireles"
                "apellidos" => "Holanda"
              ]
              2 => array:2 [
                "nombre" => "Daniel Pinho"
                "apellidos" => "Cassiano"
              ]
              3 => array:2 [
                "nombre" => "Ana Cl&#225;udia Cavalcante"
                "apellidos" => "Esp&#243;sito"
              ]
              4 => array:2 [
                "nombre" => "Paula Basso"
                "apellidos" => "Lima"
              ]
              5 => array:2 [
                "nombre" => "H&#233;lio Amante"
                "apellidos" => "Miot"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "pt" => array:9 [
          "pii" => "S2666275224001838"
          "doi" => "10.1016/j.abdp.2024.07.028"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "pt"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224001838?idApp=UINPBA00008Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059624001685?idApp=UINPBA00008Z"
      "url" => "/03650596/0000009900000006/v1_202410230911/S0365059624001685/v1_202410230911/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "S2666275224001814"
    "issn" => "26662752"
    "doi" => "10.1016/j.abdp.2024.07.026"
    "estado" => "S300"
    "fechaPublicacion" => "2024-11-01"
    "aid" => "1007"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "pt" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Cartas &#8208; Investiga&#231;&#227;o</span>"
      "titulo" => "Nevos melanoc&#237;ticos e melanomas da mucosa oral&#58; descri&#231;&#227;o detalhada de s&#233;rie de casos"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "931"
          "paginaFinal" => "936"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1847
              "Ancho" => 2500
              "Tamanyo" => 1044470
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Nevos intramucosos e azuis&#46; &#40;A&#41; Edema nodular coberto por mucosa &#237;ntegra na regi&#227;o esquerda do palato correspondendo a nevo melanoc&#237;tico intramucoso&#46; &#40;B&#41; Ninhos de c&#233;lulas n&#233;vicas pigmentadas separadas do revestimento epitelial por membrana basal evidente&#46; Observar c&#233;lulas poligonais e epitelioides na regi&#227;o subepitelial e as c&#233;lulas profundas semelhantes a linf&#243;citos &#40;Hematoxilina &#38; eosina&#44; barra de escala&#58; 50<span class="elsevierStyleHsp" style=""></span>&#956;&#41;&#46; C&#44; Nevo azul mostrando c&#233;lulas fusiformes anguladas&#44; profundamente assentadas com neurotiza&#231;&#227;o&#44; tipo C &#40;Hematoxilina &#38; eosina&#44; barra de escala&#58; 50<span class="elsevierStyleHsp" style=""></span>&#956;&#41;&#46; D&#44; Nevo azul composto por c&#233;lulas fusiformes e dendr&#237;ticas contendo pigmento melanina acastanhado &#40;Hematoxilina &#38; eosina&#44; barra de escala&#58; 50<span class="elsevierStyleHsp" style=""></span>&#956;&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Izadora Fernanda Veiga de Jesus Costa, Deyla Duarte Carneiro Vilela, Bruno Cunha Pires, Jener Gon&#231;alves de Farias, Val&#233;ria Souza Freitas, Jean Nunes dos Santos"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Izadora Fernanda Veiga de Jesus"
              "apellidos" => "Costa"
            ]
            1 => array:2 [
              "nombre" => "Deyla Duarte Carneiro"
              "apellidos" => "Vilela"
            ]
            2 => array:2 [
              "nombre" => "Bruno Cunha"
              "apellidos" => "Pires"
            ]
            3 => array:2 [
              "nombre" => "Jener Gon&#231;alves de"
              "apellidos" => "Farias"
            ]
            4 => array:2 [
              "nombre" => "Val&#233;ria Souza"
              "apellidos" => "Freitas"
            ]
            5 => array:2 [
              "nombre" => "Jean Nunes dos"
              "apellidos" => "Santos"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0365059624001648"
        "doi" => "10.1016/j.abd.2024.03.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059624001648?idApp=UINPBA00008Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224001814?idApp=UINPBA00008Z"
    "url" => "/26662752/0000009900000006/v1_202410301154/S2666275224001814/v1_202410301154/pt/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2666275224001899"
    "issn" => "26662752"
    "doi" => "10.1016/j.abdp.2024.07.034"
    "estado" => "S300"
    "fechaPublicacion" => "2024-11-01"
    "aid" => "1016"
    "copyright" => "Sociedade Brasileira de Dermatologia"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "pt" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Cartas &#8208; Investiga&#231;&#227;o</span>"
      "titulo" => "Guselcumabe&#44; risanquizumabe e tildraquizumabe demonstram efic&#225;cia e seguran&#231;a semelhantes no tratamento da psor&#237;ase&#58; estudo comparativo direto na pr&#225;tica cl&#237;nica"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "922"
          "paginaFinal" => "927"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 2287
              "Ancho" => 3508
              "Tamanyo" => 467425
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Resultados de PASI &#40;A&#41;&#44; ASC &#40;B&#41;&#44; DLQI &#40;C&#41; e IGA &#40;D&#41;&#46; Uma tend&#234;ncia evidente de diminui&#231;&#227;o dos valores para todas as quatro medidas com os tr&#234;s medicamentos pode ser observada &#224; medida que as semanas de observa&#231;&#227;o avan&#231;am&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Miguel Mansilla&#8208;Polo, Antonio Sahuquillo&#8208;Torralba, Conrad Pujol&#8208;Marco, Guillermo Bargues&#8208;Navarro, Rafael Botella&#8208;Estrada"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Miguel"
              "apellidos" => "Mansilla&#8208;Polo"
            ]
            1 => array:2 [
              "nombre" => "Antonio"
              "apellidos" => "Sahuquillo&#8208;Torralba"
            ]
            2 => array:2 [
              "nombre" => "Conrad"
              "apellidos" => "Pujol&#8208;Marco"
            ]
            3 => array:2 [
              "nombre" => "Guillermo"
              "apellidos" => "Bargues&#8208;Navarro"
            ]
            4 => array:2 [
              "nombre" => "Rafael"
              "apellidos" => "Botella&#8208;Estrada"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0365059624001740"
        "doi" => "10.1016/j.abd.2024.04.004"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059624001740?idApp=UINPBA00008Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224001899?idApp=UINPBA00008Z"
    "url" => "/26662752/0000009900000006/v1_202410301154/S2666275224001899/v1_202410301154/pt/main.assets"
  ]
  "pt" => array:17 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Cartas &#8208; Investiga&#231;&#227;o</span>"
    "titulo" => "Aus&#234;ncia de efic&#225;cia da N&#8208;acetilciste&#237;na oral no tratamento do melasma facial em mulheres&#58; ensaio cl&#237;nico randomizado&#44; duplo&#8208;cego e controlado com placebo"
    "tieneTextoCompleto" => true
    "saludo" => "<span class="elsevierStyleItalic">Prezado Editor&#44;</span>"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "928"
        "paginaFinal" => "931"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Melissa de Almeida Corr&#234;a Alfredo, Ingrid Rocha Meireles Holanda, Daniel Pinho Cassiano, Ana Cl&#225;udia Cavalcante Esp&#243;sito, Paula Basso Lima, H&#233;lio Amante Miot"
        "autores" => array:6 [
          0 => array:3 [
            "nombre" => "Melissa de Almeida Corr&#234;a"
            "apellidos" => "Alfredo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Ingrid Rocha Meireles"
            "apellidos" => "Holanda"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Daniel Pinho"
            "apellidos" => "Cassiano"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Ana Cl&#225;udia Cavalcante"
            "apellidos" => "Esp&#243;sito"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Paula Basso"
            "apellidos" => "Lima"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:4 [
            "nombre" => "H&#233;lio Amante"
            "apellidos" => "Miot"
            "email" => array:1 [
              0 => "helio.a.miot@unesp.br"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Departamento de Infectologia&#44; Dermatologia&#44; Diagn&#243;stico por Imagem e Radioterapia&#44; Faculdade de Medicina&#44; Universidade Estadual Paulista&#44; Botucatu&#44; SP&#44; Brasil"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Departamento de Dermatologia&#44; Universidade Federal de S&#227;o Paulo&#44; S&#227;o Paulo&#44; SP&#44; Brasil"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Departamento de Medicina&#44; Universidade do Oeste Paulista&#44; Unoeste&#44; Presidente Prudente&#44; SP&#44; Brasil"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspond&#234;ncia&#46;"
          ]
        ]
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1386
            "Ancho" => 2508
            "Tamanyo" => 212163
