Sinta Murlistyarini; Sekar Puspita Lilasari; Santosa Basuki
Abstract
Background: Melasma is a hypermelanosis disorder of the skin induced by UV radiation, which triggers various inflammatory mediators, including prostaglandin E2 (PGE2) and interleukin-17 (IL-17). This study aimed to evaluate the difference in serum PGE2 and IL-17 levels between melasma and non-melasma ...
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Background: Melasma is a hypermelanosis disorder of the skin induced by UV radiation, which triggers various inflammatory mediators, including prostaglandin E2 (PGE2) and interleukin-17 (IL-17). This study aimed to evaluate the difference in serum PGE2 and IL-17 levels between melasma and non-melasma patients.Methods: We consecutively sampled the melasma and nonmelasma patients in the Dermatovenereology Outpatient Clinic of Dr. Saiful Anwar Hospital, Malang, Indonesia, from November to December 2017. As many as 46 people, ranging from 21–55 years old, were divided into two groups based on the inclusion and exclusion criteria. The examination of PGE2 and IL-17 serum levels was done using ELISA.Results: The average serum PGE2 level was 886.04 ± 785.32 ng/L in the melasma group and 541.70 ± 408.54 ng/L in the non-melasma group. The average serum IL-17 level was 82.23 ± 61.08 ng/L in melasma subjects and 52.66 ± 28.62 ng/L in non-melasma.Conclusion: The increased PGE2 serum level in melasma plays a role in the process of melanogenesis in keratinocytes and melanocytes and affects the mechanism of vasodilation. IL-17 augments COX-2 levels, thereby causing chronic melasma.
Madhulika A Mhatre; Shashikant Malkud; Venkataram Mysore
Abstract
Background: The Q-switched neodymium: yttrium aluminum garnet laser (QS-Nd:YAG) is effective in the treatment of tattoos and different pigmentary conditions; however, little has been published regarding the removal of facial cutaneous pigmented lesions. The aim of this study was to determine the effectiveness ...
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Background: The Q-switched neodymium: yttrium aluminum garnet laser (QS-Nd:YAG) is effective in the treatment of tattoos and different pigmentary conditions; however, little has been published regarding the removal of facial cutaneous pigmented lesions. The aim of this study was to determine the effectiveness and safety of QS-Nd:YAG laser in the treatment of facial pigmentary lesions in Indian patients. Methods: Data of 100 patients with pigmented facial lesions treated with QS-Nd:YAG laser were analyzed. Clinical improvement of skin lesions was assessed by the physician’s global assessment of two blinded observers. This was done based on photographs taken at the baseline and after the last treatment session. Side effects were recorded if present, and patient satisfaction was evaluated after each treatment session. Results: The majority of the patients had post-inflammatory hyperpigmentation (n=41), followed by melasma (n=19), photomelanosis (n=15), nevus of Ota (n=5), periorbital melanosis (n=5), nevus spilus (n=3), Riehl melanosis (n=3), Café-au-lait macules (n=2), freckles (n=2), lichen planus pigmentosus (n=2), compound nevus (n=1), Hori’s nevus (n=1), and pigmentary demarcation lines (n=1). 10% of patients showed more than 50% improvement in pigmentation from the baseline level; no response was seen in 22% of patients, while 7% experienced worsened pigmentation. Conclusion: The degree of improvement and efficacy in clearing pigmentation is partial, variable, and inconsistent. Worsening of pigmentation may be seen and needs to be discussed with the patient prior to treatment
Sepideh Tehrani; Setareh Tehrani; Mitra Esmaili-Azad; Mahnaz Vaezi; Nazi Saljoughi
Volume 15, Issue 1 , 2012, , Pages 11-14
Abstract
Background: Melasma is a brown or grayish brown symmetrical facial hyperpigmentation.A number of medicamens can be used for the treatment of this condition. For better results in treating melasma, combination therapy is preferred. The aim of this study was to determine the clinical efficacy and adverse ...
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Background: Melasma is a brown or grayish brown symmetrical facial hyperpigmentation.A number of medicamens can be used for the treatment of this condition. For better results in treating melasma, combination therapy is preferred. The aim of this study was to determine the clinical efficacy and adverse effects of azelaic acid 20% plus hydroquinone 5% versus hydroquinone 5% alone in the management of melasma. Method: This study was performed as a double blind randomized clinical trial. We randomly prescribed two regimes including azelaic acid 20% cream plus hydroquinone 5% or hydroquinone 5% alone once daily for 4 months in 64 patients. Clinical efficacy (with MASI score) and side effects were assessed after one, two and four months of treatment. Result: MASI score reduction was from 9.35 to 2.9 in patients using azelaic acid 20% plus hydroquinone and from 9.58 to 4.02 in patients using hydroquinone 5%. Drug adverse effects, including burning (most frequent), itching, stinging, dryness and erythema, were present in 50% of the participants in the azelaic acid 20% plus hydroquinone group and 35% of the individuals in the hydroquinone 5% group (P= 0.034), but were tolerated by most patients. Conclusion: Both therapeutic regimens showed a remarkable efficacy in the treatment of melasma but azelaic acid 20% plus hydroquinone was more effective with a more rapid onset of therapeutic response. Azelaic acid 20% plus hydroquinone had more side effects although they were slight in most cases.
