Abstract

Melasma is a highly prevalent disorder of acquired pigmentation that results in localized, chronic hypermelanosis of the skin, affecting the individual on personal and social fronts. Aim: The study aims to understand the epidemiology, etiology and clinical features of melasma. Materials and Methods: The present study was an observational study conducted on 300 patients of facial melasma presenting to the outpatient department of Dermatology, Venereology, and Leprology. Results: The most common age group affected was 21-30 years (48.6%), followed by 31-40years(23%), and the least affected group was 18- 20 years (10%). The mean age of patients included in the present study was 26.5 years. The youngest age of presentation was 18 years, while the oldest was 48 years. Females were more commonly affected (77.3%) compared to males(24.6%) and the male to female ratio was found to be 1:3.14. Housewives were the most commonly affected by this condition (48.3%). Fitzpatrick type IV was the most commonly seen skin type (55.3%), followed by skin type V(41.6%), and type III (1.3%).The majority of patients(51.3%) in the present study had melasma lesions for less than1 year duration. Malar was the predominant clinical pattern(63%). Epidermal type of melasma was the most common (43.3%). The majority had no family history(55%) in the present study. Out of 300 patients, 21 (70%) had sun exposure for less than1 hour every day.The most common etiological factor was sun exposure, found in 120 patients(40%). Most of the patients (60%) reported aggravation of lesions with sun exposure, followed by cosmetic usage in 28.3% patients(fair and lovely, ponds, vicco, miltani mitti, borolin); the least commonly found aggravating factor was drug usage (tetracycline, steroids, phenytoin, cisplatin) reported in only 5% of patients. Only 105 (35%) out of 300 patients were treatment naïve.The rest of the patients included in the study had used some form of treatment before the presentation. Hypothyroidism was observed in 55 patients (18.3%) in the present study. Conclusion: The pathogenic mechanism causing melasma might be heterogeneous in various ethnic groups in the population. This study approaches towards recognizing the epidemiology and etiology of melasma which in turn can provide ideas to solve the therapeutic challenges in treatment of this condition.

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