Research Article
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Anatomic analysis of etiology and incidence of melasma development in women

Year 2024, Volume: 49 Issue: 2, 343 - 352, 30.06.2024
https://doi.org/10.17826/cumj.1424519

Abstract

Purpose: Melasma is a condition originating from facial hyperpigmentation, significantly affecting quality of life. While its etiology is multifactorial, lifestyle and external factors are crucial in its manifestation. The main objective of this study was to unveil the relationship between environmental factors and melasma incidence numerically. Also, optimizing the treatment strategies and aiding the development of computerized diagnostic tools were aimed.
Materials and Methods: Data was collected from 100 volunteer women in the Cukurova region of Turkey via questionnaire. Multiple computational approaches and statistical tests were used to analyze associated with melasma and environmental factors such as body mass index, sports status, and smoking.
Results: The relationship between the environmental factors (such as body mass index (p<0.001, r=0.47), sports status (p<0.001, r=19.3), and smoking (p<0.001, r=16)) and melasma was found to be significant. Our findings also highlight the potential role of several features like regular medicine intake (p<0.001 r=14), chronic diseases (p=0.001, r=10.2), and water consumption (p<0.001, r=-0.373) in melasma development.
Conclusion: Our study contributes to the literature on the incidence and etiology of melasma in the Cukurova regional population of Turkey. Moreover, this study provides foundational insights for the future development of a machine learning-based classification mechanism to enhance treatment efficiency and patient satisfaction.

