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Published on: January 19, 2024
Melasma: a clinico-epidemiological study of 312 cases
1Department of Dermatology, Midnapore Medical College, West Bengal, India .
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.
Insights
This study investigated melasma, a skin pigmentation disorder, identifying key factors like sun exposure, pregnancy, and genetics. It highlights the need for further research into its complex causes and triggers.
Area of Science:
- Dermatology
- Epidemiology
- Pathogenesis of skin disorders
Background:
- Melasma is an acquired skin hyperpigmentation disorder presenting as symmetrical, gray-brown patches, predominantly on sun-exposed areas.
- Its exact pathogenesis remains unclear, though genetic predisposition, hormonal influences, and UV radiation are considered significant contributing factors.
Purpose of the Study:
- To elucidate the clinico-epidemiological characteristics of melasma.
- To identify precipitating and aggravating factors associated with melasma development and exacerbation.
Main Methods:
- A prospective study involving 312 patients diagnosed with melasma over one year.
- Data collection included patient demographics, clinical presentation, Wood light examination findings, and self-reported triggering factors.
Main Results:
- The study found a female preponderance (4:1 ratio) with a mean age of onset at 29.99 years.
- Sun exposure (55.12%), pregnancy (56/250 females), and oral contraceptives (46/250 females) were common triggers. Centrofacial pattern and dermal melasma were most prevalent.
- A positive family history was noted in 33.33% of patients, and 20 patients had co-existing hypothyroidism.
Conclusions:
- While the precise etiology of melasma is unknown, this study reinforces the multifactorial nature of the disorder.
- Identifying specific causative and provocative factors is crucial for understanding and managing melasma effectively.
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