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Melasma facial tratado com fotoprote&#231;&#227;o e placebo oral&#44; por oito semanas&#46; &#40;A&#41; Antes do tratamento&#46; &#40;B&#41; Ap&#243;s o tratamento&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Melasma &#233; discromia cr&#244;nica adquirida&#44; mais prevalente em mulheres na menacme e caracterizado por hipermelanose cut&#226;nea em &#225;reas fotoexpostas&#44; especialmente a face&#46; O melasma pode ser desencadeado por fotoexposi&#231;&#227;o&#44; gesta&#231;&#227;o&#44; altera&#231;&#245;es hormonais e medicamentos&#44; por&#233;m sua patog&#234;nese n&#227;o &#233; completamente compreendida&#44; refletindo&#8208;se na frequente recorr&#234;ncia ap&#243;s o tratamento&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">O estresse oxidativo&#44; causado por fatores externos como exposi&#231;&#227;o &#224; radia&#231;&#227;o solar&#44; dist&#250;rbios do sono&#44; polui&#231;&#227;o&#44; inflama&#231;&#227;o da pele e estresse emocional&#44; pode induzir e perpetuar a melanog&#234;nese&#44; independentemente da irradia&#231;&#227;o ultravioleta&#46; Ademais&#44; a eumelanog&#234;nese &#233; um processo oxidativo intracelular&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">1</span></a> Marcadores s&#233;ricos de estresse oxidativo s&#227;o elevados em pacientes com melasma&#44; havendo forte correla&#231;&#227;o entre n&#237;veis de glutationa peroxidase plasm&#225;tica e sua gravidade&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">1&#44;3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Nos &#250;ltimos anos&#44; antioxidantes orais e t&#243;picos mostraram&#8208;se eficazes no tratamento do melasma&#59; entretanto&#44; nenhum ensaio cl&#237;nico foi conduzido com N&#8208;acetilciste&#237;na&#44; que constitui composto &#8220;tiol&#8221; e atua como doador de L&#8208;ciste&#237;na&#44; levando &#224; reposi&#231;&#227;o e ao aumento dos n&#237;veis da glutationa intracelular&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">2&#44;4&#8211;6</span></a> O objetivo deste estudo foi avaliar a efic&#225;cia do uso da N&#8208;acetilciste&#237;na oral&#44; por oito semanas&#44; no tratamento do melasma facial em mulheres adultas&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Entre abril e julho&#47;2022 foi conduzido ensaio cl&#237;nico randomizado&#44; paralelo&#44; multic&#234;ntrico &#40;Inst1&#44; Inst2&#44; Inst3&#41;&#44; duplo&#8208;cego&#44; e controlado com placebo em 50 mulheres&#46; Os crit&#233;rios de inclus&#227;o foram&#58; mulheres entre 18 e 60 anos com melasma facial moderado a grave &#40;mMASI &#62;<span class="elsevierStyleHsp" style=""></span>4&#41;&#44; sem tratamento h&#225; pelo menos 45 dias&#44; exceto pelo uso de filtro solar&#46; N&#227;o foram inclu&#237;das portadoras de outras dermatoses faciais concomitantes&#44; dermatoses com fotossensibilidade&#44; hist&#243;ria de hipersensibilidade &#224; N&#8208;acetilciste&#237;na&#44; gestantes ou lactantes&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">As participantes foram randomizadas &#40;1&#58;1&#41; compondo 25 blocos com duas participantes cada&#44; a partir de simula&#231;&#227;o computacional &#40;randomiza&#231;&#227;o central&#41;&#44; e alocadas consecutivamente segundo sequ&#234;ncia num&#233;rica dos produtos acondicionados em envelopes pardos&#46; O grupo NAC recebeu c&#225;psulas contendo N&#8208;acetilciste&#237;na 600<span class="elsevierStyleHsp" style=""></span>mg&#44; 2<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>&#47;dia&#44; por oito semanas&#59; o grupo PLAC recebeu c&#225;psulas de placebo&#44; id&#234;nticas quanto &#224; cor e formato do ativo&#46; Todas receberam filtro solar de amplo espectro &#40;FPS 60&#41; com cor e foram orientadas para uso cada 3 horas&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">As participantes foram avaliadas na inclus&#227;o &#40;T0&#41; e ap&#243;s oito semanas &#40;T8&#41;&#46; O desfecho prim&#225;rio foi a redu&#231;&#227;o do escore mMASI &#40;<span class="elsevierStyleItalic">modified Melasma Area and Severity Index&#41;&#44;</span> aferido por pesquisador &#8220;cego&#8221; quanto aos grupos&#46; Os desfechos secund&#225;rios foram&#58; MELASQoL &#40;<span class="elsevierStyleItalic">Melasma Quality of Life Scale</span>&#41;&#44; colorimetria &#40;Dif&#8208;L&#44; diferen&#231;a entre a luminosidade &#42;L entre pele s&#227; e melasma&#41;&#44; GAIS &#40;<span class="elsevierStyleItalic">Global Aesthetic Improvement Scale</span>&#41; por avalia&#231;&#227;o fotogr&#225;fica cega&#44; e efeitos adversos&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">O tamanho da amostra foi calculado para detectar uma diferen&#231;a<span class="elsevierStyleHsp" style=""></span>&#62; 10&#37; na mudan&#231;a no escore mMASI entre os grupos no T8&#44; com coeficiente de correla&#231;&#227;o de 0&#44;75 e desvio padr&#227;o de 18&#37;&#44; considerando poder de 80&#37; e n&#237;vel alfa de 0&#44;05&#37;&#44; resultando em 25 pacientes em cada grupo &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>50&#41;&#46; Os dados foram analisados por inten&#231;&#227;o de tratamento &#40;quanto &#224; ader&#234;ncia&#41;&#44; e casos faltantes &#40;<span class="elsevierStyleItalic">dropouts</span>&#41; n&#227;o foram analisados&#46; As varia&#231;&#245;es dos escores foram comparadas de acordo com os grupos e ajustados pelos valores iniciais usando modelos lineares generalizados com an&#225;lise robusta&#46; Os escores GAIS foram comparados pelo teste de Mann&#8208;Whitney&#46; Considerou&#8208;se significante p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">7</span></a> O estudo foi aprovado no comit&#234; de &#233;tica e registrado no REBEC &#40;RBR&#8208;73zrnjh&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Dentre 64 mulheres eleg&#237;veis&#44; 10 n&#227;o preencheram os crit&#233;rios de inclus&#227;o&#44; e quatro n&#227;o concordaram em participar do estudo&#46; Das 50 mulheres inclu&#237;das&#44; 49 conclu&#237;ram o estudo&#44; havendo um <span class="elsevierStyleItalic">dropout</span> no grupo PLAC por raz&#227;o independente do tratamento&#46; Os principais dados cl&#237;nicos e demogr&#225;ficos da amostra est&#227;o dispostos na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#44; e n&#227;o diferiram entre os grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#62; 0&#44;1&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Os desfechos e ilustra&#231;&#245;es cl&#237;nicas est&#227;o demonstrados nas <a class="elsevierStyleCrossRefs" href="#fig0005">figuras 1 a 3</a>&#46; Ap&#243;s oito semanas&#44; ambos os grupos reduziram o escore de gravidade &#40;mMASI&#41;&#58; houve redu&#231;&#227;o de 12&#37; &#40;95&#37;CI 8&#37;&#8208;19&#37;&#41; no grupo NAC e 12&#37; &#40;95&#37;CI 5&#37;&#8208;21&#37;&#41; no grupo PLAC &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;613&#41;&#46; MELASQoL e colorimetria reduziram nos participantes de ambos os grupos &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41;&#59; entretanto&#44; suas redu&#231;&#245;es n&#227;o mostraram diferen&#231;a entre os grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#62; 0&#44;7&#41;&#46; De acordo com a an&#225;lise de fotografias&#44; o grupo NAC resultou em 60&#37; &#40;95&#37;CI 40&#37;&#8208;76&#37;&#41; de melhora global &#40;GAIS&#41;&#44; contra 29&#37; &#40;95&#37;CI 12&#37;&#8208;44&#37;&#41; do grupo PLAC &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;317&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">A medica&#231;&#227;o foi bem tolerada pelas participantes&#46; Apenas oito mulheres do grupo NAC e duas do grupo PLAC relataram pirose ou epigastralgia&#44; sem necessidade de interromper o tratamento&#59; duas mulheres do NAC e tr&#234;s do PLAC referiram sonol&#234;ncia&#44; e uma do NAC relatou sensa&#231;&#227;o de boca seca&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Este ensaio foi o primeiro a avaliar o uso da N&#8208;aceticiste&#237;na oral em regime isolado associada a filtro solar de amplo espectro para o tratamento do melasma&#46; Demonstrou&#8208;se que&#44; embora bem tolerada&#44; N&#8208;acetilciste&#237;na oral&#44; no regime testado&#44; n&#227;o reduziu os escores objetivos e subjetivos avaliados&#44; quando comparado ao desempenho do placebo oral&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">N&#8208;acetilciste&#237;na oral &#233; potente antioxidante com potencial de restaurar a glutationa intracelular&#46; Em dermatologia&#44; &#233; empregado principalmente no tratamento de dermatocompuls&#245;es&#44; e na pseudoporfiria&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">8&#44;9</span></a> Em ensaio n&#227;o randomizado com 30 mulheres eg&#237;pcias&#44; um grupo &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#41; recebeu glutationa oral 500<span class="elsevierStyleHsp" style=""></span>mg&#47;dia&#44; outro utilizou glutationa t&#243;pica 2&#37;&#44; e outro utilizou placebo por quatro semanas&#44; sempre associado com filtro solar com FPS 30&#46; Houve superioridade no desempenho dos grupos oral e t&#243;pico&#44; sem registros de efeitos adversos&#46; O estudo utilizou uma pequena amostra&#44; n&#227;o empregou as m&#233;tricas convencionais &#40;p&#46; ex&#46;&#44; mMASI&#41; e foi de curta