Yazdanfar Ameneh; Hashemi Banafsheh
Volume 13, Issue 2 , 2010, , Pages 51-53
Abstract
Introduction: Melasma is a common acquired hypermelanosis seen mainly in women which occurs on the sun-exposed skin of the face. The exact cause of melasma is unknown. The majority of the cases are attributed to pregnancy, combined oral contraceptive pills, genetic factors, sun exposure, use of cosmetic ...
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Introduction: Melasma is a common acquired hypermelanosis seen mainly in women which occurs on the sun-exposed skin of the face. The exact cause of melasma is unknown. The majority of the cases are attributed to pregnancy, combined oral contraceptive pills, genetic factors, sun exposure, use of cosmetic products, thyroid disorders and anti-convulsant drugs. This study was performed to evaluate the relationship between thyroid autoimmunity and melasma. Methods: In this case-control study, 45 females with melasma who were 20-50 years old and were referred to our clinic and 45 age-matched healthy females with no history of melasma as the control group were evaluated. The skin and thyroid of all of them were examined carefully and their sera were collected and evaluated for thyroid function tests and anti thyroid peroxidase (anti TPO). Data was also statistically analyzed. Results: Serum anti TPO level was higher than normal in %24.4 of the patients and %6.7 of the controls. The difference between two groups was statistically significant (P=0.019). Serum T3 level was higher than normal in %75.6 of the patients and %48.9 of the controls. The difference between the two groups was also statistically significant (P=0.008). Mean serum anti TPO, T3 and TSH were higher in the case group than the control group, but the difference was not statistically significant. Conclusion: A possible relationship might be observed between thyroid autoimmunity and melasma.
Hasan Edalatkhan; Nayereh Amini Sani; Somayeh Zeynizadeh
Volume 10, Issue 1 , 2007, , Pages 54-59
Abstract
Background and aim: It seems that melanocytic nevi, freckle and lentigo are more common in women with melasma, and a common genetic background may exist. In this study the prevalence and number of lentigo, freckle and melanocytic nevus were compared in women with and without melasma.Materials and methods: ...
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Background and aim: It seems that melanocytic nevi, freckle and lentigo are more common in women with melasma, and a common genetic background may exist. In this study the prevalence and number of lentigo, freckle and melanocytic nevus were compared in women with and without melasma.Materials and methods: In a case-control study, 120 women with melasma (case group) and 120 women without melasma (control group), matched for age, were examined by a dermatologist. The singnosis of lesions were done only by clinical observation. Data were analysed by SPSS software using chi-square (or Fisher) test and p<0.05 was considered as significant.Results: The mean age was 29.97±6.6 years in case group and 29.7±6.7 in control group (non significant). Prevalence of freckles was higher in control group (24.3% versus 4.16%, p<0.001). 77 patients (64.1%) in case group and 20 (16.6%) of control group had lentigo (p<0.001). The mean number of lentigo in case group was 25.2 and in control group was 8 (p=0.01). The prevalence of melanocytic nevus in control group was lower than case group (96.6% versus 98.3%), but this difference was not significant. The mean number of melanocytic nevi was 2.8 in control group and 13.2 in case group (p<0.001). Campbell de Morgan angiomas were seen in 26 (21.8%) of case group and in 6 (5%) of control group (p<0.001). The mean number of these angiomas was 1 in control group and 5.2 in case group (p=0.02).Conclusion: The prevalence and number of melanocytic nevi were higher in women who had melasma. Common factors or genes may have a role in appearing of melasma and moles.
A Kiani; M Ahmari; MR Rezvani Far
Volume 9, Issue 2 , 2006, , Pages 154-158
Abstract
Background and aim: Melasma is an acquired, symmetric hyperpigmentation, specially in sun-exposed skin. Disorders of thyroid gland result from processes that stimulate the overproduction or underproduction of thyroid hormones. This study was performed to assess the association of melasma with thyroid ...
