A clinical and dermatoscopic study of melasma

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Original Article

Author Details : Akbar Ali Shanavaz, Meghana Bathina, Vishal B Amin*, Malcolm Pinto, Manjunath Shenoy M

Volume : 6, Issue : 1, Year : 2020

Article Page : 50-56

https://doi.org/10.18231/j.ijced.2020.012

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Abstract

Context: Melasma is an acquired hypermelanosis that occurs exclusively in sun-exposed area mostly on
face and rarely on the neck and forearms. It is more common in women and in Asians. Exact pathogenesis
remains elusive, however, genetic predisposition and ultraviolet light exposure seem to play an important
role.
Aim of the study : The aim of this study was to evaluate facial melasma clinically and dermatoscopically
and to compare the consistency of the findings with respect to each type of melasma. Dermatoscopy is
increasingly being used for diagnosis of pigmentary disorders other than malignancy.
Settings and design: Hospital based cross sectional descriptive study.
Materials and Methods: Study was conducted in the Dermatology department of Yenepoya Medical
College and Hospital on 110 patients during the period of December 2016 to June 2018.Clinical
examination includes standard dermatological examination along with Wood’s lamp and dermatoscopic
examination (Detailed format attached).
Heine Delta 20 plus Dermatoscope was used for evaluation of the lesions.
Sample size is calculated using G* lower software n=110 minimum sample, with level of significance alpha
= 5%,power =80 % Effective size= 0.27
Results: A total of 110 patients with clinical diagnosis of melasma attending the Department of
dermatology in Yenepoya medical college were studied during a period of 18 months. Maximum number
of patients (35.5%) belonged to the age group between 31 and 40 years. Study showed a female
preponderance (69.1%) . On the basis of Fitzpatrick skin type, patients with Type IV (90%). With respect
to occupation housewives (60%) and manual labourers /farmers (25.5%) formed the majority indicating
chronic sunexposure to be a leading cause for melasma. Patients having Centrofacial pattern predominated
with 59.1% of the total. In 43.6% of the women cycles were regular, 5.45% had irregular cycles and 20.9%
of the women had attained menopause. We found that 66.4% of the patients had a moderate MASI score.
UnderWood’s lamp examination patchy enhancement was seen in 56.4% of the patients indicating a mixed
pattern. Among the various patterns observed reticuloglobular pattern dominated our study with 85.45%
of patients being positive for the pattern. In our study patients presented with some additional features
under dermatoscopy namely telangiectasia (36.1%), followed by depigmentation (24.5%). On the basis of
dermatoscopy, 64.5% predominantly showed an epidermal pattern.
Conclusion: Dermoscopy serves as useful tool in assessing the type of melasma based on the MASI score.

Keywords: Dermoscopy, Melasma, Woods lamp, MASI.

How to cite : Shanavaz A A, Bathina M, Amin V B, Pinto M, Manjunath Shenoy M, A clinical and dermatoscopic study of melasma. IP Indian J Clin Exp Dermatol 2020;6(1):50-56

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