dura&#231;&#227;o&#59; entretanto&#44; seus resultados reiteram o papel de antioxidantes no tratamento do melasma&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">10</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">As poss&#237;veis limita&#231;&#245;es deste estudo incluem a brevidade da interven&#231;&#227;o &#40;oito semanas&#41;&#59; entretanto&#44; espera&#8208;se que ap&#243;s dois ciclos de renova&#231;&#227;o do epit&#233;lio possa&#8208;se perceber m&#237;nima interfer&#234;ncia na melaniza&#231;&#227;o&#44; como evidenciado em outros ensaios terap&#234;uticos no melasma com ativos orais&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">6&#44;11&#44;12</span></a> Al&#233;m disso&#44; a inclus&#227;o de apenas adultos do sexo feminino&#44; e com melasma moderado a grave &#40;mMASI<span class="elsevierStyleHsp" style=""></span>&#62; 4&#41;&#44; reduz a generaliza&#231;&#227;o dos resultados&#46; Outros estudos devem ser conduzidos para prospectar subst&#226;ncias antioxidantes no tratamento do melasma ou na preven&#231;&#227;o de sua recorr&#234;ncia&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Em conclus&#227;o&#44; apesar de bem tolerado no regime empregado&#44; N&#8208;acetilciste&#237;na oral n&#227;o foi eficaz no tratamento do melasma&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0075" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribui&#231;&#227;o dos autores</span><p id="par0080" class="elsevierStylePara elsevierViewall">Melissa de Almeida Corr&#234;a Alfredo&#58; Idealiza&#231;&#227;o do estudo&#44; escrita e aprova&#231;&#227;o do texto final&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Ingrid Rocha Meireles Holanda&#58; Idealiza&#231;&#227;o do estudo&#44; escrita e aprova&#231;&#227;o do texto final&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Daniel Pinho Cassiano&#58; Idealiza&#231;&#227;o do estudo&#44; escrita e aprova&#231;&#227;o do texto final&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Paula Basso Lima&#58; Idealiza&#231;&#227;o do estudo&#44; escrita e aprova&#231;&#227;o do texto final&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Ana Cl&#225;udia Cavalcante Esp&#243;sito&#58; Idealiza&#231;&#227;o do estudo&#44; escrita e aprova&#231;&#227;o do texto final&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">H&#233;lio Amante Miot&#58; Idealiza&#231;&#227;o do estudo&#44; escrita e aprova&#231;&#227;o do texto final&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0110" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:4 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Suporte financeiro"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Contribui&#231;&#227;o dos autores"
        ]
        2 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Conflito de interesses"
        ]
        3 => array:1 [
          "titulo" => "Refer&#234;ncias"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2023-09-03"
    "fechaAceptado" => "2023-10-24"
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Como citar este artigo&#58; Alfredo MAC&#44; Holanda IRM&#44; Cassiano DP&#44; Esp&#243;sito ACC&#44; Lima PB&#44; Miot HA&#46; Lack of efficacy of oral N&#8208;acetylcysteine in the treatment of facial melasma in women&#58; a randomized&#44; double&#8208;blind&#44; placebo&#8208;controlled clinical trial&#46; An Bras Dermatol&#46; 2024&#59;99&#58;928&#8211;31&#46;</p>"
      ]
      1 => array:2 [
        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Trabalho realizado na Faculdade de Medicina de Botucatu&#44; Universidade Estadual Paulista&#44; Botucatu&#44; SP&#44; Brasil&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2345
            "Ancho" => 3008
            "Tamanyo" => 340319
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Gr&#225;ficos da varia&#231;&#227;o do mMASI &#40;A&#41;&#44; MELASQoL &#40;B&#41;&#44; colorimetria &#40;Dif&#8208;&#42;L &#91;C&#93;&#41;&#44; e avalia&#231;&#227;o da melhora entre os grupos estudados &#40;GAIS &#8211; <span class="elsevierStyleItalic">Global Aesthetic Improvement Scale</span> &#91;D&#93;&#41;&#44; no T8&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1373
            "Ancho" => 2508
            "Tamanyo" => 193336
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Melasma facial tratado com fotoprote&#231;&#227;o e N&#8208;acetilciste&#237;na oral&#44; por oito semanas&#46; &#40;A&#41; Antes do tratamento&#46; &#40;B&#41; Ap&#243;s o tratamento&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1386
            "Ancho" => 2508
            "Tamanyo" => 212163
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Melasma facial tratado com fotoprote&#231;&#227;o e placebo oral&#44; por oito semanas&#46; &#40;A&#41; Antes do tratamento&#46; &#40;B&#41; Ap&#243;s o tratamento&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabela 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">ACO&#44; anticoncepcional oral&#59; Dif&#8208;L&#44; diferen&#231;a entre a luminosidade &#40;&#42;L&#41; entre pele adjacente e melasma&#59; DP&#44; desvio padr&#227;o&#59; mMASI&#44; <span class="elsevierStyleItalic">modified Melasma Area and Severity Index</span>&#59; MELASQoL&#44; <span class="elsevierStyleItalic">Melasma Quality of Life Scale</span>&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&#8208;acetilciste&#237;na&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Placebo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Idade &#40;anos&#41;&#44; m&#233;dia &#40;DP&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#44;1 &#40;7&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&#44;1 &#40;7&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#44;6 &#40;7&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Fototipo&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;40&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;44&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;42&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>V&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;32&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;30&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hist&#243;ria familiar&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;84&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;60&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;72&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">ACO&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Exposi&#231;&#227;o solar di&#225;ria &#40;min&#47;d&#41;&#44; mediana &#40;p25&#8208;p75&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;0&#8211;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;0&#8211;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;0&#8211;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Gesta&#231;&#245;es&#44; mediana &#40;p25&#8208;p75&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;2&#8211;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;1&#8211;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;1&#8211;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Idade de in&#237;cio &#40;anos&#41;&#44; m&#233;dia &#40;DP&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;4 &#40;7&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#44;5 &#40;9&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#44;0 &#40;8&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">mMASI&#44; m&#233;dia &#40;DP&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;8 &#40;3&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;1 &#40;3&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;8 &#40;3&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">MELASQoL&#44; m&#233;dia &#40;DP&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#44;7 &#40;15&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#44;2 &#40;13&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#44;5 &#40;14&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Dif&#8208;L&#44; m&#233;dia &#40;DP&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;0 &#40;2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;9 &#40;1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;0 &#40;2&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3706856.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Principais dados cl&#237;nicos e demogr&#225;ficos da amostra</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Refer&#234;ncias"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:12 [
            0 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Update on melasma&#8208;part I&#58; pathogenesis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;C&#46;C&#46; Esp&#243;sito"
                            1 => "D&#46;P&#46; Cassiano"
                            2 => "C&#46;N&#46; da Silva"
                            3 => "P&#46;B&#46; Lima"
                            4 => "J&#46;A&#46;F&#46; Dias"
                            5 => "K&#46; Hassun"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s13555-022-00779-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatol Ther &#40;Heidelb&#41;&#46;"
                        "fecha" => "2022"
                        "volumen" => "12"