References

  • Kim JC, Park TJ, Kang HY. Skin-aging pigmentation: who is the real enemy? Cells. 2022;11:2541.
  • Lin C, Zhu X. Efficacy of photorejuvenation combined with tranexamic acid and hydroquinone cream in the treatment of complex facial pigmentation. Medicine (Baltimore). 2023;102:e34556.
  • Callender VD, Baldwin H, Cook-Bolden FE, Alexis AF, Gold LS, Guenin E. Effects of topical retinoids on acne and post-inflammatory hyperpigmentation in patients with skin of color: a clinical review and implications for practice. Am J Clin Dermatol. 2022;23:69-81.
  • Kim K, Huh Y, Lim KM. Anti-pigmentary natural compounds and their mode of action. Int J Mol Sci. 2021;22:6206.
  • Botsali A, Esme P, Erbil H, Çalışkan E. Comparison of fractional erbium:YAG laser-assisted tranexamic acid delivery alone and in combination with oral tranexamic acid in melasma. Lasers Med Sci. 2022;37:2823-30.
  • Lee YS, Lee YJ, Lee JM, Han TY, Lee JHY, Choi JE. The low-fluence q-switched nd:yag laser treatment for melasma: a systematic review. Medicina (Kaunas). 2022;58:936.
  • Cassiano DP, Espósito ACC, Hassun KM, Lima MMDA, Lima EVA, Miot LDB et al. Histological changes in facial melasma after treatment with triple combination cream with or without oral tranexamic acid and/or microneedling: a randomised clinical trial. Indian J Dermatol Venereol Leprol. 2022;88:761-70.
  • Reilley-Luther J, Cline A, Zimmerly A, Moy J. Representation of Fitzpatrick skin type in dermatology textbooks compared with national percentiles. Dermatol Online J. 2020;26:13030/qt91h8k9zc.
  • Rachmin I, Ostrowski SM, Weng QY, Fisher DE. Topical treatment strategies to manipulate human skin pigmentation. Adv Drug Deliv Rev. 2020;153:65-71.
  • Piętowska Z, Nowicka D, Szepietowski JC. Understanding melasma-how can pharmacology and cosmetology procedures and prevention help to achieve optimal treatment results? A narrative review. Int J Environ Res Public Health. 2022;19:12084.
  • Kruk J, Aboul-Enein BH, Duchnik E. Exercise-induced oxidative stress and melatonin supplementation: current evidence. J Physiol Sci. 2021;71:27.
  • Bešlić I, Lugović-Mihić L, Vrtarić A, Bešlić A, Škrinjar I, Hanžek M et al. Melatonin in dermatologic allergic diseases and other skin conditions: current trends and reports. Int J Mol Sci. 2023;24:4039.
  • Sadoghi B, Schmid-Zalaudek K, Zalaudek I, Fink-Puches R, Niederkorn A, Wolf I et al. Prevalence of nevi, atypical nevi, and lentigines in relation to tobacco smoking. PLoS One. 2021;16:e0254772.
  • Palma L, Marques LT, Bujan J, Rodrigues LM. Dietary water affects human skin hydration and biomechanics. Clin Cosmet Investig Dermatol. 2015;8:413-21.
  • Tezel H, Ozyurt AB, Erkekoglu P. Current approaches for melasma treatment and possible toxic effects. Hacettepe University Journal of the Faculty of Pharmacy. 2022;42:105-20.
  • Al-Jefri K, Newbury-Birch D, Muirhead CR, Gilvarry E, Araújo-Soares V, Reynolds NJ et al. High prevalence of alcohol use disorders in patients with inflammatory skin diseases. Br J Dermatol. 2017;177:837-44.
  • Ko SH, Chi CC, Yeh ML, Wang SH, Tsai YS, Hsu MY. Lifestyle changes for treating psoriasis. Cochrane Database Syst Rev. 2019;7:CD011972.
  • Diotallevi F, Campanati A, Martina E, Radi G, Paolinelli M, Marani A et al. The role of nutrition in immune-mediated, inflammatory skin disease: a narrative review. Nutrients. 2022;14:59.
  • Yen H, Li WQ, Dhana A, Li T, Qureshi A, Cho E. Red meat and processed meat intake and risk for cutaneous melanoma in white women and men: two prospective cohort studies. J Am Acad Dermatol. 2018;79:252-7.
  • Rothberg BEG, Bulloch KJ, Fine JA, Barnhill RL, Berwick M. Red meat and fruit intake is prognostic among patients with localized cutaneous melanomas more than 1 mm thick. Cancer Epidemiology. 2014;38:599–607.
  • Wang Y, Zhao J, Jiang L, Mu Y. The Application of skin care product in melasma treatment. Clin Cosmet Investig Dermatol. 2021;14:1165-71.
  • Morgado-Carrasco D, Piquero-Casals J, Granger C, Passeron T. Melasma: The need for tailored photoprotection to improve clinical outcomes. Photodermatol Photoimmunol Photomed. 2022;38:515-21.
  • Doolan BJ, Gupta M. Melasma. Aust J Gen Pract. 2021;50:880-5.
  • Rajanala S, Maymone MBC, Vashi NA. Melasma pathogenesis: a review of the latest research, pathological findings, and investigational therapies. Dermatol Online J. 2019;25:13030/qt47b7r28c.
  • Locci-Molina N, Wang A, Kroumpouzos G. Melasma improving spontaneously upon switching from a combined oral contraceptive to a hormone-releasing intrauterine device: a report of four cases. Acta Derm Venereol. 2015;95:624-25.
  • Ago HS, Tesalonika SGS. The relationship between sleep quality and students' acne vulgaris severity at Medical Faculty Universitas Kristen Indonesia. Journal of Advanced Research in Dynamical and Control System. 2020;12:186-91.
  • Vilar GN, Santos LAD, Sobral Filho JF. Quality of life, self-esteem andpsychosocial factors in adolescents with acne vulgaris. An Bras Dermatol. 2015;90:622-9.
  • Gupta A, Sharma YK, Dash KN, Chaudhari ND, Jethani S. Quality of life in acne vulgaris: relationship clinical severity and demographic data. Indian J Dermatol Venereol Leprol. 2016:82:3;292-7.
  • Sarkar R, Bansal A, Ailawadi P. Future therapies in melasma: what lies ahead? Indian J Dermatol Venereol Leprol. 2020;86:8-17.
  • Palma L, Marques LT, Bujan J, Rodrigues LM. Dietary water affects human skin hydration and biomechanics. Clin Cosmet Investig Dermatol. 2015;8:413-21.
  • Chambers ES, Vukmanovic-Stejic M. Skin barrier immunity and ageing. Immunology. 2020;160:116-25.
  • Oh SM, Lee YE, Ko MJ, Baek JH, Shin MK. Proposal of facial pigmentary unit and facial hyperpigmentation type for Fitzpatrick skin types II-IV. Skin Res Technol. 2023;29:e13251.

