Association between clinical characteristics, quality of life, and sleep quality in patients with periorbital hyperchromia

Barone, Carolina Rocha; Boza, Juliana Catucci; Machado, Priscila Pereira; Cestari, Tânia Ferreira

doi:10.1111/jocd.12549

Cited by 7 publications

(12 citation statements)

References 21 publications

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“…13 In a previous study, conducted by the same group of authors, evaluating the quality of life of patients with POH, an average DLQI of 4.92 ± 4.99 was obtained. 11 This value is in the same range of a small effect in relation to that obtained in other dermatological diseases of predominantly esthetic impairment, such as melasma, vitiligo, and actinic keratosis. [14][15][16] When other common dermatological diseases (such as acne, atopic dermatitis, and psoriasis) are evaluated under the same tools, patients usually present with average values, which correspond in general terms to a moderate effect over the dermatological quality of life.…”

Section: Pohsupporting

confidence: 57%

“…The included population covered a wide age group, all Fitzpatrick phototypes, and genders. Even though POH seemed to affect men and women similarly, the complaint was more frequent in female patients . The preponderance in this gender was possibly due to the fact that women may be more conscious about their appearance .…”

Section: Discussionmentioning

confidence: 86%

“…Some studies already researched lack of sleep in patients with POH, showing that 40% (Sheth et al), 51.1% (Ranu et al), and 34% (Barone et al) of the studied groups lacked hours of sleep quantitatively in relation to the ideal minimum sleep duration. Still, the last study even found that patients also had sleep issues qualitatively, because they presented with a mean of 6.04 ± 2.60 (assessed with the PSQI), which corresponded to poor quality of sleep …”

Section: Discussionmentioning

confidence: 97%

“…The calculated sample size was 280 subjects, 140 cases, and 140 controls, predicting 10% of possible losses. This value was stipulated taking into account the mean of 6.04 ± 2.60 of PSQI of patients with POH, 11 and it corresponded to a difference of approximately three points in the index that ranges from zero to 21, which corresponds to around 15% difference between groups. For this calculation, a power of 80% was considered, and a statistical significance was defined as a P-value lower than .05.…”

Section: Materials S and Me Thodsmentioning

confidence: 99%

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The influence of sleep quality on the development of periocular hyperchromia: a case‐control study

Barone

Boza

Pires

et al. 2019

J of Cosmetic Dermatology

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Background Periorbital hyperchromia (POH), popularly known as “dark circles,” is a very frequent complaint in dermatological appointments. It affects all phototypes, genders, and ages, and it is associated with a tired and aged aspect to the face, which may lead to esthetic concerns and impairments in the quality of life. Its etiology is multifactorial, and it is believed that sleep disorders may be considered as precipitating or aggravating factors. Aims Our objective is to compare sleep quality (using the Pittsburgh Sleep Quality Index—PSQI) of patients with POH to patients without this complaint. Methods A single‐center, case‐control study. Patients from both genders were included. Cases were patients with POH, and controls had no POH. Demographic data, Dermatology Life Quality Index (DLQI), and PSQI were collected. A power of 80% and statistical significance when a P‐value was lower than .05 were stipulated. Results Out of 303 patients, 149 cases and 154 controls, with a mean age of 35.83 ± 11.38 for cases and 37.52 ± 14.89 for controls, there was no significant difference between groups. The DLQI revealed a mean of 4.86 ± 4.89 for cases and 2.25 ± 3.73 for controls (P < .0001), which translates into a modest effect in life quality. The PSQI mean was 5.93 ± 2.52 for cases and 6.14 ± 3.58 for controls (P = .633), which characterizes the poor quality of sleep. Conclusions Dark circles impact negatively on the quality of life of affected patients, especially in women. Contrary to what has been believed, sleep alone does not seem to influence the appearance of POH. NCT03393624.

