(Last Updated On: December 30, 2019)

Liezel A. Gener-Pangilinan MD, Evangeline B. Handog MD, Ma. Teresita Gabriel MD, Benedicto D. Carpio MD, Ma. Angela M. Lavadia MD, Wilson Loginus MD, Johannes F. Dayrit MD

Abstract

Abstract: Background: Melasma is an acquired hyperpigmentary disorder occurring in the sun-exposed areas of the face and neck. There is little information on its prevalence, epidemiology and clinical characteristics in the Philippines.

Objective: To determine the prevalence, epidemiology and clinical characteristics of melasma in Philippine dermatology patients

Methods: This was a multicenter, cross-sectional study conducted from July to December 2013. The investigators determined the prevalence of melasma in 12,068 dermatology patients from six government hospitals and private centers in Metro Manila, Philippines. The melasma patients, aged 18 years and above, were given self-administered questionnaires with topics related to demographic information and medical history. They were also examined by the investigators (dermatologists) to determine the clinical profile of their melasma.

Results: Of the 12,068 dermatology patients who were seen at the selected hospitals and private centers, 153 (1.26%) were clinically diagnosed with melasma. A majority of the melasma patients were Filipinos (73.20%), aged 41-50 years old (37.91%), with an average age of 42.40 + 9.68 years, and Fitzpatrick skin types III and IV (29.41% and 57.52%, respectively). Melasma was more prevalent in females (81.70%), most of whom had prior history of pregnancy (76.8%). Oral contraceptive use was also reported in 37.6% of the female patients from which 63.83% have used it for only 1 year or less. A majority had no thyroid disease (75.16%) and daily sun exposure was limited to 1 hr or less for most patients (43.14%). Their melasma was mostly malar in distribution (60.13%), epidermal (61.44%), and mild (51.63%) to moderate (27.45%) in severity. The average mMASI score was 4.63 + 3.32.

Conclusion: The prevalence of melasma was low among the Philippine dermatology patients sampled. A majority of the melasma patients were Filipinos, aged 41-50 years old, with Fitzpatrick skin type IV, limited sun exposure, and no thyroid disease. They were mostly females with a prior history of pregnancy. Their melasma was mostly malar, epidermal, and mild in severity. These descriptive data can serve as baseline information for further studies on melasma in the Philippines

 

Citation

Gener-Pangilinan LA, Handog EB, Gabriel MT, Carpio BD, Lavadia MAL, Longinus W, Dayrit JF.
Prevalence, epidemiology and clinical characteristics of melasma in Philippine dermatology patients: a multicenter, cross-sectional study. J Phil Dermatol Soc 2019, 28(1), 15-23

 

Keywords

melasma, Asian skin, pigmentation, Philippines

Handel AC, Miot LDB, Miot HA Melasma: a clinical and epidemiological review. An Bras Dermatol. 2014; 89(5): 7761-782.

Sheth VM, Pandya AG. Melasma: A comprehensive update Part II. J Am Acad
Dermatol. 2011; 65(4):699-714.

Lawrence N, Cox SE, Brody H. Treatment of melasma with Jessner’s solution versus glycolic acid: a comparison of clinical efficacy and evaluation of the predictive ability of Wood’s light examination. J Am Acad Dermatol. 1997;
36(4): 589-93.
Walker SL, Shah M, Hubbard VG, Pradhan HM, Ghimire M. Skin disease is common in rural Nepal: results of a point prevalence study. Br J Dermatol.
2008;158:334-8.

Sivayathorn A. Melasma in Orientals. Clin Drug Investigation. 1995; 10 (Suppl 2): 34-40.

Chan R, Park KC, Lee MH, Lee ES, Chang SE, Leow, YH, Legarda Montinola F,Tsi R-Y, Tsai T-H, Shek S, Kerrouche N, Thomas G, and Verallo-Rowell V. A randomized controlled trial of the efficacy and safety of a fixed triple
combination (fluocinolone acetonide 0.01%, hydroquinone 4%, tretinoin 0.05%) compared with hydroquinone 4% cream in Asian patients with moderate to severe melasma. Br J Dermatol. 2008 (159): 697-703.

 Hann S-K, Im S, Chung WS, Kim DY. Pigmentary Disorders in the South East.
Dermatol Clin. 2007; 25: 431-438.

Ortonne JP, Arellano I, Berneburg M, Cestari T, Chan H, Grimes P, Hexsel D,
Im S, Lim S, Lui H, Pandya A, Picardo M, Rendon M, Taylor S, Van Der Veen JPW, Westerhof W. A global survey of the role of ultraviolet radiation and hormonal influences in the development of melasma. Europ Acad of Dermatol and Venereol. 2009; 23: 1254-1262.

