Melasma in North Indians: A clinical, epidemiological, and etiological study

Abstract

Background: Melasma is a common, acquired and symmetrical hypermelanosis characterized by more/less dark brownish macules, with an irregular contour, but clear limits, on photoexposed sites. The pathogenesis is unknown, but several clinical patterns and etiological factors have been implicated. Aims: Our present study aims to elucidate the epidemiology, clinical patterns and etiological factors in the causation of melasma in North Indians. Methods: A total of 200 consecutive patients attending the out-patient clinic from September 2013 to February 2104 with the clinical diagnosis of melasma were enrolled for the study. Photographic record was kept to study the clinical patterns. Results: The mean age of patients with melasma was 32.9 years, ranging from 18 to 60 years. Female patients out-numbered male patients, and ratio of female to male patients was 6.14:1. Patients sought medical treatment on an average of 1.79 years after appearance of melasma. 48.84% of female patients and 78.57% of males reported exacerbation with sun exposure. 36.4% of the females reported onset of melasma during pregnancy. Family history was observed in 29.07% of our female patients and 14.28% of males. History of use of mustard oil either for massage or for cooking was given by 54.07% of females and 32.14% of males, while 45.35% of females and 32.14% of males used topical corticosteroids or over-the-counter products for the treatment of melasma. Centro-facial was the most common pattern observed in 76.74% of the female patients while the malar pattern was seen in 85.71% of males. Other patterns we observed were mandibular (3.5%), lateral cheek (1.5%) and brachial (1%). Conclusion: The exact pathogenesis of melasma is unknown. Here in we have tried to elucidate the epidemiology, clinical patterns, and etiological factors in the causation of this pigmentary imperfection.