                        "paginaInicial" => "1967"
                        "paginaFinal" => "1988"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35904706"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Update on melasma&#8208;part II&#58; treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;P&#46; Cassiano"
                            1 => "A&#46;C&#46;C&#46; Esp&#243;sito"
                            2 => "C&#46;N&#46; da Silva"
                            3 => "P&#46;B&#46; Lima"
                            4 => "J&#46;A&#46;F&#46; Dias"
                            5 => "K&#46; Hassun"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s13555-022-00780-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatol Ther &#40;Heidelb&#41;&#46;"
                        "fecha" => "2022"
                        "volumen" => "12"
                        "paginaInicial" => "1989"
                        "paginaFinal" => "2012"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35906506"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Oxidative stress status in patients with melasma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46;Y&#46; Se&#231;kin"
                            1 => "G&#46; Kalkan"
                            2 => "Y&#46; Ba&#351;"
                            3 => "A&#46; Akba&#351;"
                            4 => "Y&#46; &#214;nder"
                            5 => "H&#46; &#214;zyurt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3109/15569527.2013.834496"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cutan Ocul Toxicol&#46;"
                        "fecha" => "2014"
                        "volumen" => "33"
                        "paginaInicial" => "212"
                        "paginaFinal" => "217"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24147944"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "N&#8208;Acetylcysteine as a bleaching agent in the treatment of melasma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;D&#46; Njoo"
                            1 => "H&#46;E&#46; Menke"
                            2 => "S&#46; Pavel"
                            3 => "W&#46; Westerhof"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol&#46;"
                        "fecha" => "1997"
                        "volumen" => "9"
                        "paginaInicial" => "86"
                        "paginaFinal" => "87"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Glutathione as an oral whitening agent&#58; a randomized&#44; double&#8208;blind&#44; placebo&#8208;controlled study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46; Arjinpathana"
                            1 => "P&#46; Asawanonda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3109/09546631003801619"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dermatolog Treat&#46;"
                        "fecha" => "2012"
                        "volumen" => "23"
                        "paginaInicial" => "97"
                        "paginaFinal" => "102"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20524875"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "French maritime pine bark extract &#40;pycnogenol&#41; in association with triple combination cream for the treatment of facial melasma in women&#58; a double&#8208;blind&#44; randomized&#44; placebo&#8208;controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46;B&#46; Lima"
                            1 => "J&#46;A&#46;F&#46; Dias"
                            2 => "A&#46;C&#46;C&#46; Esposito"
                            3 => "L&#46;D&#46;B&#46; Miot"
                            4 => "H&#46;A&#46; Miot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol&#46;"
                        "fecha" => "2021"
                        "volumen" => "35"
                        "paginaInicial" => "502"
                        "paginaFinal" => "508"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "P&#8208;value and effect&#8208;size in clinical and experimental studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;C&#46; Miola"
                            1 => "H&#46;A&#46; Miot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/1677-5449.210038"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Vasc Bras&#46;"
                        "fecha" => "2021"
                        "volumen" => "20"
                        "paginaInicial" => "e20210038"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34267792"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "N&#8208;Acetylcysteine in psychodermatological disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;O&#46; Nwankwo"
                            1 => "M&#46; Jafferany"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Dermatol Ther&#46;"
                        "fecha" => "2019"
                        "volumen" => "32"
                        "paginaInicial" => "e13073"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pseudoporphyria induced by dialysis treated with oral N&#8208;acetylcysteine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;M&#46; Guiotoku"
                            1 => "F&#46;P&#46; Pereira"
                            2 => "H&#46;A&#46; Miot"
                            3 => "M&#46;E&#46; Marques"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/s0365-05962011000200031"
                      "Revista" => array:6 [
                        "tituloSerie" => "An Bras Dermatol&#46;"
                        "fecha" => "2011"
                        "volumen" => "86"
                        "paginaInicial" => "383"
                        "paginaFinal" => "385"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21603831"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of the efficacy and safety of topical and oral glutathione in treatment of melasma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;A&#46; Farahat"
                            1 => "H&#46; El-Garhy"
                            2 => "N&#46;A&#46; El-Mahdy"
                            3 => "B&#46;M&#46; Ali"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "The Medical Journal of Cairo University&#46;"
                        "fecha" => "2018"
                        "volumen" => "86"
                        "paginaInicial" => "3083"
                        "paginaFinal" => "3092"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Oral ketotifen associated with famotidine for the treatment of facial melasma&#58; a randomized&#44; double&#8208;blind&#44; placebo&#8208;controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;A&#46;F&#46; Dias"
                            1 => "P&#46;B&#46; Lima"
                            2 => "D&#46;P&#46; Cassiano"
                            3 => "A&#46;C&#46;C&#46; Esposito"
                            4 => "E&#46; Bagatin"
                            5 => "L&#46;D&#46;B&#46; Miot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jdv.17692"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol&#46;"
                        "fecha" => "2022"
                        "volumen" => "36"
                        "paginaInicial" => "e123"
                        "paginaFinal" => "e125"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34553413"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy and safety of microneedling and oral tranexamic acid in the treatment of facial melasma in women&#58; an open&#44; evaluator&#8208;blinded&#44; randomized clinical trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Cassiano"
                            1 => "A&#46;C&#46;C&#46; Esposito"
                            2 => "K&#46; Hassun"
                            3 => "E&#46; Bagatin"
                            4 => "M&#46;M&#46;D&#46;A&#46; Lima"
                            5 => "E&#46;V&#46;A&#46; Lima"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2020.02.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol&#46;"
                        "fecha" => "2020"
                        "volumen" => "83"
                        "paginaInicial" => "1176"
                        "paginaFinal" => "1178"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32035945"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "pt"
  "url" => "/26662752/0000009900000006/v1_202410301154/S2666275224001838/v1_202410301154/pt/main.assets"
  "Apartado" => array:4 [
    "identificador" => "95147"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Cartas - Investiga&#231;&#227;o"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/26662752/0000009900000006/v1_202410301154/S2666275224001838/v1_202410301154/pt/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224001838?idApp=UINPBA00008Z"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Cartas ‐ Investigação
Ausência de eficácia da N‐acetilcisteína oral no tratamento do melasma facial em mulheres: ensaio clínico randomizado, duplo‐cego e controlado com placebo
Melissa de Almeida Corrêa Alfredoa, Ingrid Rocha Meireles Holandaa, Daniel Pinho Cassianob, Ana Cláudia Cavalcante Espósitoc, Paula Basso Limaa, Hélio Amante Miota,
Corresponding author
helio.a.miot@unesp.br

Autor para correspondência.
