Abstract: Melasma is a disorder of hyperpigmentation that is frustratingly resistant to therapy with a high recurrence rate on treatment discontinuation. With the scarcity of melasma epidemiological studies from India, we conducted this study to see clinico-epidemiological trends and therapeutic response. Totally 957 melasma patients were studied during the 5-year period between October 2014 and September 2019. A female preponderance was seen. Patients were classified as early, moderate, and late responders if they had more than 80% clinical improvement within 8, 8-12, and 12-16 weeks rest classified as nonresponders. Six hundred and forty-eight patients with mMASI of ≤5 had been prescribed non-hydroquinone-based therapies who had overall response rate of 40.9% by end of 16 weeks, 309 with mMASI >5 received hydroquinone based triple combination with a response rate of 33.6% at end of 16 weeks. A total of 33.65% responded to triple combination compared to 40.1% in the non-hydroquinone group. All nonresponders received oral tranexamic acid 250 mg twice daily. Most patients on oral tranexamic acid group developed recurrence by 6 weeks post discontinuation, compared with triple combination therapy group who had relapsed by 2 months post discontinuation and 4 months to relapse with non-hydroquinone-based therapies. Side effects experienced were 0.83% in hydroquinone group reporting erythema and burning. 0.57% in non-hydroquinone group perceived stinging sensation and none from tranexamic acid group. The longest follow up available in our study was for 18 months. The emergent need of the hour is a long, safe, and effective therapy for melasma.
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References: Prabha N, Mahajan VK, Mehta KS, Chauhan PS, Gupta M. Cosmetic contact sensitivity in patients with melasma: results of a pilot study. Dermatol Res Pract. 2014;2014:316219.
Sonthalia S, Sarkar R. Etiopathogenesis of melasma. Pigment Int. 2015;2(1):21-27.
Sarkar R, Gokhale N, Godse K, et al. Medical Management of Melasma: a review with consensus recommendations by Indian pigmentary expert group. Indian J Dermatol. 2017;62(6):558.
Pandya AG, Hynan LS, Bhore R, et al. Reliability assessment and validation of the melasma area and severity index (MASI) and a new modified MASI scoring method. J Am Acad Dermatol. 2011;64(1):78-83, 83.e1-2.
Pasricha JS, Khaitan BK, Dash S. Pigmentary disorders in India. Dermatol Clin. 2007;25(3):343-352.
Grimes PE. Melasma. Etiologic and therapeutic considerations. Arch Dermatol. 1995;131(12):1453-1457.
Sarkar R, Jain RK, Puri P. Melasma in Indian males. Dermatol Surg. 2003;29(2):204.
Kumar S, Mahajan B, Kamra N. Melasma in north Indians: a clinical, epidemiological, and etiological study. Pigment Int. 2014;1(2):95-99.
Achar A, Rathi S. Melasma: a clinico-epidemiological study of 312 cases. Indian J Dermatol. 2011;56(4):380-382.
Satish D, Aparna A, Radhika V. A clinico-epidemiological study of melasma in 402 patients in an office-based practice. Clin Dermatol Rev. 2019;3(2):154-156.
Sarkar R, Ailawadi P, Garg S. Melasma in Men. J Clin Aesthetic Dermatol. 2018;11(2):53-59.
Meghana V, Gopinath H, Karthikeyan K, Venugopal V. Face and neck pigmentary alterations in hair dye users: a cross-sectional study from South India. Indian Dermatol Online J. 2020;11(5):760-765.
Ortonne JP, Arellano I, Berneburg M, et al. A global survey of the role of ultraviolet radiation and hormonal influences in the development of melasma. J Eur Acad Dermatol Venereol. 2009;23(11):1254-1262.
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(11):1305-1310.
Kheradmand M, Afshari M, Damiani G, Abediankenari S, Moosazadeh M. Melasma and thyroid disorders: a systematic review and meta-analysis. Int J Dermatol. 2019;58(11):1231-1238.
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