Clinico-epidemiological Study and Quality of Life Assessment in Melasma

BACKGROUND: Melasma is one of the most common and distressing pigmentary disorders presenting to dermatology clinics. The precise cause of melasma remains unknown. It is notably difficult to treat and has a tendency to relapse. Its population prevalence varies according to ethnic composition, skin phototype, and intensity of sun exposure. Due to its frequent facial involvement, the disease has an impact on the quality of life of patients. AIMS: To study the clinico-epidemiological pattern, dermascopy, wood's lamp findings and the quality of life in patients with melasma. SETTINGS AND DESIGN: Observational/descriptive study. MATERIALS AND METHODS: Patients with melasma were screened. History, clinical examination, Wood's lamp examination (WLE) and dermoscopy were done. Severity of melasma was assessed by the calculating melasma area severity index (MASI) score. Quality of Life (QOL) was assessed using MELASQOL scale with a standard structured questionnaire. STATISTICAL ANALYSIS: Descriptive, Chi-square test and contingency coefficient analysis. RESULTS: In 140 cases of melasma, 95 (67.9%) were females and 45 (32%) were males. Common age group affected was 31-40 years (65%). Majority were unskilled workers with average sun exposure of more than 4 hours (44%). Family history was observed in 18% cases. Malar type (68%) was the most common pattern observed. Mean MASI score was 5.7. WLE showed dermal type in 69% cases. Common findings on dermoscopy were reticular pigment network with perifollicular sparing and color varying from light to dark brown. Mean MELASQOL score was 28.28, with most patients reporting embarrassment and frustration. CONCLUSIONS: This study showed that melasma has a significant negative effect on QOL because though asymptomatic it is disfiguring affecting self-esteem. Dermoscopic examination did not help in differentiating the type of melasma.