Kadınlarda melazma gelişim sıklığı ve etiyolojisinin anatomik analizi

Year 2024, Volume: 49 Issue: 2, 343 - 352, 30.06.2024
https://doi.org/10.17826/cumj.1424519

Abstract

Amaç: Melazma fasiyal hiperpigmentasyondan kaynaklanan, yaşam kalitesini önemli ölçüde etkileyen bir durumdur. Etiyolojisi çok faktörlü olmakla birlikte, ortaya çıkışında yaşam tarzı ve dış faktörler çok önemlidir. Bu çalışmanın temel amacı çevresel faktörler ile melazma görülme sıklığı arasındaki ilişkiyi sayısal olarak ortaya koymaktır. Ayrıca tedavi stratejilerinin optimize edilmesi ve bilgisayarlı tanı araçlarının geliştirilmesine yardımcı olunması da amaçlanmıştır.
Gereç ve Yöntem: Akdeniz bölgesindeki 100 gönüllü kadından anket yoluyla veriler toplandı. Verileri analiz etmek için çoklu hesaplamalı yaklaşımlar ve istatistiksel testler kullanıldı ve vücut kitle indeksi, spor durumu ve sigara içme gibi çevresel faktörlerin melazma ile ilişkisi incelendi.
Bulgular: Çalışmamızda incelediğimiz çevresel faktörler (vücut kitle indeksi (p<0.001, r=0.47), spor durumu (p<0.001, r=19.3) ve sigara içme (p<0.001, r=16) gibi) ve melasma ilişkisi anlamlı bulunmuştur. Bulgularımız aynı zamanda düzenli ilaç alımı (p<0.001 r=14), kronik hastalıklar (p=0.001, r=10.2) ve su tüketimi (p<0.001, r=-0.373) gibi çeşitli özelliklerin melazma gelişimindeki potansiyel rolünü de ortaya koymuştur.
Sonuç: Çalışmamız Akdeniz toplumunda melazmanın görülme sıklığı ve etiyolojisi konusunda literatüre katkı sağlamaktadır. Ayrıca bu çalışma, tedavi verimliliğini ve hasta memnuniyetini artırmak için makine öğrenimine dayalı bir sınıflandırma mekanizmasının gelecekteki gelişimi için temel bilgiler sunmaktadır.

