Abstract:

Wang Hui, Guo Lifang, Ge Yiping, Wu Yule, Wu Qiuju, Zhang Mengli, Wang Qianqiu, Lin Tong Department of Laser, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China （Wang H ［current affiliation: Department of Dermatology, Affiliated Hospital of Qingdao University, Qingdao 266003, China］, Guo LF, Ge YP, Wu YL, Wu QJ, Zhang ML, Lin T）; Department of Sexually Transmitted Disease Clinical Management, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China （Wang QQ） Corresponding authors: Lin Tong, Email: ddlin@hotmail.com; Wang Qianqiu, Email: wangqq@ncstdlc.org 【Abstract】 Objective To investigate the etiology, aggravating factors of melasma and its influence on quality of life in patients. Methods Demographic, behavioral and clinical data were collected from 166 female patients with melasma through a questionnaire survey. Melasma area severity index （MASI）, dermatology life quality index （DLQI） and melasma quality of life scale （MELA-SQOL） were calculated. Multiple linear regression analysis was carried out to identify factors influencing melasma severity and quality of life in patients. Results Of the 166 patients, 55 （33.13%） had a history of pregnancy within 1 year before the occurrence of melasma, and 8 （4.82%） had a history of sun exposure within 1 month before it. The MASI, DLQI and MELA-SQOL scores were 5.99 ± 4.01, 4.34 ± 4.41 and 30.54 ± 17.91 in these patients respectively. Multiple linear regression analysis showed that the MELA-SQOL score significantly decreased with age （β = －0.220, t = 2.874, P < 0.05）, but increased with deepening of skin color （β = 0.217, t = 2.827, P < 0.05）. Moreover, the MASI score significantly increased with age among premenopausal patients with melasma （β = 0.244, t = 3.387, P = 0.001）, and higher in patients with Fitzpatrick skin type Ⅳ than in those with Fitzpatrick skin type Ⅲ （β = 0.322, t = 4.615, P < 0.001）. Conclusions The occurrence of melasma is associated with fluctuation of hormone levels and sun exposure. The darker the lesion color and the younger the age, the greater the impact on the quality of life in patients with melasma. Melasma is more severe in patients with Fitzpatrick skin type Ⅳ than in those with Fitzpatrick skin type Ⅲ, and seems to exacerbate with age among premenopausal patients.