a Departamento de Infectologia, Dermatologia, Diagnóstico por Imagem e Radioterapia, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brasil
b Departamento de Dermatologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil
c Departamento de Medicina, Universidade do Oeste Paulista, Unoeste, Presidente Prudente, SP, Brasil
Read
896
Times
was read the article
326
Total PDF
570
Total HTML
Share statistics
 array:22 [
  "pii" => "S2666275224001838"
  "issn" => "26662752"
  "doi" => "10.1016/j.abdp.2024.07.028"
  "estado" => "S300"
  "fechaPublicacion" => "2024-11-01"
  "aid" => "1010"
  "copyrightAnyo" => "2024"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "en" => array:17 [
      "pii" => "S0365059624001685"
      "issn" => "03650596"
      "doi" => "10.1016/j.abd.2023.10.005"
      "estado" => "S300"
      "fechaPublicacion" => "2024-11-01"
      "aid" => "1010"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:1 [
        "total" => 0
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Letter - Research</span>"
        "titulo" => "Lack of efficacy of oral N-acetylcysteine &#8203;&#8203;in the treatment of facial melasma in women&#58; a randomized&#44; double-blind&#44; placebo-controlled clinical trial"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "928"
            "paginaFinal" => "931"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:8 [
            "identificador" => "fig0005"
            "etiqueta" => "Fig&#46; 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 2310
                "Ancho" => 3008
                "Tamanyo" => 329629
              ]
            ]
            "detalles" => array:1 [
              0 => array:3 [
                "identificador" => "at0085"
                "detalle" => "Fig&#46; "
                "rol" => "short"
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Graphs of the variation in mMASI &#40;A&#41;&#44; MELASQoL &#40;B&#41;&#44; colorimetry &#40;Dif-&#42;L - C&#41;&#44; and assessment of improvement between the studied groups &#40;GAIS &#8210; Global Aesthetic Improvement Scale - D&#41;&#44; at T8&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Melissa de Almeida Corr&#234;a Alfredo, Ingrid Rocha Meireles Holanda, Daniel Pinho Cassiano, Ana Cl&#225;udia Cavalcante Esp&#243;sito, Paula Basso Lima, H&#233;lio Amante Miot"
            "autores" => array:6 [
              0 => array:2 [
                "nombre" => "Melissa de Almeida Corr&#234;a"
                "apellidos" => "Alfredo"
              ]
              1 => array:2 [
                "nombre" => "Ingrid Rocha Meireles"
                "apellidos" => "Holanda"
              ]
              2 => array:2 [
                "nombre" => "Daniel Pinho"
                "apellidos" => "Cassiano"
              ]
              3 => array:2 [
                "nombre" => "Ana Cl&#225;udia Cavalcante"
                "apellidos" => "Esp&#243;sito"
              ]
              4 => array:2 [
                "nombre" => "Paula Basso"
                "apellidos" => "Lima"
              ]
              5 => array:2 [
                "nombre" => "H&#233;lio Amante"
                "apellidos" => "Miot"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "pt" => array:9 [
          "pii" => "S2666275224001838"
          "doi" => "10.1016/j.abdp.2024.07.028"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "pt"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224001838?idApp=UINPBA00008Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059624001685?idApp=UINPBA00008Z"
      "url" => "/03650596/0000009900000006/v1_202410230911/S0365059624001685/v1_202410230911/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "S2666275224001814"
    "issn" => "26662752"
    "doi" => "10.1016/j.abdp.2024.07.026"
    "estado" => "S300"
    "fechaPublicacion" => "2024-11-01"
    "aid" => "1007"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "pt" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Cartas &#8208; Investiga&#231;&#227;o</span>"
      "titulo" => "Nevos melanoc&#237;ticos e melanomas da mucosa oral&#58; descri&#231;&#227;o detalhada de s&#233;rie de casos"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "931"
          "paginaFinal" => "936"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1847
              "Ancho" => 2500
              "Tamanyo" => 1044470
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Nevos intramucosos e azuis&#46; &#40;A&#41; Edema nodular coberto por mucosa &#237;ntegra na regi&#227;o esquerda do palato correspondendo a nevo melanoc&#237;tico intramucoso&#46; &#40;B&#41; Ninhos de c&#233;lulas n&#233;vicas pigmentadas separadas do revestimento epitelial por membrana basal evidente&#46; Observar c&#233;lulas poligonais e epitelioides na regi&#227;o subepitelial e as c&#233;lulas profundas semelhantes a linf&#243;citos &#40;Hematoxilina &#38; eosina&#44; barra de escala&#58; 50<span class="elsevierStyleHsp" style=""></span>&#956;&#41;&#46; C&#44; Nevo azul mostrando c&#233;lulas fusiformes anguladas&#44; profundamente assentadas com neurotiza&#231;&#227;o&#44; tipo C &#40;Hematoxilina &#38; eosina&#44; barra de escala&#58; 50<span class="elsevierStyleHsp" style=""></span>&#956;&#41;&#46; D&#44; Nevo azul composto por c&#233;lulas fusiformes e dendr&#237;ticas contendo pigmento melanina acastanhado &#40;Hematoxilina &#38; eosina&#44; barra de escala&#58; 50<span class="elsevierStyleHsp" style=""></span>&#956;&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Izadora Fernanda Veiga de Jesus Costa, Deyla Duarte Carneiro Vilela, Bruno Cunha Pires, Jener Gon&#231;alves de Farias, Val&#233;ria Souza Freitas, Jean Nunes dos Santos"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Izadora Fernanda Veiga de Jesus"
              "apellidos" => "Costa"
            ]
            1 => array:2 [
              "nombre" => "Deyla Duarte Carneiro"
              "apellidos" => "Vilela"
            ]
            2 => array:2 [
              "nombre" => "Bruno Cunha"
              "apellidos" => "Pires"
            ]
            3 => array:2 [
              "nombre" => "Jener Gon&#231;alves de"
              "apellidos" => "Farias"
            ]
            4 => array:2 [
              "nombre" => "Val&#233;ria Souza"
              "apellidos" => "Freitas"
            ]
            5 => array:2 [
              "nombre" => "Jean Nunes dos"
              "apellidos" => "Santos"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0365059624001648"
        "doi" => "10.1016/j.abd.2024.03.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059624001648?idApp=UINPBA00008Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224001814?idApp=UINPBA00008Z"
    "url" => "/26662752/0000009900000006/v1_202410301154/S2666275224001814/v1_202410301154/pt/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2666275224001899"
    "issn" => "26662752"
    "doi" => "10.1016/j.abdp.2024.07.034"
    "estado" => "S300"
    "fechaPublicacion" => "2024-11-01"
    "aid" => "1016"
    "copyright" => "Sociedade Brasileira de Dermatologia"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "pt" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Cartas &#8208; Investiga&#231;&#227;o</span>"
      "titulo" => "Guselcumabe&#44; risanquizumabe e tildraquizumabe demonstram efic&#225;cia e seguran&#231;a semelhantes no tratamento da psor&#237;ase&#58; estudo comparativo direto na pr&#225;tica cl&#237;nica"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "922"
          "paginaFinal" => "927"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 2287
              "Ancho" => 3508
              "Tamanyo" => 467425
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Resultados de PASI &#40;A&#41;&#44; ASC &#40;B&#41;&#44; DLQI &#40;C&#41; e IGA &#40;D&#41;&#46; Uma tend&#234;ncia evidente de diminui&#231;&#227;o dos valores para todas as quatro medidas com os tr&#234;s medicamentos pode ser observada &#224; medida que as semanas de observa&#231;&#227;o avan&#231;am&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Miguel Mansilla&#8208;Polo, Antonio Sahuquillo&#8208;Torralba, Conrad Pujol&#8208;Marco, Guillermo Bargues&#8208;Navarro, Rafael Botella&#8208;Estrada"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Miguel"
              "apellidos" => "Mansilla&#8208;Polo"
            ]
            1 => array:2 [
              "nombre" => "Antonio"
              "apellidos" => "Sahuquillo&#8208;Torralba"
            ]
            2 => array:2 [
              "nombre" => "Conrad"
              "apellidos" => "Pujol&#8208;Marco"
            ]
            3 => array:2 [
              "nombre" => "Guillermo"
              "apellidos" => "Bargues&#8208;Navarro"
            ]
            4 => array:2 [
              "nombre" => "Rafael"
              "apellidos" => "Botella&#8208;Estrada"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0365059624001740"
        "doi" => "10.1016/j.abd.2024.04.004"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059624001740?idApp=UINPBA00008Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224001899?idApp=UINPBA00008Z"
    "url" => "/26662752/0000009900000006/v1_202410301154/S2666275224001899/v1_202410301154/pt/main.assets"
  ]
  "pt" => array:17 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Cartas &#8208; Investiga&#231;&#227;o</span>"
    "titulo" => "Aus&#234;ncia de efic&#225;cia da N&#8208;acetilciste&#237;na oral no tratamento do melasma facial em mulheres&#58; ensaio cl&#237;nico randomizado&#44; duplo&#8208;cego e controlado com placebo"
    "tieneTextoCompleto" => true
    "saludo" => "<span class="elsevierStyleItalic">Prezado Editor&#44;</span>"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "928"
