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Melazma Hastalarının Epidemiyolojik ve Klinik Özelliklerinin Değerlendirilmesi

Year 2023, Volume: 76 Issue: 3, 220 - 226, 24.10.2023

Elif Demirci Saadet

Abstract

Amaç: Melazma en sık yüz bölgesinde yerleşen, hiperpigmente lezyonlarla karakterli edinsel bir pigmentasyon bozukluğudur. Etiyolojisi tam olarak bilinmemekle birlikte; genetik faktörler, ultraviyole maruziyeti, oral kontraseptifler (OKS), hormonlar, gebelik, ilaç kullanımı, bazı kozmetik ürünler, endokrinolojik hastalıklar ve psikolojik faktörler tetikleyebilmektedir Çalışmamızda melazma tanısı alan hastaların epidemiyolojik özelliklerini araştırmak ve ülkemizdeki verilere katkı sağlamak amaçlanmıştır.

Gereç ve Yöntem: 2013-2021 yılları arasında dermatoloji kliniğine başvuran ve melazma tanısı almış hastaların dosyaları geriye dönük tarandı. Hastaların yaş, cinsiyet, Fitzpatrick deri tipi, melazmanın klinik tipi, güneşten koruyucu kullanımları, gebelik, OKS kullanımı, diğer ilaç kullanımları ve aile öyküleri incelendi. Ayrıca serbest T3 ve T4, TSH ve tiroid oto antikorlarının sonuçları kayıt edildi. İstatistiksel analizler için SPSS 26 (Statistical Package for the Social Sciences) programı kullanıldı.

Bulgular: İki yüz doksan üç hasta çalışmaya dahil edildi ve ortalama yaşları 37,17±7,97 yıl olup, tümü kadındı. Hastaların %4,4’ü deri tipi II, %51,2’si deri tipi III ve %44’ü deri tipi IV’e sahipti. Melazma %48,5 malar, %45,1 santrofasiyal, %3,8 mandibular tipteydi. Olguların %34,5’inde gebelik, %17,4’ünde aile öyküsü, %13’ünde OKS kullanımı saptandı. Gebelikle tetiklenen olgularda malar ve mandibular yerleşim anlamlı düzeyde yüksek saptanırken, santrofasiyal yerleşim oranı anlamlı düzeyde düşük saptandı (p<0,05). Deri tipi II olan hastalarda güneşten koruyucu kullanma alışkanlığı daha fazlaydı (p<0,05).

Sonuç: Melazma en sık gebelik, ultraviyole maruziyeti ve OKS kullanımına bağlı olarak gelişen ve kadınlarda daha sık görülen bir pigmentasyon bozukluğudur. Güneşten korunma hastalığı önlemede etkili olmasına rağmen hastaların çok az bir kısmı düzenli güneşten koruyucu uygulamaktadır.

Anahtar Kelimeler: Melazma, Etiyoloji, Klinik Özellikler

Keywords

Melazma Etiyoloji Klinik Özellikler

Ethical Statement

Çalışma öncesi Medicana Ankara Hastanesi Etik Kurulu’ndan BŞH-2022/02 sayılı onay alındı (tarih: 29.01.2022).

