Quality of life in patients of melasma
Keywords:
Melasma, quality of life, DLQIAbstract
Objectives To determine the impact of melasma on quality of life (QoL) using Dermatology Life Quality Index (DLQI) in our patients. Patients and methods An observational study was carried out at the Department of Dermatology, King Edward Medical University/ Mayo Hospital, Lahore from December 12, 2009 to June 11, 2010. A total of 100 patients suffering from melasma, of any severity, with age 16 years or above, belonging to either sex, who themselves were able to understand and fill the DLQI questionnaire in English or Urdu version, were enrolled in the study. Using the DLQI questionnaire, consisting of 10 questions, patients were asked to score on a scale from 0-3 for each of 10 items. The data were analyzed after compiling the results. The higher the DLQI score, the poorer is the QoL. Results Mean age of the patients was 29.90±7.18 years. There were 82 (82%) female and 18 (18%) male patients. The mean DLQI score of all patients was 17.08±5.22. The findings indicate several areas in which melasma had an impact on individual’s QoL, particularly in relation to symptoms and feelings and personal relationships. Women reported poorer QoL compared to men. Mean DLQI score was 16.00+4.93 in males and 17.32+5.28 in females. Patients with mild, moderate and severe disease had mean DLQI scores of 16.23±5.35, 19.32±3.99 and 22.0±2.0, respectively. Conclusion Melasma causes a “very large effect” on patients’ quality of life. Impairment of QoL is greater in females and patients with severe disease.References
Zanieri F, Assad GB, Campolmi P, Lotti T. Melasma: Successful treatment with pidobenzone 4% (K5lipogel). Dermatol Ther. 2008;21:S18-19.
Sachdeva S. Comparative efficacy of 10-20% trichloroacetic acid and 35-70% glycolic acid peel in 60 cases of melasma, freckles, lentigines and postinflammatory hyperpigmentation. J Pak Assoc Dermatol. 2006;16:74-8.
Lapeere H, Boone B, Schepper SD et al. Hypomelanoses and hypermelanoses. In: Wolff K, Goldsmith LA, Katz SI et al., editors. Fitzpatrick's Dermatology in General Medicine, 7th edn. Philadelphia: McGraw-Hill; 2008. P. 635 .
Adalatkhah H, Amani F. The correlation between melasma, ovarian cysts and androgenic hormones (a case-control study). Res J Biol Sci. 2007;2:593-6.
Dogra A, Gupta S. Comparative efficacy of 20% trichloroacetic acid and 50% glycolic acid peels in treatment of recalcitrant melasma. J Pak Assoc Dermatol. 2006;16:79-85.
Knott L. Chloasma (Melasma) [online] 2009 [cited 2009 May 31]. Available from: http://www.patient.co.uk/showdoc/40002152/.
Doward LC, McKenna SP. Evolution of quality of life assessment. In: Rajagopalan R, Sheretz EF, Anderson TR, eds. Care Management of Skin Diseases. New York: Marcell-Dekker; 1998. P. 9-94.
Noor SM, Khurshid K, Mahmood T, Haroon TS. Quality of life in vitiligo patients. J Pak Assoc Dermatol. 2004;14:55-8.
Finlay AY, Khan GK. Dermatology life quality index (DLQI). A simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19:210-6.
Adalatkhah H, Sadeghi-Bazargani H, Amini-sani N, Zeynizadeh S. Melasma and its association with different types of nevi in women: a case-control study. BMC Dermatol. 2008;8:3.
Farag A, Sabry H, Alam M. Melasma and its impact on health related quality of life (HRQoL) in Egyptian women before and after treatment with a quadruple combination serum (hydroquinone 4%, kojic acid 1%, glycolic acid 6% and ascorbic acid 2%). J Pan Arab League Dermatol. 2007;18:17-30.
Nicolaidou E, Antoniou C, Katsambas A. Origin, clinical presentation, and diagnosis of facial hypermelanoses. Dermatol Clin. 2007;25:321-6.
Jobanputra R, Bachmann M. The effect of skin diseases on quality of life in patients from different social and ethnic groups in Cape Town, South Africa. Int J Dermatol. 2000;39:826-31.
Balkrishnan R, McMichael A, Camacho F et al. Development and validation of a health related quality of life instrument for women with melasma. Br J Dermatol. 2003;149:572-7.
Sarkar R, Puri P, Jain RK et al. Melasma in men: a clinical, aetiological and histological study. J Eur Acad Dermatol Venereol. 2010;24:768-72.
Arellano I, León G, Luna C. Quality of life in Mexican patients with melasma. Cosmet Dermatol. 2006;5:343-5.
Dominguez AR, Balkrishnan R, Ellzey AR, Pandya AG. Melasma in Latina patients: Cross-cultural adaptation and validation of a quality-of-life questionnaire in Spanish language. J Am Acad Dermatol. 2006;55:59-66.