Rashmi Sarkar1, Soumya Jagadeesan2, Shasikumar Basavapura Madegowda3, Sonali Verma4, Iffat Hassan5, Yasmeen Bhat5, Khushboo Minni6, Abhijeet Jha7, Anupam Das8, Geraldine Jain9, Latika Arya10, Zubin Mandlewala11, Jimish Bagadia12, Vijay Garg1. 1. Department of Dermatology, Maulana Azad Medical College, New Delhi, Delhi, India. 2. Department of Dermatology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India. 3. Department of Dermatology, Mandya Institute of Medical Sciences, Mandya, Karnataka, India. 4. Department of Dermatology, Maulana Azad Medical College and Hospital, New Delhi, Delhi, India. 5. Department of Dermatology, Sexually Transmitted Diseases & Leprosy Government Medical College Srinagar (University of Kashmir), Srinagar, Jammu & Kashmir, India. 6. Port Trust Hospital, Wadala, Mumbai, Maharashtra, India. 7. Department of Skin and Venereal diseases, Patna Medical College and Hospital, Patna, Bihar, India. 8. KPC Medical College and Hospital, Kolkata, West Bengal, India. 9. Punarnawah LASER & Aesthetic Centre, Jaipur, Rajasthan, India. 10. L A Skin & Aesthetic Clinic, Defence Colony, New Delhi, Delhi, India. 11. Reflectionz Clinic, Mumbai, Maharashtra, India. 12. K.J.Somaiya Medical College, Mumbai, Maharashtra, India.
Abstract
BACKGROUND: Though melasma is a common skin condition in India, epidemiological studies are few and geographically confined. The present study was designed to gain insights into factors involved in causation and aggravation of melasma, demographic distribution, clinical presentations, and treatment patterns. METHODS: A cross-sectional multicentric study was conducted in 10 centers distributed across the four regions of India. Data including demographics, personal and family medical history, triggering and aggravating factors, clinical patterns, and details of past treatment regimens were recorded, and severity was estimated using the modified Melasma Area and Severity Index (MASI) score. Data collected by site dermatologists were collated and analyzed. RESULTS: The study evaluated 1,001 patients with melasma from 10 centers. Mean age was 38.02 years. Females dominated (85%). Proportion of males was highest in the east (22.2%) and lowest in the south (10.8%). Majority of patients belonged to intermediate skin phototypes. There was a significant difference (P = 0.000) between duration of sun exposure and duration of cooking fire/occupational heat exposure across the four regions. There was a significant association (P = 0.003, Mann-Whitney U test) and a positive correlation between duration of cooking heat/occupational heat exposure and severity of melasma. Sunscreens were used by only one-fifth of the study population (19.6%) whereas use of steroids and triple combinations was more common (28%). CONCLUSION: One of the largest studies on melasma from the subcontinent, this study describes the epidemiological determinants of melasma. Data suggests that the duration of cooking fire/occupational heat exposure may be linked to severity of melasma. Sunscreen use seems inadequate in Indian patients; use of steroid-containing medications is more common.
BACKGROUND: Though melasma is a common skin condition in India, epidemiological studies are few and geographically confined. The present study was designed to gain insights into factors involved in causation and aggravation of melasma, demographic distribution, clinical presentations, and treatment patterns. METHODS: A cross-sectional multicentric study was conducted in 10 centers distributed across the four regions of India. Data including demographics, personal and family medical history, triggering and aggravating factors, clinical patterns, and details of past treatment regimens were recorded, and severity was estimated using the modified Melasma Area and Severity Index (MASI) score. Data collected by site dermatologists were collated and analyzed. RESULTS: The study evaluated 1,001 patients with melasma from 10 centers. Mean age was 38.02 years. Females dominated (85%). Proportion of males was highest in the east (22.2%) and lowest in the south (10.8%). Majority of patients belonged to intermediate skin phototypes. There was a significant difference (P = 0.000) between duration of sun exposure and duration of cooking fire/occupational heat exposure across the four regions. There was a significant association (P = 0.003, Mann-Whitney U test) and a positive correlation between duration of cooking heat/occupational heat exposure and severity of melasma. Sunscreens were used by only one-fifth of the study population (19.6%) whereas use of steroids and triple combinations was more common (28%). CONCLUSION: One of the largest studies on melasma from the subcontinent, this study describes the epidemiological determinants of melasma. Data suggests that the duration of cooking fire/occupational heat exposure may be linked to severity of melasma. Sunscreen use seems inadequate in Indian patients; use of steroid-containing medications is more common.
Authors: Ana Cláudia C Espósito; Daniel P Cassiano; Carolina N da Silva; Paula B Lima; Joana A F Dias; Karime Hassun; Ediléia Bagatin; Luciane D B Miot; Hélio Amante Miot Journal: Dermatol Ther (Heidelb) Date: 2022-07-29