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The mean age of the study patients was found to be 32.90 7.92 years which was similar to the studies by Kumar et al .,[] Garg et al .,[] and Achar and Rathi.[] The disease duration of melasma in majority of patients (56.0%) was between 1 to 3 years, which is in concordance with the study by Kumar et al .[] Similar to the study by Khurana et al ., majority of patients (78%) in our study were found to be of Fitzpatrick skin type IV, followed by Fitzpatrick skin type V and type III.[] The assessment of mean difference in VAS over both cheeks before and after TA (right cheek) and glutathione (left cheek) revealed that both the treatment options were effective [Table 2]

In research models, this mechanism has been studied in the context of photoprotection in UV-sensitive conditions particularly erythropoietic protoporphyria (EPP), where clinical development of afamelanotide as a subcutaneous implant has resulted in regulatory approval in Europe and the United States

These findings highlight a possible critical link between gut fungal dysbiosis and PCOS pathogenesis

[DOI] [PMC free article] [PubMed] [Google Scholar] 109.Chugh R., Wathen J.K., Maki R.G., Benjamin R.S., Patel S.R., Meyers P.A., Priebat D.A., Reinke D.K., Thomas D.G., Keohan M.L., et al