Supporting Institution

-

Project Number

-

Thanks

-

References

  • 1. Doolan BJ, Gupta M. Melasma. Aust J Gen Pract. 2021;50:880-885.
  • 2. Handel AC, Miot LD, Miot HA. Melasma: a clinical and epidemiological review. An Bras Dermatol. 2014;89:771-782.
  • 3. Majid I, Aleem S. Melasma: Update on Epidemiology, Clinical Presentation, Assessment, and Scoring. J Skin Stem Cell. 2021;8:e120283.
  • 4. Balık Z, Balık A, Yüksel S, et al. Evaluation of Demographic Features, Clinical Characteristics and Quality of Life in Melasma Patients as Compared to the Control Group. Turkiye Klinikleri J Dermatol. 2020;30:81-87.
  • 5. Ozdemir S, Ozdemir M. Melasma in Pregnancy. Turkderm-Turk Arch Dermatol Venereol. 2006;40:98-100.
  • 6. Çakmak SK, Özcan N, Kılıç A, et al. Etiopathogenetic factors, thyroid functions and thyroid autoimmunity in melasma patients. Postepy Dermatol Alergol. 2015;32:327-330.
  • 7. Tzouveka E. Epidemiology and Risk Factors of Melasma. J Pigment Disord. 2014:1;1-3.
  • 8. Sarkar R, Jain RK, Puri P. Melasma in Indian males. Dermatol Surg. 2003;29:204.
  • 9. Tamega Ade A, Miot LD, Bonfietti C, et al. Clinical patterns and epidemiological characteristics of facial melasma in Brazilian women. J Eur Acad Dermatol Venereol. 2013;27:151-156.
  • 10. Guinot C, Cheffai S, Latreille J, et al. Aggravating factors for melasma: a prospective study in 197 Tunisian patients. J Eur Acad Dermatol Venereol. 2010;24:1060-1069.
  • 11. Achar A, Rathi SK. Melasma: a clinico-epidemiological study of 312 cases. Indian J Dermatol. 2011;56:380-382.
  • 12. Sarkar R, Jagadeesan S, Basavapura Madegowda S, et al. Clinical and epidemiologic features of melasma: a multicentric cross-sectional study from India. Int J Dermatol. 2019;58:1305-1310.
  • 13. Goh CL, Dlova CN. A retrospective study on the clinical presentation and treatment outcome of melasma in a tertiary dermatological referral centre in Singapore. Singapore Med J. 1999;40:455-458.
  • 14. Hexsel D, Lacerda DA, Cavalcante AS, et al. Epidemiology of melasma in Brazilian patients: a multicenter study. Int J Dermatol. 2014;53:440-444.
  • 15. Handel AC, Lima PB, Tonolli VM, et al. Risk factors for facial melasma in women: a case-control study. Br J Dermatol. 2014;171:588-594.
  • 16. Satish DA, Aparna AD, Radhika VK. A clinico-epidemiological study of melasma in 402 patients in an office-based practice. Clin Dermatol Rev. 2019;3:154-156.
  • 17. Lakhdar H, Zouhair K, Khadir K, et al. Evaluation of the effectiveness of a broad-spectrum sunscreen in the prevention of chloasma in pregnant women. J Eur Acad Dermatol Venereol. 2007;21:738-742.
  • 18. Boukari F, Jourdan E, Fontas E, et al. Prevention of melasma relapses with sunscreen combining protection against UV and short wavelengths of visible light: a prospective randomized comparative trial. J Am Acad Dermatol. 2015;72:189-190.
  • 19. KrupaShankar DS, Somani VK, Kohli M, et al. A cross-sectional, multicentric clinico-epidemiological study of melasma in India. Dermatol Ther (Heidelb).2014;4:71-81.
  • 20. Lutfi RJ, Fridmanis M, Misiunas AL, et al. Association of melasma with thyroid autoimmunity and other thyroidal abnormalities and their relationship to the origin of the melasma. J Clin Endocrinol Metab. 1985;61:28-31.
  • 21. Yazdanfar A, Hashemi B. Association of melasma with thyroid autoimmunity: a case-control study. Iran J Dermatol. 2010;13:51-53.
  • 22. Kheradmand M, Afshari M, Damiani G, et al. Melasma and thyroid disorders: a systematic review and meta-analysis. Int J Dermatol. 2019;58:1231-1238.
  • 23. Yazıcı AC, Baz K, İkizoğlu G, et al. The role of sex and thyroid hormones in the etiopathogenesis of melasma in men. Turkiye Klinikleri J Med Sci. 2006;26:240-244.

Evaluation of Epidemiological and Clinical Features of Melasma Patients

Year 2023, Volume: 76 Issue: 3, 220 - 226, 24.10.2023

Elif Demirci Saadet

Abstract

Objectives: Melasma is an acquired pigmentation disorder characterized by hyperpigmented lesions most commonly located in the face area. Although the etiology is not fully known; genetic factors, ultraviolet exposure, oral contraceptive pills (OCPs), hormones, pregnancy, drug use, cosmetic products, endocrinological diseases, and psychological factors can trigger. In our study, it was aimed to investigate the epidemiological characteristics of patients diagnosed with melasma and to contribute to the data in our country.

