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Category: Volume 07 Issue 08 August 2019
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Title: Clinico-epidemiological Study of Men with Melasma at High Altitude

Authors: Aditi Sharma, Himang Jharaik, Rajni Sharma, Dhaarna Wadhwa, Shailja Chauhan

 DOI: https://dx.doi.org/10.18535/jmscr/v7i8.76

Abstract

Background: Melasma (Greek ‘melas’- black) is a common, acquired hypermelanosis that occurs in sun-exposed areas mostly involving the face. Though multiple factors have been implicated in its etiopathogenesis the exact causes of melasma remains poorly understood. Despite several similarities between melasma in men and women, there are certain differences in clinical, etiological, and treatment aspects of melasma in men.

Aim and Objectives: To study certain differences in clinical and etiological aspects of melasma in men.

Material and Methods: 30 consecutive men with a clinical diagnosis of melasma presenting to the out-patient department were enrolled in the study. Detailed history regarding age, sex, occupation, onset, duration and progression of melasma, family history and aggravating factors was taken and various clinical patterns namely centro-facial, malar, mandibular were documented.

Results: 30 patients aged between 21 and 46 years (mean 30.1 years) were included in the study, the duration of melasma at presentation ranged from 2 months to 8 years. A positive family history was obtained in 11(36.7%) patients. Exacerbation on sun exposure was reported by 16(53.3%) patients. The malar pattern was the most common pattern seen in 21(70%) men followed by centro-facial in 8(26.7%) and mandibular in one (3.3%) patient.

Conclusion: Melasma was previously considered a pigmentation disorder of the females, but the occurrence in men is not uncommon and appears to affect dark-skinned men of Asian and African- American origin more frequently. This could also be attributed to the fact that men are becoming more aware of their appearance and media hype of various treatment modalities available.

References

  1. Vachiramon V, Suchonwanit P, Thadanipon K (2012) Melasma in men. J CosmetDermatol 11: 151-157.
  2. Sarkar R, Puri P, Jain RK, Singh A, Desai A (2010) Melasma in men: a clinical, aetiological and histological study. J Eur Acad Dermatol Venereol 24: 768-772.
  3. Pichardo R, Vallejos Q, Feldman SR, Schulz MR, Verma A, et al. (2009) The prevalence of melasma and its association with quality of life in adult male Latino migrant workers. Int J Dermatol 48: 22-26.
  4. Abdel-Malek Z, Kadekaro AL. Human pigmentation: its regulation by ultraviolet light and by endocrine, paracrine, and autocrine factors. In: Nordlund JJ, Boissy RE, Hearing VJ, King RA, Oetting W, OrtonneJP,editors. The Pigmentary System. 2nd ed. Oxford: Blackwell Publishing; 2006. p. 410-20.
  5. Lin JY, Fisher DE. Melanocyte biology and skin pigmentation. Nature 2007; 445:843-50.
  6. Mahmood K, Nadeem M, Aman S, et al. Role of estrogen, progesterone and prolactin in the etiopathogenesis of melasma in females. J Pak Assoc Dermatol. 2011;21: 241–47.
  7. Tadokoro T, Rouzaud F, Itami S, et al. The inhibitory effect of androgen and sex-hormone-binding globulin on the intracellular cAMP level and tyrosinase activity of normal human melanocytes. Pigment Cell Res. 2003;16:190–219.
  8. Famenini S, Gharavi NM, Beynet DP (2014) Finasteride associated melasma in a Caucasian male. J Drugs Dermatol 13: 484-486
  9. Mahmoud BH, Ruvolo E, Hexsel CL, et al. Impact of long-wave length UVA and visible light on melano competent skin. J Invest Dermatol. 2010;130:2092–2097.
  10. Taylor SC. Skin of color: biology, structure, function, and implications for dermatologic disease. J Am Acad Dermatol 2002; 46 (2 Suppl Understanding) :S41-62.
  11. Jablonski NG, Chaplin G. The evolution of human skin coloration. JHumEvol 2000;39:57-106.
  12. Vázquez M, Maldonado H, Benmamán C, Sánchez JL (1988) Melasma in men. A clinical and histologic study. Int J Dermatol 27: 25-27.
  13. Sarkar R, Puri P, Jain RK, et al. Melasma in men: a clinical, aetiological and histological study. J Eur Acad Dermatol Venereol. 2010;24: 768–772
  14. Sarkar R, Jain RK, Puri P. Melasma in Indian males. Dermatol Surg. 2003;29: 204.
  15. Mahmoud BH, Ruvolo E, Hexsel CL, et al. Impact of long-wavelength UVA and visible light on melano competent skin. J Invest Dermatol. 2010;130:2092–2097.
  16. Hassan I, Aleem S, Bhat YJ, Anwar P. A clinico-epidemiological study of facial melanosis. Pigment Int 2015;2:34-40.
  17. O’Brien TJ, Dyall-Smith D, Hall AP. Melasma of the forearms. Australas J Dermatol. 1997;38:35–37.
  18. Lonsdale-Eccles AA, Langtry JA. Melasma on the nape of the neck in a man. Acta Derm Venereol. 2005;85: 181–182.

Corresponding Author

Himang Jharaik

Medical Officer, Department of Obstetrics and Gynecology, Civil Hospital, Theog, District Shimla 171201 Himachal Pradesh, India