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DOI 10.1007/s13555-014-0046-1
ORIGINAL RESEARCH
ABSTRACT
common
condition.
pigment
disorders
seen
by
Patients
were
examined
to
study
India
identify
the
V. R. Mysore
Venkat Charmalaya Clinic, Vijayanagar, Bangalore,
Karnataka, India
S. Aurangabadkar
Skin and Laser Clinic, Brij Tarang, Green Lands,
Begumpet, Hyderabad, Andhra Pradesh, India
S. Malakar
Rita Skin Foundation, GD Block, Salt Lake City,
Kolkata 700106, West Bengal, India
M. Vedamurthy
RSV Skin and Laser Centre, Mahalinghapuram,
Chennai, Tamil Nadu, India
G. Kadhe S. Motlekar P. Ahirrao
Wockhardt Ltd., Wockhardt Towers, Bandra Kurla
Complex, Mumbai 400051, Maharashtra, India
72
were
documented.
Results: The mean age of the 331 enrolled
Other
factors
such
as
concomitant
on
the
regional
variability
in
the
and
METHODS
Study Characteristics
Epidemiology;
INTRODUCTION
2012August 2012).
increased
Melasma
occurs
due
to
an
73
replacement
therapy
(HRT)
among
postmenopausal women, oral contraceptives
use
Data Collection
female
and
concomitant
conditions
were
excluded.
Informed Consent
Statistical Analysis
Study Assessments
including
age,
gender,
marital
p\0.05 was
significant.
RESULTS
considered
as
statistically
74
with
(range
2062 years)
patients
was
centrofacial
melasma
(42%)
Disease Chronicity
East
West
North
South
Overall
44
82
78
127
331
34.3 8.9
38.6 7.7
40.2 9.2
35.4 9.9
37.2 9.3
0.0003*
Sex (M/F)
(10/34)
(13/69)
(13/65)
(29/98)
(65/266)
0.5604
(23/21)
(69/13)
(68/10)
(97/30)
(257/74)
8 (18.18)
23 (28.04)
30 (38.46)
42 (33)
103 (31.11)
Chi-square test
* One-way ANOVA
p value
\0.001
0.1207
13 (17%)
31 (40%)
24 (31%)
7 (9%)
12 (15%)
19 (24%)
15 (19%)
32 (41%)
2029
3039
4049
[50
\1
12
23
[3
Distribution
Melasma pattern
3 (4%)
\20
3 (4%)
2 (2%)
4 (5%)
Upper lip
Chin
Mandible
21 (27%)
Forehead
36 (46%)
14 (18%)
Nose
4 (5%)
Mandibular
74 (95%)
17 (22%)
Malar
Cheeks
43 (55%)
Centrofacial
North
(n 5 78)
Regions (n/ %)
Parameter
Explanatory variable
1 (2%)
7 (16%)
15 (34%)
18 (41%)
44 (100%)
21 (48%)
23 (52%)
23 (52%)
5 (11%)
9 (20%)
7 (16%)
5 (11%)
16 (36%)
20 (45%)
3 (7%)
East
(n 5 44)
6 (7%)
8 (10%)
19 (23%)
42 (51%)
75 (91%)
9 (11%)
41 (50%)
32 (39%)
35 (43%)
13 (16%)
19 (23%)
15 (18%)
1 (1%)
14 (17%)
35 (43%)
24 (29%)
8 (10%)
West
(n 5 82)
7 (5%)
8 (6%)
14 (11%)
31 (24%)
59 (46%)
117 (92%)
8 (6%)
1 (1%)
1 (1%)
24 (19%)
51 (40%)
42 (33%)
52 (42%)
18 (14%)
55 (43%)
2 (2%)
5 (4%)
24 (19%)
54 (42%)
38 (30%)
6 (4%)
South
(n 5 127)
11(3%)
17 (5%)
32 (10%)
86 (26%)
115 (35%)
310 (94%)
8 (2%)
47 (14%)
4 (1%)
130 (39%)
140 (42%)
142 (43%)
51 (15%)
102 (31%)
36 (11%)
13 (4%)
67 (20%)
136 (41%)
95 (29%)
20 (6%)
Overall
(n/ %)
54 (69%)
16 (20%)
Yes
Yes
0
72 (92%)
6 (8%)
3 [15]
Upper Lower
Upper Middle
Upper
Quality of life [IQR]
20 (26%)
17 (22%)
0
3 (4%)
0
0
38 (49%)
Triple combination
Monotherapy
Combination therapy
HQAHA combination
Supercial chemical peel
Vitamin C
No treatment
Treatment used
Lower Middle
Socioeconomic class
8 (10%)
Yes
16 (21%)
No
10 (13%)
45 (58%)
Multiple
Yes
4 (5%)
Single
Menopause status