Methods: The data of patients who applied to the dermatology clinic between 2013-2021 and were diagnosed with melasma were retrospectively analyzed. Age, sex, Fitzpatrick skin type, clinical type of melasma, sunscreen use, pregnancy, OCP use, other drug use, and family history of the patients were examined. In addition, the results of free T3 and T4, TSH, and thyroid autoantibodies were recorded. SPSS 26 (Statistical Package for the Social Sciences) program was used for statistical analysis.

Results: Two hundred and ninety-three patients were included in the study and their mean age was 37.17±7.97 years, all of whom were female. 4.4% of the patients had skin type II, 51.2% had skin type III and 44% had skin type IV. Melasma was 48.5% malar, 45.1% centrofacial and 3.8% mandibular type. Pregnancy was detected in 34.5%, family history in 17.4%, and OCP use in 13% of the cases. In cases triggered by pregnancy, malar, and mandibular type were significantly higher, while the centrofacial type rate was significantly lower (p<0.05). The rate of using sunscreen was higher in patients with skin type II (p<0.05).

Conclusion: Melasma is a pigmentation disorder that most commonly develops due to pregnancy, ultraviolet exposure, and OCP use and is more common in women. Although sun protection is effective in preventing the disease, very few patients apply sunscreen regularly.

Key Words: Melasma, Etiology, Clinical Features

Keywords

Melasma Etiology Clinical Features

Ethical Statement

Çalışma öncesi Medicana Ankara Hastanesi Etik Kurulu’ndan BŞH-2022/02 sayılı onay alındı (tarih: 29.01.2022).

Supporting Institution

-

Project Number

-

Thanks

-

References

  • 1. Doolan BJ, Gupta M. Melasma. Aust J Gen Pract. 2021;50:880-885.
  • 2. Handel AC, Miot LD, Miot HA. Melasma: a clinical and epidemiological review. An Bras Dermatol. 2014;89:771-782.
  • 3. Majid I, Aleem S. Melasma: Update on Epidemiology, Clinical Presentation, Assessment, and Scoring. J Skin Stem Cell. 2021;8:e120283.
  • 4. Balık Z, Balık A, Yüksel S, et al. Evaluation of Demographic Features, Clinical Characteristics and Quality of Life in Melasma Patients as Compared to the Control Group. Turkiye Klinikleri J Dermatol. 2020;30:81-87.
  • 5. Ozdemir S, Ozdemir M. Melasma in Pregnancy. Turkderm-Turk Arch Dermatol Venereol. 2006;40:98-100.
  • 6. Çakmak SK, Özcan N, Kılıç A, et al. Etiopathogenetic factors, thyroid functions and thyroid autoimmunity in melasma patients. Postepy Dermatol Alergol. 2015;32:327-330.
  • 7. Tzouveka E. Epidemiology and Risk Factors of Melasma. J Pigment Disord. 2014:1;1-3.
  • 8. Sarkar R, Jain RK, Puri P. Melasma in Indian males. Dermatol Surg. 2003;29:204.
  • 9. Tamega Ade A, Miot LD, Bonfietti C, et al. Clinical patterns and epidemiological characteristics of facial melasma in Brazilian women. J Eur Acad Dermatol Venereol. 2013;27:151-156.
  • 10. Guinot C, Cheffai S, Latreille J, et al. Aggravating factors for melasma: a prospective study in 197 Tunisian patients. J Eur Acad Dermatol Venereol. 2010;24:1060-1069.
  • 11. Achar A, Rathi SK. Melasma: a clinico-epidemiological study of 312 cases. Indian J Dermatol. 2011;56:380-382.
  • 12. Sarkar R, Jagadeesan S, Basavapura Madegowda S, et al. Clinical and epidemiologic features of melasma: a multicentric cross-sectional study from India. Int J Dermatol. 2019;58:1305-1310.
  • 13. Goh CL, Dlova CN. A retrospective study on the clinical presentation and treatment outcome of melasma in a tertiary dermatological referral centre in Singapore. Singapore Med J. 1999;40:455-458.
  • 14. Hexsel D, Lacerda DA, Cavalcante AS, et al. Epidemiology of melasma in Brazilian patients: a multicenter study. Int J Dermatol. 2014;53:440-444.
  • 15. Handel AC, Lima PB, Tonolli VM, et al. Risk factors for facial melasma in women: a case-control study. Br J Dermatol. 2014;171:588-594.
  • 16. Satish DA, Aparna AD, Radhika VK. A clinico-epidemiological study of melasma in 402 patients in an office-based practice. Clin Dermatol Rev. 2019;3:154-156.
  • 17. Lakhdar H, Zouhair K, Khadir K, et al. Evaluation of the effectiveness of a broad-spectrum sunscreen in the prevention of chloasma in pregnant women. J Eur Acad Dermatol Venereol. 2007;21:738-742.
  • 18. Boukari F, Jourdan E, Fontas E, et al. Prevention of melasma relapses with sunscreen combining protection against UV and short wavelengths of visible light: a prospective randomized comparative trial. J Am Acad Dermatol. 2015;72:189-190.
  • 19. KrupaShankar DS, Somani VK, Kohli M, et al. A cross-sectional, multicentric clinico-epidemiological study of melasma in India. Dermatol Ther (Heidelb).2014;4:71-81.
  • 20. Lutfi RJ, Fridmanis M, Misiunas AL, et al. Association of melasma with thyroid autoimmunity and other thyroidal abnormalities and their relationship to the origin of the melasma. J Clin Endocrinol Metab. 1985;61:28-31.
  • 21. Yazdanfar A, Hashemi B. Association of melasma with thyroid autoimmunity: a case-control study. Iran J Dermatol. 2010;13:51-53.
  • 22. Kheradmand M, Afshari M, Damiani G, et al. Melasma and thyroid disorders: a systematic review and meta-analysis. Int J Dermatol. 2019;58:1231-1238.
  • 23. Yazıcı AC, Baz K, İkizoğlu G, et al. The role of sex and thyroid hormones in the etiopathogenesis of melasma in men. Turkiye Klinikleri J Med Sci. 2006;26:240-244.
There are 23 citations in total.