        "paginaFinal" => "931"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Melissa de Almeida Corr&#234;a Alfredo, Ingrid Rocha Meireles Holanda, Daniel Pinho Cassiano, Ana Cl&#225;udia Cavalcante Esp&#243;sito, Paula Basso Lima, H&#233;lio Amante Miot"
        "autores" => array:6 [
          0 => array:3 [
            "nombre" => "Melissa de Almeida Corr&#234;a"
            "apellidos" => "Alfredo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Ingrid Rocha Meireles"
            "apellidos" => "Holanda"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Daniel Pinho"
            "apellidos" => "Cassiano"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Ana Cl&#225;udia Cavalcante"
            "apellidos" => "Esp&#243;sito"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Paula Basso"
            "apellidos" => "Lima"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:4 [
            "nombre" => "H&#233;lio Amante"
            "apellidos" => "Miot"
            "email" => array:1 [
              0 => "helio.a.miot@unesp.br"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Departamento de Infectologia&#44; Dermatologia&#44; Diagn&#243;stico por Imagem e Radioterapia&#44; Faculdade de Medicina&#44; Universidade Estadual Paulista&#44; Botucatu&#44; SP&#44; Brasil"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Departamento de Dermatologia&#44; Universidade Federal de S&#227;o Paulo&#44; S&#227;o Paulo&#44; SP&#44; Brasil"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Departamento de Medicina&#44; Universidade do Oeste Paulista&#44; Unoeste&#44; Presidente Prudente&#44; SP&#44; Brasil"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspond&#234;ncia&#46;"
          ]
        ]
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1386
            "Ancho" => 2508
            "Tamanyo" => 212163
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Melasma facial tratado com fotoprote&#231;&#227;o e placebo oral&#44; por oito semanas&#46; &#40;A&#41; Antes do tratamento&#46; &#40;B&#41; Ap&#243;s o tratamento&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Melasma &#233; discromia cr&#244;nica adquirida&#44; mais prevalente em mulheres na menacme e caracterizado por hipermelanose cut&#226;nea em &#225;reas fotoexpostas&#44; especialmente a face&#46; O melasma pode ser desencadeado por fotoexposi&#231;&#227;o&#44; gesta&#231;&#227;o&#44; altera&#231;&#245;es hormonais e medicamentos&#44; por&#233;m sua patog&#234;nese n&#227;o &#233; completamente compreendida&#44; refletindo&#8208;se na frequente recorr&#234;ncia ap&#243;s o tratamento&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">O estresse oxidativo&#44; causado por fatores externos como exposi&#231;&#227;o &#224; radia&#231;&#227;o solar&#44; dist&#250;rbios do sono&#44; polui&#231;&#227;o&#44; inflama&#231;&#227;o da pele e estresse emocional&#44; pode induzir e perpetuar a melanog&#234;nese&#44; independentemente da irradia&#231;&#227;o ultravioleta&#46; Ademais&#44; a eumelanog&#234;nese &#233; um processo oxidativo intracelular&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">1</span></a> Marcadores s&#233;ricos de estresse oxidativo s&#227;o elevados em pacientes com melasma&#44; havendo forte correla&#231;&#227;o entre n&#237;veis de glutationa peroxidase plasm&#225;tica e sua gravidade&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">1&#44;3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Nos &#250;ltimos anos&#44; antioxidantes orais e t&#243;picos mostraram&#8208;se eficazes no tratamento do melasma&#59; entretanto&#44; nenhum ensaio cl&#237;nico foi conduzido com N&#8208;acetilciste&#237;na&#44; que constitui composto &#8220;tiol&#8221; e atua como doador de L&#8208;ciste&#237;na&#44; levando &#224; reposi&#231;&#227;o e ao aumento dos n&#237;veis da glutationa intracelular&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">2&#44;4&#8211;6</span></a> O objetivo deste estudo foi avaliar a efic&#225;cia do uso da N&#8208;acetilciste&#237;na oral&#44; por oito semanas&#44; no tratamento do melasma facial em mulheres adultas&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Entre abril e julho&#47;2022 foi conduzido ensaio cl&#237;nico randomizado&#44; paralelo&#44; multic&#234;ntrico &#40;Inst1&#44; Inst2&#44; Inst3&#41;&#44; duplo&#8208;cego&#44; e controlado com placebo em 50 mulheres&#46; Os crit&#233;rios de inclus&#227;o foram&#58; mulheres entre 18 e 60 anos com melasma facial moderado a grave &#40;mMASI &#62;<span class="elsevierStyleHsp" style=""></span>4&#41;&#44; sem tratamento h&#225; pelo menos 45 dias&#44; exceto pelo uso de filtro solar&#46; N&#227;o foram inclu&#237;das portadoras de outras dermatoses faciais concomitantes&#44; dermatoses com fotossensibilidade&#44; hist&#243;ria de hipersensibilidade &#224; N&#8208;acetilciste&#237;na&#44; gestantes ou lactantes&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">As participantes foram randomizadas &#40;1&#58;1&#41; compondo 25 blocos com duas participantes cada&#44; a partir de simula&#231;&#227;o computacional &#40;randomiza&#231;&#227;o central&#41;&#44; e alocadas consecutivamente segundo sequ&#234;ncia num&#233;rica dos produtos acondicionados em envelopes pardos&#46; O grupo NAC recebeu c&#225;psulas contendo N&#8208;acetilciste&#237;na 600<span class="elsevierStyleHsp" style=""></span>mg&#44; 2<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>&#47;dia&#44; por oito semanas&#59; o grupo PLAC recebeu c&#225;psulas de placebo&#44; id&#234;nticas quanto &#224; cor e formato do ativo&#46; Todas receberam filtro solar de amplo espectro &#40;FPS 60&#41; com cor e foram orientadas para uso cada 3 horas&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">As participantes foram avaliadas na inclus&#227;o &#40;T0&#41; e ap&#243;s oito semanas &#40;T8&#41;&#46; O desfecho prim&#225;rio foi a redu&#231;&#227;o do escore mMASI &#40;<span class="elsevierStyleItalic">modified Melasma Area and Severity Index&#41;&#44;</span> aferido por pesquisador &#8220;cego&#8221; quanto aos grupos&#46; Os desfechos secund&#225;rios foram&#58; MELASQoL &#40;<span class="elsevierStyleItalic">Melasma Quality of Life Scale</span>&#41;&#44; colorimetria &#40;Dif&#8208;L&#44; diferen&#231;a entre a luminosidade &#42;L entre pele s&#227; e melasma&#41;&#44; GAIS &#40;<span class="elsevierStyleItalic">Global Aesthetic Improvement Scale</span>&#41; por avalia&#231;&#227;o fotogr&#225;fica cega&#44; e efeitos adversos&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">O tamanho da amostra foi calculado para detectar uma diferen&#231;a<span class="elsevierStyleHsp" style=""></span>&#62; 10&#37; na mudan&#231;a no escore mMASI entre os grupos no T8&#44; com coeficiente de correla&#231;&#227;o de 0&#44;75 e desvio padr&#227;o de 18&#37;&#44; considerando poder de 80&#37; e n&#237;vel alfa de 0&#44;05&#37;&#44; resultando em 25 pacientes em cada grupo &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>50&#41;&#46; Os dados foram analisados por inten&#231;&#227;o de tratamento &#40;quanto &#224; ader&#234;ncia&#41;&#44; e casos faltantes &#40;<span class="elsevierStyleItalic">dropouts</span>&#41; n&#227;o foram analisados&#46; As varia&#231;&#245;es dos escores foram comparadas de acordo com os grupos e ajustados pelos valores iniciais usando modelos lineares generalizados com an&#225;lise robusta&#46; Os escores GAIS foram comparados pelo teste de Mann&#8208;Whitney&#46; Considerou&#8208;se significante p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">7</span></a> O estudo foi aprovado no comit&#234; de &#233;tica e registrado no REBEC &#40;RBR&#8208;73zrnjh&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Dentre 64 mulheres eleg&#237;veis&#44; 10 n&#227;o preencheram os crit&#233;rios de inclus&#227;o&#44; e quatro n&#227;o concordaram em participar do estudo&#46; Das 50 mulheres inclu&#237;das&#44; 49 conclu&#237;ram o estudo&#44; havendo um <span class="elsevierStyleItalic">dropout</span> no grupo PLAC por raz&#227;o independente do tratamento&#46; Os principais dados cl&#237;nicos e demogr&#225;ficos da amostra est&#227;o dispostos na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#44; e n&#227;o diferiram entre os grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#62; 0&#44;1&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Os desfechos e ilustra&#231;&#245;es cl&#237;nicas est&#227;o demonstrados nas <a class="elsevierStyleCrossRefs" href="#fig0005">figuras 1 a 3</a>&#46; Ap&#243;s oito semanas&#44; ambos os grupos reduziram o escore de gravidade &#40;mMASI&#41;&#58; houve redu&#231;&#227;o de 12&#37; &#40;95&#37;CI 8&#37;&#8208;19&#37;&#41; no grupo NAC e 12&#37; &#40;95&#37;CI 5&#37;&#8208;21&#37;&#41; no grupo PLAC &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;613&#41;&#46; MELASQoL e colorimetria reduziram nos participantes de ambos os grupos &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41;&#59; entretanto&#44; suas redu&#231;&#245;es n&#227;o mostraram diferen&#231;a entre os grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#62; 0&#44;7&#41;&#46; De acordo com a an&#225;lise de fotografias&#44; o grupo NAC resultou em 60&#37; &#40;95&#37;CI 40&#37;&#8208;76&#37;&#41; de melhora global &#40;GAIS&#41;&#44; contra 29&#37; &#40;95&#37;CI 12&#37;&#8208;44&#37;&#41; do grupo PLAC &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;317&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">A medica&#231;&#227;o foi bem tolerada pelas participantes&#46; Apenas oito mulheres do grupo NAC e duas do grupo PLAC relataram pirose ou epigastralgia&#44; sem necessidade de interromper o tratamento&#59; duas mulheres do NAC e tr&#234;s do PLAC referiram sonol&#234;ncia&#44; e uma do NAC relatou sensa&#231;&#227;o de boca seca&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Este ensaio foi o primeiro a avaliar o uso da N&#8208;aceticiste&#237;na