Associate Professor ,Isra University , Pakistan
Uzma Rajar is currently working as an Associate Professor in the Section of Dermatology at Isra University Hospital Hyderabad. She holds a MBBS degree from Liaquat University of Medical & Health Science, a Liaquat University of Medical & Health Science, D.D.Sc in Dermatology from University of Wales (U.K), and a M.Sc in Dermatology from Cardiff University. She has done her internship in the Dermatology Department at LUMHS Hospital.
BACKGROUND: Skin hyperpigmentation lesions are of multiple types and include; melasma, solar Lentigines, nevi, macules, café-au-lait spots, and ephelides (freckles), etc. Post inflammatory hyperpigmentation also occurs in conditions such as surgical trauma, physical trauma, acne, atopic dermatitis, contact dermatitis, lichen planus, psoriasis, drug eruptions, and etc. During clinical approach to skin hyperpigmentation, one must considers about an increase in melanocytes, increase in melanin pigment production, and/or some other pigment, endogenous or exogenous, which is being deposited in skin.
OBJECTIVES OF STUDY:
- To evaluate clinical presentation of melasma with other hyperpigmentary disorders of skin
- To compare histopathological features of melasma with other hyperpigmentory disorders of skin
SUBJECTS AND METHODS: A Prospective, observational study was conducted at the outpatient department of Dermatology Department Isra University Hospital Hyderabad from July 2014 - December 2014. A sample of 87 subjects was selected according to non-probability simple random sampling as per inclusion and exclusion criteria including 43 melasma and 44 other skin hyperpigmentary disorders. Detailed clinical examination was performed prior to the biopsy to mark the biopsy site. Aspirin and non-steroidal anti-inflammatory drugs were stopped at least 5 days before biopsy. A single strand or in some cases >one punch biopsies of skin were obtained and sent for histopathological evaluation. All the clinical and histological data were entered in proforma designed for the study. Collected data was analyzed on SPSS version 21.0. (IBM, corporation, USA) P-value of significance was taken at 0.05.
RESULTS: Mean ± SD age of study subjects was noted as 39.51± 9.32 and 39.50± 9.21 years in melasma and other skin hyperpigmentory disorders respectively. Female population predominated in the present study. 37 (42.5%) were male and 49 (56.3%) were female. Common presenting features were the hyperpigmentaion, skin peeling, itching, erythema and telangiectasia. Hyperpigmentaion, itching and erythema were the common presenting complaints. Telangiectasia was noted in 3 male in melasma and 1 female in other skin hyperpigmentory disorders. Of 43 melasma patients (Group A), the hyperkeratosis was noted in 3 male patients only (X2=48, p=0.0001). Parakeratosis and acanthosis were noted in female melasma patients. While hyperkeratosis, parakeratosis and acanthosis were noted in female patients of other hyperpigmentory disorders (Group B) (X2=38, p=0.0001).
CONCLUSION: Common presenting features were the hyperpigmentaion, skin peeling, itching, erythema and telangiectasia in melasma and other hyperpigmentary lesions. Hyperpigmentaion, itching and erythema were the common presenting complaints. Telangiectasia was noted also. Histopathological findings suggested no major differences in the melasma and other hyperpigmentary disorders.