A clinical study of melasma and assessment of Dermatology Life Quality Index at a tertiary health care center in South India

Background: Melasma is a common acquired hypermelanosis, notorious for its recalcitrant nature. Though benign in nature, it could significantly affect the quality of life in some patients. Therefore, apart from pharmacologic management in cases of resistant melasma, the need for psychologic counseling would be imperative to improve the quality of life in such patients. Aim: To analyze the clinical patterns of melasma along with all other demographic parameters followed by Wood’s lamp (WL) examination, Melasma Area and Severity Index (MASI) scoring and assessment of Dermatology Life Quality Index (DLQI) in all the participants of our study. Methods: A prospective, observational and descriptive study done over a period of 7 months in 175 freshly diagnosed females with melasma above 18 years of age. Results: Majority of the patients with melasma were in the 31–40 year age group (44%), followed by 21–30 (26.9%) and 41–50 (16.6%) years. The duration of melasma in most of our patients was below 1 year. Sunlight (48.5%) appeared to be the major precipitating factor followed by cosmetics (22.2%). A significant association with hypothyroidism was demonstrated amongst our participants. A positive family history was noted in 54.85% of the study subjects. The dermal variant was the most common type of melasma that was observed. The mean MASI score observed was 5.3 and the mean DLQI seen in our study was 1.46. Conclusion: Melasma is common in middle-aged females. Solar radiation constitutes a major risk factor for melasma. Hypothyroidism appears to have a significant association with melasma. It is important to evaluate the DLQI in all patients with melasma to holistically manage these patients.