oral em regime isolado associada a filtro solar de amplo espectro para o tratamento do melasma&#46; Demonstrou&#8208;se que&#44; embora bem tolerada&#44; N&#8208;acetilciste&#237;na oral&#44; no regime testado&#44; n&#227;o reduziu os escores objetivos e subjetivos avaliados&#44; quando comparado ao desempenho do placebo oral&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">N&#8208;acetilciste&#237;na oral &#233; potente antioxidante com potencial de restaurar a glutationa intracelular&#46; Em dermatologia&#44; &#233; empregado principalmente no tratamento de dermatocompuls&#245;es&#44; e na pseudoporfiria&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">8&#44;9</span></a> Em ensaio n&#227;o randomizado com 30 mulheres eg&#237;pcias&#44; um grupo &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#41; recebeu glutationa oral 500<span class="elsevierStyleHsp" style=""></span>mg&#47;dia&#44; outro utilizou glutationa t&#243;pica 2&#37;&#44; e outro utilizou placebo por quatro semanas&#44; sempre associado com filtro solar com FPS 30&#46; Houve superioridade no desempenho dos grupos oral e t&#243;pico&#44; sem registros de efeitos adversos&#46; O estudo utilizou uma pequena amostra&#44; n&#227;o empregou as m&#233;tricas convencionais &#40;p&#46; ex&#46;&#44; mMASI&#41; e foi de curta dura&#231;&#227;o&#59; entretanto&#44; seus resultados reiteram o papel de antioxidantes no tratamento do melasma&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">10</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">As poss&#237;veis limita&#231;&#245;es deste estudo incluem a brevidade da interven&#231;&#227;o &#40;oito semanas&#41;&#59; entretanto&#44; espera&#8208;se que ap&#243;s dois ciclos de renova&#231;&#227;o do epit&#233;lio possa&#8208;se perceber m&#237;nima interfer&#234;ncia na melaniza&#231;&#227;o&#44; como evidenciado em outros ensaios terap&#234;uticos no melasma com ativos orais&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">6&#44;11&#44;12</span></a> Al&#233;m disso&#44; a inclus&#227;o de apenas adultos do sexo feminino&#44; e com melasma moderado a grave &#40;mMASI<span class="elsevierStyleHsp" style=""></span>&#62; 4&#41;&#44; reduz a generaliza&#231;&#227;o dos resultados&#46; Outros estudos devem ser conduzidos para prospectar subst&#226;ncias antioxidantes no tratamento do melasma ou na preven&#231;&#227;o de sua recorr&#234;ncia&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Em conclus&#227;o&#44; apesar de bem tolerado no regime empregado&#44; N&#8208;acetilciste&#237;na oral n&#227;o foi eficaz no tratamento do melasma&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0075" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribui&#231;&#227;o dos autores</span><p id="par0080" class="elsevierStylePara elsevierViewall">Melissa de Almeida Corr&#234;a Alfredo&#58; Idealiza&#231;&#227;o do estudo&#44; escrita e aprova&#231;&#227;o do texto final&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Ingrid Rocha Meireles Holanda&#58; Idealiza&#231;&#227;o do estudo&#44; escrita e aprova&#231;&#227;o do texto final&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Daniel Pinho Cassiano&#58; Idealiza&#231;&#227;o do estudo&#44; escrita e aprova&#231;&#227;o do texto final&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Paula Basso Lima&#58; Idealiza&#231;&#227;o do estudo&#44; escrita e aprova&#231;&#227;o do texto final&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Ana Cl&#225;udia Cavalcante Esp&#243;sito&#58; Idealiza&#231;&#227;o do estudo&#44; escrita e aprova&#231;&#227;o do texto final&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">H&#233;lio Amante Miot&#58; Idealiza&#231;&#227;o do estudo&#44; escrita e aprova&#231;&#227;o do texto final&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0110" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:4 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Suporte financeiro"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Contribui&#231;&#227;o dos autores"
        ]
        2 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Conflito de interesses"
        ]
        3 => array:1 [
          "titulo" => "Refer&#234;ncias"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2023-09-03"
    "fechaAceptado" => "2023-10-24"
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Como citar este artigo&#58; Alfredo MAC&#44; Holanda IRM&#44; Cassiano DP&#44; Esp&#243;sito ACC&#44; Lima PB&#44; Miot HA&#46; Lack of efficacy of oral N&#8208;acetylcysteine in the treatment of facial melasma in women&#58; a randomized&#44; double&#8208;blind&#44; placebo&#8208;controlled clinical trial&#46; An Bras Dermatol&#46; 2024&#59;99&#58;928&#8211;31&#46;</p>"
      ]
      1 => array:2 [
        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Trabalho realizado na Faculdade de Medicina de Botucatu&#44; Universidade Estadual Paulista&#44; Botucatu&#44; SP&#44; Brasil&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2345
            "Ancho" => 3008
            "Tamanyo" => 340319
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Gr&#225;ficos da varia&#231;&#227;o do mMASI &#40;A&#41;&#44; MELASQoL &#40;B&#41;&#44; colorimetria &#40;Dif&#8208;&#42;L &#91;C&#93;&#41;&#44; e avalia&#231;&#227;o da melhora entre os grupos estudados &#40;GAIS &#8211; <span class="elsevierStyleItalic">Global Aesthetic Improvement Scale</span> &#91;D&#93;&#41;&#44; no T8&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1373
            "Ancho" => 2508
            "Tamanyo" => 193336
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Melasma facial tratado com fotoprote&#231;&#227;o e N&#8208;acetilciste&#237;na oral&#44; por oito semanas&#46; &#40;A&#41; Antes do tratamento&#46; &#40;B&#41; Ap&#243;s o tratamento&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1386
            "Ancho" => 2508
            "Tamanyo" => 212163
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Melasma facial tratado com fotoprote&#231;&#227;o e placebo oral&#44; por oito semanas&#46; &#40;A&#41; Antes do tratamento&#46; &#40;B&#41; Ap&#243;s o tratamento&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabela 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">ACO&#44; anticoncepcional oral&#59; Dif&#8208;L&#44; diferen&#231;a entre a luminosidade &#40;&#42;L&#41; entre pele adjacente e melasma&#59; DP&#44; desvio padr&#227;o&#59; mMASI&#44; <span class="elsevierStyleItalic">modified Melasma Area and Severity Index</span>&#59; MELASQoL&#44; <span class="elsevierStyleItalic">Melasma Quality of Life Scale</span>&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&#8208;acetilciste&#237;na&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Placebo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Idade &#40;anos&#41;&#44; m&#233;dia &#40;DP&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#44;1 &#40;7&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&#44;1 &#40;7&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#44;6 &#40;7&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Fototipo&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;40&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;44&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;42&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>V&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;32&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;30&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hist&#243;ria familiar&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;84&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;60&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;72&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">ACO&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Exposi&#231;&#227;o solar di&#225;ria &#40;min&#47;d&#41;&#44; mediana &#40;p25&#8208;p75&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;0&#8211;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;0&#8211;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;0&#8211;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Gesta&#231;&#245;es&#44; mediana &#40;p25&#8208;p75&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;2&#8211;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;1&#8211;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;1&#8211;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Idade de in&#237;cio &#40;anos&#41;&#44; m&#233;dia &#40;DP&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;4 &#40;7&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#44;5 &#40;9&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#44;0 &#40;8&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">mMASI&#44; m&#233;dia &#40;DP&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;8 &#40;3&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;1 &#40;3&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;8 &#40;3&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">MELASQoL&#44; m&#233;dia &#40;DP&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#44;7 &#40;15&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#44;2 &#40;13&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#44;5 &#40;14&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Dif&#8208;L&#44; m&#233;dia &#40;DP&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;0 &#40;2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;9 &#40;1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;0 &#40;2&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3706856.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Principais dados cl&#237;nicos e demogr&#225;ficos da amostra</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Refer&#234;ncias"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:12 [
