Melasma: A clinico-epidemiological study of 312 cases

Abstract

Background:Melasma is an acquired increased pigmentation of the skin, characterized by gray-brown symmetrical patches, mostly in the sun-exposed areas of the skin. The pathogenesis is unknown, but genetic or hormonal influences with UV radiation are important.Aims:Our present research aims to study the clinico-epidemiological pattern and the precipitating or provocation factors in melasma.Materials and Methods:A total of 312 patients were enrolled for the study over a period of one year.Results:The mean age of patients with melasma was 33.45 years, ranging from 14 to 54 years. There was female preponderance with a female to male ratio of approximately 4 : 1. The mean age of onset was 29.99 years, with the youngest and oldest being 11 and 49 years, respectively. The patients sought medical treatment on an average of 3.59 years after appearance of melasma. About 55.12% of our patients reported that their disease exacerbated during sun exposure. Among 250 female patients, 56 reported pregnancy and 46 reported oral contraceptive as the precipitating factors. Only 34 patients had given history of exacerbation of melasma during pregnancy. A positive family history of melasma was observed in 104 (33.33%) patients. Centrofacial was the most common pattern (55.44%) observed in the present study. Wood light examination showed the dermal type being the most common in 54.48% and epidermal and mixed were seen in 21.47% and 24.03% of the cases, respectively. We tried to find an association with endocrinal diseases and observed that 20 of them had hypothyroidism.Conclusion:The exact cause of melasma is unknown. However, many factors have been implicated in the etiopathogenesis of this disorder. Here we try to identify the causative factors and provocation to develop melasma.

A Cross-Sectional, Multicentric Clinico-Epidemiological Study of Melasma in India

“…The mean age of patients in the eastern region was 34.3 years, similar to a hospital-based study from the same region (33.4 years) [6]. The mean age of onset of melasma observed in the present study was 34.1 years; however, a previously conducted hospital-based study reported the age of onset to be 29.9 years [6].…”

“…The patterns exhibited regional variation as reported in the previous studies from India [6, 8]. Mandibular pattern was observed only among patients from the northern region.…”

“…The mean age of onset of melasma observed in the present study was 34.1 years; however, a previously conducted hospital-based study reported the age of onset to be 29.9 years [6]. The disease chronicity of 3 years was similar to a previously conducted hospital-based study [6]. A p value very close to the threshold significance level (0.05) indicates that the association between the two could not be rejected and it may be in this case because of sampling limitations.…”

Melasma Dalam Sudut Pandang Genetik

“…Hiperpigmentasi yang diinduksi sinar UV akan segera sembuh spontan, sementara pada melasma hal tersebut tidak terjadi. 21,26,27 Jalur utama dan penting di dalam melanogenesis, cAMP akan mengaktifkan PKA, selanjutnya akan menstimulasi CREB yang merupakan faktor transkripsi dan meningkatkan ekspresi regulasi MITF. Dengan ikatan MITF dan tirosinase akan meningkatkan sintesis melanin.…”

Kojic acid vis-a-vis its combinations with hydroquinone and betamethasone valerate in melasma: A randomized, single blind, comparative study of efficacy and safety

“…[12] It may be idiopathic, may appear during pregnancy[3] or be associated with use of oral contraceptives. [3456] Affecting all the races, it is most prevalent in the Hispanics and Asians of skin types IV, V, and VI with centrofacial, malar, and mandibular distribution. [3678] Its location and occurrence in the nonpregnant women and even in men suggest some role of ultraviolet (UV) radiation.…”