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Section: Pohsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 97%

Section: Materials S and Me Thodsmentioning

confidence: 99%

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The influence of sleep quality on the development of periocular hyperchromia: a case‐control study

Barone

Boza

Pires

et al. 2019

J of Cosmetic Dermatology

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“…Sleep quality has been investigated in skin diseases such as psoriasis and atopic dermatitis 42–44 . A percentage of 38.2–60% of psoriatic patients presented poor sleep quality (PSQI, >5) 42,45–48 .…”

Section: Discussionmentioning

confidence: 99%

Relationship between rosacea and sleep

Wang

Xie

Gong

et al. 2020

The Journal of Dermatology

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Rosacea is a chronic facial skin disease involved in neurovascular dysregulation and neurogenic inflammation. Behavioral factors such as stress, anxiety, depression and sleep were identified to be associated with other inflammatory skin diseases. Few studies have reported sleep status in rosacea. Aiming to investigate the relationship between rosacea and sleep, a case-control survey was conducted, enrolling 608 rosacea patients and 608 sex-and age-matched healthy controls. Sleep quality was assessed through the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Diagnosis and severity grading of rosacea were evaluated under the standard guidelines of the National Rosacea Society. More rosacea patients (52.3%, n = 318) suffered poor sleep quality (PSQI, >5) than the healthy controls (24.0%, n = 146), displaying a much higher PSQI score (rosacea vs control, 6.20 vs 3.95). There was a strong association between sleep quality and rosacea (odds ratio [OR], 3.525; 95% confidence interval [CI], 2.759-4.519). Moreover, the severity of rosacea was also associated with sleep quality (OR, 1.847; 95% CI, 1.332-2.570). Single nucleotide polymorphisms in hydroxytryptamine receptor 2A and adrenoceptor-b1 genes, which are associated with sleep behaviour, were detected and revealed to be associated with rosacea. Furthermore, the LL-37-induced rosacea-like phenotype and sleep-deprivation mice models were applied, revealing that sleep deprivation aggravated the rosacea-like phenotype in mice, with higher expression of matrix metallopeptidase 9, Toll-like receptor 2, cathelicidin antimicrobial peptide and vascular endothelial growth factor. In conclusion, rosacea patients presented poorer sleep quality, as well as a higher propability of genetic background with sleep disturbance. In addition, poor sleep might aggravate rosacea through regulating inflammatory factors, contributing to a vicious cycle in the progression of disease. Logistic regression adjusted by sex, age and BMI. Bold indicates significance. Values of Scores of seven components of the PSQI and global PSQI score are shown as means AE standard deviation. Values of sleep quality (good, bad) are shown as n (%). CI, confidence interval; OR, odds ratio; PSQI, Pittsburgh Sleep Quality Index.

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Treatments of Periorbital Hyperpigmentation: A Systematic Review

et al. 2020

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BACKGROUND Periorbital hyperpigmentation (POH) is an aesthetic concern for patients. Etiologies of the condition include pigmentary, structural, vascular, and mixed causes. OBJECTIVE To systematically review the current literature for treatment of POH. METHODS A systematic literature review was performed on PubMed. Search terms included “infraorbital dark circles,” “dark circles,” “periorbital hyperpigmentation,” “idiopathic hyperchromia AND orbital,” “under-eye circles,” “ICHOR (idiopathic cutaneous hyperchromia of the orbital region),” “dark circles” AND “treatment,” and “filler” AND “dark circles.” RESULTS A total of 39 studies were included. Effective treatments for POH include lasers, topical creams and serums, fillers, chemical peels, carboxytherapy, plasma-rich platelet injections, blepharoplasty, and normobaric oxygen. CONCLUSION Soft tissue fillers and autologous fat grafting are most effective in treating dark circles due to volume loss. Blepharoplasty surgery is best when excessive skin laxity is the underlying cause. Various topical creams and chemical peels are useful in treating pigment-based POH, whereas lasers are mildly to moderately beneficial for both vascular and pigment types. Given the scarcity of high-quality evidence supporting these results, recommendations should be interpreted selectively. Additional randomized clinical trials studying POH will be helpful.

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Association between clinical characteristics, quality of life, and sleep quality in patients with periorbital hyperchromia

Abstract: Periorbital hyperchromia negatively impacts patients' QoL. Dissatisfaction is directly related to disease severity.

Cited by 7 publications

References 21 publications

The influence of sleep quality on the development of periocular hyperchromia: a case‐control study

The influence of sleep quality on the development of periocular hyperchromia: a case‐control study

Relationship between rosacea and sleep

Treatments of Periorbital Hyperpigmentation: A Systematic Review

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