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Background and aim: Melasma is an acquired, symmetric hyperpigmentation, specially in sun-exposed skin. Disorders of thyroid gland result from processes that stimulate the overproduction or underproduction of thyroid hormones. This study was performed to assess the association of melasma with thyroid disorders.Materials and Methods: This case-control study was performed on 45 non-pregnant women between 20-50 years with and without melasma. Thyroid hormones and autoantibodies including T3, T4, TSH, anti TPO and anti TG were measured by ELISA in both groups.Results: In patients with melasma, the frequency of thyroid disorders was 37.8% versus 11.1% in the control group (P=0.013,OR=4.8,95% CI=1.60-14.7). The mean level of TSH, anti TPO and anti TG in control patients was lower than in patients but the difference was not significant.Conclusion: Melasma is associated with thyroid disorders specially hypothyroidism and autoimmune disorders.
SH Tabatabaei
Volume 9, Issue 1 , 2006, , Pages 71-82
H Edalat Khah; F Amani; G Rezaifar
Volume 7, Issue 2 , 2004, , Pages 72-77
Abstract
Background: Melasma is a pattern of facial pigmentation that affects upper lip, cheeks, forehead and chin. The disease is seen mainly in 30-55 year old women, and may be regarded as a physiological change in pregnancy. Its etiologic nature is still unknown. Objective: To determine the prevalence of melasma ...
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Background: Melasma is a pattern of facial pigmentation that affects upper lip, cheeks, forehead and chin. The disease is seen mainly in 30-55 year old women, and may be regarded as a physiological change in pregnancy. Its etiologic nature is still unknown. Objective: To determine the prevalence of melasma in women in Ardebil city. Patients and Methods: The study was cross sectional-descriptive study done on 855 women in Ardebil city in 2002. Sampling method was cluster and 855 women in the age range of 12-85 years in 25 health services (From each family one woman over 11 years) were randomly selected and necessary information have been collected by a questionnaire. Descriptive and analytic statistics were used to analyze data in SPSS program. Results: The prevalence of melasma among total participants was 39.5% and 9.5% of melasma cases were pregnant women. The distribution of hyperpigmentation was mainly centrofacial (64.7%), and in 40.8% cases there was a positive familial history for melasma. Conclusion: Melasma is a common disease in Ardebil, and abundant search is necessary to understand the etiology and treatment of this disease.
MR Mortazavi; Z Safaei Naraghi; M Mohammad Zadeh
Volume 7, Issue 1 , 2003, , Pages 38-42
Abstract
Actinic lichen planus is a clinical variant of lichen planus, involving mainly sun-exposed areas and manifested as annular lesions with a pigmented center surrounded by a hypopigmented zone. A rare presentation of actinic lichen planus mimics melasma but have distinctive histopathologic picture in favour ...
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Actinic lichen planus is a clinical variant of lichen planus, involving mainly sun-exposed areas and manifested as annular lesions with a pigmented center surrounded by a hypopigmented zone. A rare presentation of actinic lichen planus mimics melasma but have distinctive histopathologic picture in favour of actinic lichen planus. Herein, we report a 14-year-old boy who presented with a melasma-like patch on the left side of forehead. Histopathologic findings including pigmentation of basal layer accompanied with vacuolization and also pigmentary macrophages in dermis were in favour of actinic lichen planus.
H Edalat Khah; M Mirza Namadi
Volume 6, Issue 2 , 2003, , Pages 14-19
Abstract
Background: Melasma is the acquired, gradual and symmetric hyper pigmentation of the face. Melasma has been related to many factors such as pregnancy, genetic, endocrine and sun exposure but the exact relationship to endocrine factors isn’t still clear. Objectives: To evaluate the relationship ...
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Background: Melasma is the acquired, gradual and symmetric hyper pigmentation of the face. Melasma has been related to many factors such as pregnancy, genetic, endocrine and sun exposure but the exact relationship to endocrine factors isn’t still clear. Objectives: To evaluate the relationship between melasma and polycystic ovarian disease and androgenic hormones. Patients and Methods: This case-control study was performed on 101 patients with melasma and 101 control patients referred to the skin clinic of Ardebil University of Medical Sciences. Serum levels of LH, FSH, DHEAS, prolactin, testosterone and 17-hydroxy progesterone were measured and sonography of ovaries was done. Results: The age of the study subjects ranged from 15 to 45 years. There was no significant difference in serum levels of any of hormones between cases and control groups (P<0.05). Ovarian cysts were found in 65.3% of melasma patients and 47.5% of control patients (P=0.01). Conclusion: These results confirm the possible role of ovarian cysts or another common etiologic factor in melasma. More studies are required in this subject.