Pregnancy
29.84 16.9
North
(n 5 78)
Regions (n/ %)
Parameter
Explanatory variable
Table 2 continued
17 (39%)
1 (2%)
12 (27%)
6 (14%)
19 (43%)
4 [45]
14 (32%)
26 (59%)
2 (5%)
2 (5%)
10 (23%)
14 (32%)
11 (25%)
9 (20%)
22 (50%)
11 (25%)
32.1 15.4
East
(n 5 44)
12 (15%)
13 (16%)
40 (49%)
2 (2%)
1 (1%)
52 (63%)
6 [3.257]
23 (28%)
39 (48%)
8 (10%)
12 (15%)
2 (2%)
8 (10%)
12 (15%)
36 (44%)
21 (26%)
37 (45%)
36 (44%)
32.7 20.1
West
(n 5 82)
102 (80%)
1 (1%)
1 (1%)
24 (19%)
4 [25]
11 (9%)
80 (63%)
5 (4%)
29 (23%)
3 (2%)
19 (15%)
21 (17%)
44 (35%)
33 (26%)
16 (20%)
16 (13%)
42.9 33.8
South
(n 5 127)
169 (51%)
15 (5%)
53 (5%)
5 (2%)
24 (7%)
115 (35%)
4 [25]
54 (16%)
217 (66%)
17 (5%)
43 (13%)
23 (7%)
37 (11%)
63 (19%)
136 (41%)
67 (20%)
116 (35%)
117 (35%)
35.9 25.7
Overall
(n/ %)
76
Dermatol Ther (Heidelb) (2014) 4:7181
77
of Melasma
(Fig. 1).
The association of other conditions with the
the
and
region (32%).
having
used
mometasone-based
triple
78
(7%)
and
DISCUSSION
Melasma is a hyperpigmentation disorder that
occurs on the sun-exposed areas of the skin.
Hyperpigmentation appears on the face and
neck; however, it may also occur in other
locations. Caucasian women and individuals
of darker complexion are more prone to this
disorder [12, 13]. Melasma has been reported in
8.8% of Latin American females in the southern
USA and in up to 40% population in south-east
Asia [14, 15].
Melasma is more prevalent among women.
There is no documented literature for the
overall prevalence of melasma in India. The
present study demonstrated melasma in 24.4%
men consistent with the results of previous
of
females
with
melasma.
79
patients.
Most patients included in the present study
were
Centrofacial
and
malar
regions
causative
factors
have
been
CONCLUSION
The result of the study showed that there is a
regional variability in
clinical manifestations
the demographics,
and factors that
80
ACKNOWLEDGMENTS
Sponsorship and article-processing charges for
this study were funded by Wockhardt Ltd.
Medical writing assistance for this study was
provided by Gurpreet Virya of Knowledge
Isotopes Pvt. Ltd. (Mohali, Punjab, India) and
was funded by Wockhardt Ltd (Mumbai, India).
All named authors meet the ICMJE criteria for
authorship
for
this
manuscript,
take
responsibility for the integrity of the work as a
whole and have given final approval for the
version to be published.
Compliance with ethics. The study protocol
and all the amendments were reviewed and
Mumbai.
S. Kandhari received research funding for the
conduct of this trial from Wockhardt Ltd.,
Mumbai.
V.R. Mysore received research funding for the
conduct of this trial from Wockhardt Ltd.,
Mumbai.
S. Aurangabadkar received research funding for
the conduct of this trial from Wockhardt Ltd.,
Mumbai.
S. Malakar received research funding for the
conduct of this trial from Wockhardt Ltd.,
Mumbai.
M. Vedamurthy received research funding for
the conduct of this trial from Wockhardt Ltd.,
Mumbai.
S. Motlekar is an employee and stake holder by
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