Melasma and thyroid disorders: a systematic review and meta‐analysis

Abstract

AbstractsBackground Thyroid hormones may play a key role in melasma; however, melasma link with thyroid disorders remains controversial.Objectives To compare the serum levels of thyroid-stimulating hormone (TSH), T4, T3, anti-thyroid peroxidase (anti-TPO), and antithyroglobulin between patients with melasma and control group using meta-analysis.Methods We screened 10 databanks and search engines, searched mesh and nonmesh terms. The identified evidences were reviewed and quality assessed using the Newcastle-Ottawa Scale (NOS). The heterogeneity between the primary results was investigated using Cochrane and I-square indices. Random effect model was applied to combine the standardized mean differences of thyroid function indicators between patients with and without melasma. P values meta-analysis was used to investigate the association between anti-TPO and melasma. ResultsWe included seven studies, 473 cases, and 379 controls that had been investigated. The total standardized mean differences (95% confidence intervals) of TSH, T3, T4, and antithyroglobulin antibody between cases and controls were estimated to be 0.33 (0.18, 0.47), À0.01 (À0.20, 0.19), À1.50 (À2.96, À0.04), and 0.62 (0.14, 1.11), respectively. The corresponding figures among women were 0.35 (0.17, 0.52), 0.10 (À0.17, 0.38), À2.75 (À6.30, 0.81), and 0.99 (0.14, 1.83), respectively. P value of metaanalysis showed a significant relationship between anti-TPO serum level and melasma (Fisher = 26.80, P = 0.020).Conclusion Serum levels of TSH, anti-TPO, and antithyroglobulin antibody were significantly higher in patients with melasma than those without melasma. Moreover, these differences were more severe among women with melasma. What is new?• Melasma is an acquired type of hyperpigmentation and might be associated with thyroid disorders.• Results of the present study showed that serum levels of TSH, anti-thyroid peroxidase (anti-TPO), and antithyroglobulin antibody were significantly higher in patients with melasma than those without melasma. Moreover, these differences were more severe among women with melasma.• Serum levels of TSH, anti-TPO, and antithyroglobulin antibodies are associated with melasma, especially among women. Risk of biasThe Newcastle-Ottawa Scale (NOS) checklist was applied to determine the risk of bias in primary studies. This checklist evaluates the studies in three section including selection (four scores), comparability (two scores), and exposure (three scores). Each study was achieved between 0 and 9 scores, and studies with less than five scores were removed from the metaanalysis. The quality assessment was performed by two independent methodologists. 20

A cross-sectional study of thyroid profile, Anti-TPO and iron levels with uric acid of melasma cases in tertiary hospital, Bhopal

“…Moreover, these differences were more severe among women with melasma. 19 Thyroid hormone act in hemoglobin synthesis in adults by affecting hematopoietic process, hypothyroidism results in anemia. Iron deficiency anemia which is quite common in Indian subcontinent should be clarified with specific clinical condition that results in iron deficiency.…”

Evaluation of cutaneous manifestations in patients under treatment with thyroid disease

“…It is thought to be caused by increased pituitary adrenocorticotropic hormone 2 . In addition, it has been reported that there is a relationship between melasma and thyroid autoimmunity 11,12 . In a previous study, Dogra et al 13 reported that 18.7% of patients with hypothyroid had melasma and 6.2% had periocular pigmentation.…”

Skin Pigmentation and Cosmetic Considerations for Even Skin Tone

“…Predisposing factors include pregnancy, hormonal therapies (including oral contraceptives), phototoxic and anti-epileptic medications, intense sun exposure [67], and genetic predisposition [68,69]. Recent studies suggest that thyroid hormones may play a key role in melasma [70].…”