Details

Primary Language English
Subjects Dermatology
Journal Section Articles
Authors

Elif Demirci Saadet 0000-0001-7449-7951

Project Number -
Publication Date October 24, 2023
Published in Issue Year 2023 Volume: 76 Issue: 3

Cite

APA Demirci Saadet, E. (2023). Evaluation of Epidemiological and Clinical Features of Melasma Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 76(3), 220-226. https://doi.org/10.4274/atfm.galenos.2023.24196
AMA Demirci Saadet E. Evaluation of Epidemiological and Clinical Features of Melasma Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası. October 2023;76(3):220-226. doi:10.4274/atfm.galenos.2023.24196
Chicago Demirci Saadet, Elif. “Evaluation of Epidemiological and Clinical Features of Melasma Patients”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 76, no. 3 (October 2023): 220-26. https://doi.org/10.4274/atfm.galenos.2023.24196.
EndNote Demirci Saadet E (October 1, 2023) Evaluation of Epidemiological and Clinical Features of Melasma Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası 76 3 220–226.
IEEE E. Demirci Saadet, “Evaluation of Epidemiological and Clinical Features of Melasma Patients”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 76, no. 3, pp. 220–226, 2023, doi: 10.4274/atfm.galenos.2023.24196.
ISNAD Demirci Saadet, Elif. “Evaluation of Epidemiological and Clinical Features of Melasma Patients”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 76/3 (October 2023), 220-226. https://doi.org/10.4274/atfm.galenos.2023.24196.
JAMA Demirci Saadet E. Evaluation of Epidemiological and Clinical Features of Melasma Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2023;76:220–226.
MLA Demirci Saadet, Elif. “Evaluation of Epidemiological and Clinical Features of Melasma Patients”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 76, no. 3, 2023, pp. 220-6, doi:10.4274/atfm.galenos.2023.24196.
Vancouver Demirci Saadet E. Evaluation of Epidemiological and Clinical Features of Melasma Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2023;76(3):220-6.
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