Guinot C, Cheffai S, Latreille J, Dhaoui MA, Youssef S, Jaber K, et al. Aggravating factors for melasma: a prospective study in 197 Tunisian patients. J Eur Acad Dermatol Venereol. 2010; 24:1060-9.
Pérez M, Sánchez JL, Aguiló F. Endocrinologic profile of patients with idiopathic melasma. J Invest Dermatol. 1983;81:543-5.

Lutfi RJ, Fridmanis M, Misiunas AL, Pafume O, Gonzalez EA, Villemur JA, 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.

 Mogaddam MR, Alamdari MI, Maleki N, Ardabili NS, Abedkouhi S. Evaluation of autoimmune thyroid disease in melasma. J Cosm Dermatol. 2015; 14(2): 167-171.

Shin JU, Park J, Oh SH, Lee, JH. Oral Tranexamic Acid Enhances the Efficacy of Low-Fluence 1064-Nm Quality-Switched Neodymium-Doped Yttrium
Aluminum Garnet Laser Treatment for Melasma in Koreans: A Randomized, Prospective Trial. Dermatol Surg. 2013; 39: 435-442.

Rodrigues M, Ayala-Cortes AS, Rodriguez-Arambula A, Hynan L, Pandya A. Research Letter: Interpretability of the Modified Melasma Area and Severity Index (mMASI). JAMA Dermatol 2016.

Sarkar R, Arora P, Garg VK, Sonthalia S, Gokhale N. Melasma update. Indian Dermatol Online J. 2014; 5(4): 426-435.

Kong BY, Haugh IM, Schlosser BJ, Getsios S, Paller AS. Mind the Gap: Sex Bias in Basic Skin Research. J Invest Dermatol. 2016; 136(1): 12-14.

Singh R, Goyal S, Ahmed QR, Gupta N, Singh S. Effect of 82% Lactic Acid in
Treatment of Melasma. Int Sch Res Notices; 2014: 407142.

Sarkar R, Puri P, Jain RK, Singh A, Desai A. Melasma in men: a clinical, aetiological and histological study. J Eur Acad Dermatol Venereol. 2010
Jul;24(7):768-72.

Achar A, Rathi SK. Melasma: a clinico-epidemiological study of 312 cases. Indian J Dermatol. 2011; 56: 380-2.

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; 40:455-8.

 Hexsel D, Lacerda DA, Cavalcante AS, Machado Filho CA, Kalil CL, Ayres EL, et al. Epidemiology of melasma in Brazilian patients: a multicenter study. Int J Dermatol. 2013;53: 440-4.

Achar A, Rathi SK. Melasma: a clinico-epidemiological study of 312 cases. Indian J Dermatol. 2011;56(4):380–2.

Lutfi RJ, Fridmanis M, Misiunas AL, Pafume O,Gonzalez EA, Villemur JA, 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(1):28–31.

Grimes PE. Melasma etiologic and therapeutic considerations. Arch Dermatol 1995; 131: 1453–1457.

Moin A, Jabery Z, Fallah N. Prevalence and awareness of melasma during
pregnancy. Int J Dermatol. 2006;45(3):285–8.
26. Miot LD, Miot HA, Silva MG, Marques ME. Physiopathology of melasma. An
Bras Dermatol 2009; 84: 623–635.
27. Handog EB, Galang MDAVF, de Leon-Godinez MA, Chan GP. A randomized,
double-blind, placebo-controlled trial of oral procyanidin with vitamins A,
C, E for melasma among Filipino women. Int J Dermatol 2009; 48: 896-901.
28. Freitag FM, Cestari TF, Leopoldo LR, Paludo P, Boza JC. Effect of melasma
on quality of life in a sample of women living in southern Brazil. JEADV 2008;
22: 655-662.
29. Ogbechie-Godec O.A., Elbuluk N. Melasma: an Up-to-Date Comprehensive
Review. Dermatol Ther (Heidelb) 2017.

More Articles

A randomized, double-blind, comparative study on the safety and efficacy of virgin coconut (Cocos nucifera l.) oil against 1% hydrocortisone lotion as an anti-inflammatory and antipruritic preparation for mosquito reactions

  Authors: Uy, Veronica S, MD; Gracia B. Teodosio, MD, FPDS; Ma. Teresita G. Gabriel, MD, FPDS; Mary Catherine T. Galang, MD; Mohammad Yoga A. Waskito, MD; Johannes F. Dayrit, MD, FPDS     Abstract Background: Virgin coconut oil (VCO) has been reported...

read more