Main Article Content
Clinical Patterns, Factors, Melasma, Pregnancy
Adult women often develop melasma, an acquired symmetrical dyschromia affecting photo exposed areas. Dermatology clinics see it often, and its lesions affect patient quality of life.
Objective: To assess the frequency of factors leading to the melasma development in female patients at tertiary care hospital, Karachi.
Place and Duration: This Descriptive Cross-Sectional study was held at the Dermatology Department, Dr. Ruth K.M Pfau Civil Hospital, Karachi - Pakistan for Six months from May 31, 2021 to November 30, 2021.
Methods: Every patient who met the requirements and visited Civil Hospital, Karachi was studied. After discussing the study's process, hazards, and benefits, informed consent was obtained. Brief history about demographic information and duration of melasma was taken. The researcher asked the patients about the factors leading to melasma. The designed proforma was used for data collection and entered electronically for research purpose.
Results: The age of the patients ranged from 20 to 45 years with a median of 31 with interquartile range 14. In distribution of factors leading to melasma, pregnancy was noted in 25 (19.7%), oral contraceptive 18 (14.2%), sunlight exposure 31 (24.4%) while family history of melasma was noted in 44 (34.6%) patients.
Conclusion: It is to be concluded that family history of melasma was found noted as most common factor leading to melasma followed by sunlight exposure and pregnancy. More well-controlled and prospective trials are required to authenticate the current results.
2. Walker SL, Shah M, Hubbard VG, Pradhan HM, Ghimire M. Skin disease is common in rural Nepal: results of a point prevalence study. Br J Dermatol. 2008;158:334–38.
3. Alakloby OM. Pattern of skin diseases in Eastern Saudi Arabia. Saudi Med J. 2005;26: 1607–10.
4. Sheth VM, Pandya AG. Melasma a comprehensive update: part I. J Am Acad Dermatol. 2011;65:689–97.
5. Sarkar R, Arora P, Garg VK, Sonthalia S, Gokhale N. Melasma update. Indian Dermatol Online J 2014;5:426-35.
6. Ishiy PS, Silva LR, Penha MA, Handel AC, Miot HA. Skin diseases reported by workers from the campus of UNESP Rubião Jr, Botucatu-SP (Brazil) An Bras Dermatol. 2014;89:529–31.
7. Guinot C, Cheffai S, Latreille J, Dhaoui MA, Youssef S, Jaber K, et al. Aggravating factors for melasma: a prospective study in 197 Tunisian patients Eur Acad Dermatol Venereol. 2010;24:1060-69.
8. Hexsel D, Lacerda DA, Cavalcante AS, Machado Filho CA, Kalil CL, Ayres EL, et al. Epidemiology of melasma in Brazilian patients: a multicenter study. Int J Dermatol. 2013;53:440–4.
9. Kang WH, Yoon KH, Lee ES, Kim J, Lee KB, Yim H, et al. Melasma: histopathological characteristics in 56 Korean patients. Br J Dermatol. 2002;146:228–37.
10. Achar A, Rathi SK. Melasma: a clinico-epidemiological study of 312 cases. Indian J Dermatol. 2011;56:380-2.
11. Manjusha Martin, A. Hameedullah, Sneha Priya M. Unveiling the risk factors behind melasma: An observational study. IAIM, 2017; 4(11): 85-9.
12. Pichardo R, Vallejos Q, Feldman SR, Schulz MR, Verma A, Quandt SA, et al. The prevalence of melasma and its association with quality of life in adult male Latino migrant workers. Int J Dermatol. 2009;48:22–6.
13. Handel AC, Miot LD, Miot HA. Melasma: a clinical and epidemiological review. An Bras Dermatol. 2014;89(5):771-82.
14. Sonthalià S, Sarkar R. Etiopathogenesis of melesma. Pigment Int 2015;2:21-7.
15. Jagannathan M, Sadagopan K, Ekkarakudy J, Anandan H. Clinico-epidemiological study of patients with melasma in a tertiary care hospital - a prospective study. Int J Sci Stud 2017;4(11):117-20.
16. Sarkar R, Ghunawat S, Narang I, Verma S, Garg VK, Dua R. Role of broad-spectrum sunscreen alone in the improvement of melasma area severity index (MASI) and Melasma Quality of Life Index in melasma. J Cosmet Dermatol. 2019;18(4):1066-73.
17. Yeung H, Kahn B, Ly BC, Tangpricha V. Dermatologic conditions in transgender populations. Endocrinol Metab Clin North Am. 2019;48(2):429-40.
18. Mandry Pagan R, Sanchez JL. Mandibular melasma. P R Health Sci J. 2000;19(3):231–4.
19. Ritter CG, Fiss DV, Borges da Costa JA, de Carvalho RR, Bauermann G, Cestari TF. Extrafacial melasma: clinical, histopathological, and immunohistochemical case–control study. J Eur Acad Dermatol Venereol. 2013;27(9):1088–94.
20. Guinot C, Cheffai S, Latreille J, Dhaoui MA, Youssef S, Jaber K, et al. Aggravating factors for melasma: a prospective study in 197 Tunisian patients. J Eur Acad Dermatol Venereol. 2010;24(9):1060–9.
21. Tamega Ade A, Miot LD, Bonfietti C, Gige TC, Marques ME, Miot HA. Clinical patterns and epidemiological characteristics of facial melasma in Brazilian women. J Eur Acad Dermatol Venereol. 2013;27(2):151–6.
22. Mishra SN, Dhurat RS, Deshpande DJ, Nayak CS. Diagnostic utility of dermatoscopy in hydroquinone-induced exogenous ochronosis. Int J Dermatol. 2013;52(4):413–7.
23. Achar A, Rathi SK. Melasma: a clinico-epidemiological study of 312 cases. Indian J Dermatol. 2011;56(4):380–2.
24. Kang HY, Bahadoran P, Suzuki I, Zugaj D, Khemis A, Passeron T, et al. In vivo reflectance confocal microscopy detects pigmentary changes in melasma at a cellular level resolution. Exp Dermatol. 2010;19(8):e228–33.
25. Bagherani N, Gianfaldoni S, Smoller BR. An overview on melasma. J Pigment Disord. 2015;2(10):218.