            0 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Update on melasma&#8208;part I&#58; pathogenesis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;C&#46;C&#46; Esp&#243;sito"
                            1 => "D&#46;P&#46; Cassiano"
                            2 => "C&#46;N&#46; da Silva"
                            3 => "P&#46;B&#46; Lima"
                            4 => "J&#46;A&#46;F&#46; Dias"
                            5 => "K&#46; Hassun"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s13555-022-00779-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatol Ther &#40;Heidelb&#41;&#46;"
                        "fecha" => "2022"
                        "volumen" => "12"
                        "paginaInicial" => "1967"
                        "paginaFinal" => "1988"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35904706"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Update on melasma&#8208;part II&#58; treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;P&#46; Cassiano"
                            1 => "A&#46;C&#46;C&#46; Esp&#243;sito"
                            2 => "C&#46;N&#46; da Silva"
                            3 => "P&#46;B&#46; Lima"
                            4 => "J&#46;A&#46;F&#46; Dias"
                            5 => "K&#46; Hassun"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s13555-022-00780-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatol Ther &#40;Heidelb&#41;&#46;"
                        "fecha" => "2022"
                        "volumen" => "12"
                        "paginaInicial" => "1989"
                        "paginaFinal" => "2012"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35906506"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Oxidative stress status in patients with melasma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46;Y&#46; Se&#231;kin"
                            1 => "G&#46; Kalkan"
                            2 => "Y&#46; Ba&#351;"
                            3 => "A&#46; Akba&#351;"
                            4 => "Y&#46; &#214;nder"
                            5 => "H&#46; &#214;zyurt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3109/15569527.2013.834496"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cutan Ocul Toxicol&#46;"
                        "fecha" => "2014"
                        "volumen" => "33"
                        "paginaInicial" => "212"
                        "paginaFinal" => "217"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24147944"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "N&#8208;Acetylcysteine as a bleaching agent in the treatment of melasma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;D&#46; Njoo"
                            1 => "H&#46;E&#46; Menke"
                            2 => "S&#46; Pavel"
                            3 => "W&#46; Westerhof"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol&#46;"
                        "fecha" => "1997"
                        "volumen" => "9"
                        "paginaInicial" => "86"
                        "paginaFinal" => "87"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Glutathione as an oral whitening agent&#58; a randomized&#44; double&#8208;blind&#44; placebo&#8208;controlled study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46; Arjinpathana"
                            1 => "P&#46; Asawanonda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3109/09546631003801619"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dermatolog Treat&#46;"
                        "fecha" => "2012"
                        "volumen" => "23"
                        "paginaInicial" => "97"
                        "paginaFinal" => "102"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20524875"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "French maritime pine bark extract &#40;pycnogenol&#41; in association with triple combination cream for the treatment of facial melasma in women&#58; a double&#8208;blind&#44; randomized&#44; placebo&#8208;controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46;B&#46; Lima"
                            1 => "J&#46;A&#46;F&#46; Dias"
                            2 => "A&#46;C&#46;C&#46; Esposito"
                            3 => "L&#46;D&#46;B&#46; Miot"
                            4 => "H&#46;A&#46; Miot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol&#46;"
                        "fecha" => "2021"
                        "volumen" => "35"
                        "paginaInicial" => "502"
                        "paginaFinal" => "508"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "P&#8208;value and effect&#8208;size in clinical and experimental studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;C&#46; Miola"
                            1 => "H&#46;A&#46; Miot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/1677-5449.210038"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Vasc Bras&#46;"
                        "fecha" => "2021"
                        "volumen" => "20"
                        "paginaInicial" => "e20210038"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34267792"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "N&#8208;Acetylcysteine in psychodermatological disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;O&#46; Nwankwo"
                            1 => "M&#46; Jafferany"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Dermatol Ther&#46;"
                        "fecha" => "2019"
                        "volumen" => "32"
                        "paginaInicial" => "e13073"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pseudoporphyria induced by dialysis treated with oral N&#8208;acetylcysteine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;M&#46; Guiotoku"
                            1 => "F&#46;P&#46; Pereira"
                            2 => "H&#46;A&#46; Miot"
                            3 => "M&#46;E&#46; Marques"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/s0365-05962011000200031"
                      "Revista" => array:6 [
                        "tituloSerie" => "An Bras Dermatol&#46;"
                        "fecha" => "2011"
                        "volumen" => "86"
                        "paginaInicial" => "383"
                        "paginaFinal" => "385"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21603831"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of the efficacy and safety of topical and oral glutathione in treatment of melasma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;A&#46; Farahat"
                            1 => "H&#46; El-Garhy"
                            2 => "N&#46;A&#46; El-Mahdy"
                            3 => "B&#46;M&#46; Ali"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "The Medical Journal of Cairo University&#46;"
                        "fecha" => "2018"
                        "volumen" => "86"
                        "paginaInicial" => "3083"
                        "paginaFinal" => "3092"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Oral ketotifen associated with famotidine for the treatment of facial melasma&#58; a randomized&#44; double&#8208;blind&#44; placebo&#8208;controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;A&#46;F&#46; Dias"
                            1 => "P&#46;B&#46; Lima"
                            2 => "D&#46;P&#46; Cassiano"
                            3 => "A&#46;C&#46;C&#46; Esposito"
                            4 => "E&#46; Bagatin"
                            5 => "L&#46;D&#46;B&#46; Miot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jdv.17692"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol&#46;"
                        "fecha" => "2022"
                        "volumen" => "36"
                        "paginaInicial" => "e123"
                        "paginaFinal" => "e125"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34553413"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy and safety of microneedling and oral tranexamic acid in the treatment of facial melasma in women&#58; an open&#44; evaluator&#8208;blinded&#44; randomized clinical trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Cassiano"
                            1 => "A&#46;C&#46;C&#46; Esposito"
                            2 => "K&#46; Hassun"
                            3 => "E&#46; Bagatin"
                            4 => "M&#46;M&#46;D&#46;A&#46; Lima"
                            5 => "E&#46;V&#46;A&#46; Lima"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2020.02.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol&#46;"
                        "fecha" => "2020"
                        "volumen" => "83"
                        "paginaInicial" => "1176"
                        "paginaFinal" => "1178"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32035945"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "pt"
  "url" => "/26662752/0000009900000006/v1_202410301154/S2666275224001838/v1_202410301154/pt/main.assets"
  "Apartado" => array:4 [
    "identificador" => "95147"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Cartas - Investiga&#231;&#227;o"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/26662752/0000009900000006/v1_202410301154/S2666275224001838/v1_202410301154/pt/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224001838?idApp=UINPBA00008Z"
]
Article information
ISSN: 26662752
Original language: Portuguese
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 18 9 27
2024 October 243 100 343
2024 September 218 123 341
2024 August 91 94 185

Follow this link to access the full text of the article

Idiomas
Anais Brasileiros de Dermatologia
en pt
Cookies policy Política de cookies
To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.