African ancestry is associated with facial melasma in women: a cross-sectional study

Abstract

BackgroundMelasma is a chronic acquired focal hypermelanosis affecting photoexposed areas, especially for women during fertile age. Several factors contribute to its development: sun exposure, sex steroids, medicines, and family history. Melanic pigmentation pathway discloses several SNPs in different populations. Here, we evaluated the association between genetic ancestry and facial melasma.MethodsA cross-sectional study involving women with melasma and an age-matched control group from outpatients at FMB-Unesp, Botucatu-SP, Brazil was performed. DNA was extracted from oral mucosa swabs and ancestry determined by studying 61 INDELs. The genetic ancestry components were adjusted by other known risk factors by multiple logistic regression.ResultsWe evaluated 119 women with facial melasma and 119 controls. Mean age was 39 ± 9 years. Mean age at beginning of disease was 27 ± 8 years. Pregnancy (40%), sun exposure (37%), and hormonal oral contraception (22%) were the most frequently reported melasma triggers. All subjects presented admixed ancestry, African and European genetic contributions were significantly different between cases and controls (respectively 10% vs 6%; 77% vs 82%; p < 0.05). African ancestry (OR = 1.04; 95% CI 1.01 to 1.07), first generation family history (OR = 3.04; 95% CI 1.56 to 5.94), low education level (OR = 4.04; 95% CI 1.56 to 5.94), and use of antidepressants by individuals with affected family members (OR = 6.15; 95% CI 1.13 to 33.37) were associated with melasma, independently of other known risk factors.ConclusionsFacial melasma was independently associated with African ancestry in a highly admixed population.Electronic supplementary materialThe online version of this article (doi:10.1186/s12881-017-0378-7) contains supplementary material, which is available to authorized users.

Assessment of the effects of skin microneedling as adjuvant therapy for facial melasma: a pilot study

“…Beyond clinical and quality of life improvement, epidermal melanin reduction, basement membrane restoration and increase in upper dermal collagen were evidenced. Basal membrane is damaged in melasma, as there are solar elastosis and collagen fragmentation what lead to the hypothesis of great activity of metalloproteinases [ 1 – 3 , 9 ] and in upper dermis and decrease in type I collagen synthesis [ 8 , 21 – 23 ].…”

“…Due to its high prevalence, the involvement of visible photoexposed areas - such as the face, in patients at a competitive age, and the relative resistance to treatment, melasma inflicts major impact on quality of life [ 3 – 5 ].…”

Factors associated with quality of life in facial melasma: a cross‐sectional study

“…Elements related to body image, associated with interpersonal relationships, existential values, maturity, as educational and economic level can influence the subjective perception of the disease, can cause some inconsistence between QoL and clinical scores . Moreover, there is a paucity of studies that explore socio‐demographic data in melasma .…”

Análise de dados ordinais em estudos clínicos e experimentais

“…In such cases, it is preferable to describe the percentage frequencies of each category (for example, 10% stage I, 30% II, 40% III, and 20% IV), and illustrate them graphically using frequency plots (Figure 1). 9,10 In cases in which there are several ordinal categories (≥ 5), the median should be given followed by the categories in which the quartiles fall (p25-p75), as long as the sample is unimodal, for example, a visual analog pain scale (VAS), or the American Society of Anesthesiologists anesthetic risk classification (ASA). [11][12][13][14][15] Analysis of the difference between ordinal data distributed across two or more categories should prefer use of techniques that incorporate the direction of the effect inflicted by the ordering of the categories.…”

“…Graph illustrating frequencies of the ordinal variable skin phototype (I to VI) of melasma cases and controls from the Hospital das Clínicas de Botucatu (n = 238) 9. …”