References

  • Kim JC, Park TJ, Kang HY. Skin-aging pigmentation: who is the real enemy? Cells. 2022;11:2541.
  • Lin C, Zhu X. Efficacy of photorejuvenation combined with tranexamic acid and hydroquinone cream in the treatment of complex facial pigmentation. Medicine (Baltimore). 2023;102:e34556.
  • Callender VD, Baldwin H, Cook-Bolden FE, Alexis AF, Gold LS, Guenin E. Effects of topical retinoids on acne and post-inflammatory hyperpigmentation in patients with skin of color: a clinical review and implications for practice. Am J Clin Dermatol. 2022;23:69-81.
  • Kim K, Huh Y, Lim KM. Anti-pigmentary natural compounds and their mode of action. Int J Mol Sci. 2021;22:6206.
  • Botsali A, Esme P, Erbil H, Çalışkan E. Comparison of fractional erbium:YAG laser-assisted tranexamic acid delivery alone and in combination with oral tranexamic acid in melasma. Lasers Med Sci. 2022;37:2823-30.
  • Lee YS, Lee YJ, Lee JM, Han TY, Lee JHY, Choi JE. The low-fluence q-switched nd:yag laser treatment for melasma: a systematic review. Medicina (Kaunas). 2022;58:936.
  • Cassiano DP, Espósito ACC, Hassun KM, Lima MMDA, Lima EVA, Miot LDB et al. Histological changes in facial melasma after treatment with triple combination cream with or without oral tranexamic acid and/or microneedling: a randomised clinical trial. Indian J Dermatol Venereol Leprol. 2022;88:761-70.
  • Reilley-Luther J, Cline A, Zimmerly A, Moy J. Representation of Fitzpatrick skin type in dermatology textbooks compared with national percentiles. Dermatol Online J. 2020;26:13030/qt91h8k9zc.
  • Rachmin I, Ostrowski SM, Weng QY, Fisher DE. Topical treatment strategies to manipulate human skin pigmentation. Adv Drug Deliv Rev. 2020;153:65-71.
  • Piętowska Z, Nowicka D, Szepietowski JC. Understanding melasma-how can pharmacology and cosmetology procedures and prevention help to achieve optimal treatment results? A narrative review. Int J Environ Res Public Health. 2022;19:12084.
  • Kruk J, Aboul-Enein BH, Duchnik E. Exercise-induced oxidative stress and melatonin supplementation: current evidence. J Physiol Sci. 2021;71:27.
  • Bešlić I, Lugović-Mihić L, Vrtarić A, Bešlić A, Škrinjar I, Hanžek M et al. Melatonin in dermatologic allergic diseases and other skin conditions: current trends and reports. Int J Mol Sci. 2023;24:4039.
  • Sadoghi B, Schmid-Zalaudek K, Zalaudek I, Fink-Puches R, Niederkorn A, Wolf I et al. Prevalence of nevi, atypical nevi, and lentigines in relation to tobacco smoking. PLoS One. 2021;16:e0254772.
  • Palma L, Marques LT, Bujan J, Rodrigues LM. Dietary water affects human skin hydration and biomechanics. Clin Cosmet Investig Dermatol. 2015;8:413-21.
  • Tezel H, Ozyurt AB, Erkekoglu P. Current approaches for melasma treatment and possible toxic effects. Hacettepe University Journal of the Faculty of Pharmacy. 2022;42:105-20.
  • Al-Jefri K, Newbury-Birch D, Muirhead CR, Gilvarry E, Araújo-Soares V, Reynolds NJ et al. High prevalence of alcohol use disorders in patients with inflammatory skin diseases. Br J Dermatol. 2017;177:837-44.
  • Ko SH, Chi CC, Yeh ML, Wang SH, Tsai YS, Hsu MY. Lifestyle changes for treating psoriasis. Cochrane Database Syst Rev. 2019;7:CD011972.
  • Diotallevi F, Campanati A, Martina E, Radi G, Paolinelli M, Marani A et al. The role of nutrition in immune-mediated, inflammatory skin disease: a narrative review. Nutrients. 2022;14:59.
  • Yen H, Li WQ, Dhana A, Li T, Qureshi A, Cho E. Red meat and processed meat intake and risk for cutaneous melanoma in white women and men: two prospective cohort studies. J Am Acad Dermatol. 2018;79:252-7.
  • Rothberg BEG, Bulloch KJ, Fine JA, Barnhill RL, Berwick M. Red meat and fruit intake is prognostic among patients with localized cutaneous melanomas more than 1 mm thick. Cancer Epidemiology. 2014;38:599–607.
  • Wang Y, Zhao J, Jiang L, Mu Y. The Application of skin care product in melasma treatment. Clin Cosmet Investig Dermatol. 2021;14:1165-71.
  • Morgado-Carrasco D, Piquero-Casals J, Granger C, Passeron T. Melasma: The need for tailored photoprotection to improve clinical outcomes. Photodermatol Photoimmunol Photomed. 2022;38:515-21.
  • Doolan BJ, Gupta M. Melasma. Aust J Gen Pract. 2021;50:880-5.
  • Rajanala S, Maymone MBC, Vashi NA. Melasma pathogenesis: a review of the latest research, pathological findings, and investigational therapies. Dermatol Online J. 2019;25:13030/qt47b7r28c.
  • Locci-Molina N, Wang A, Kroumpouzos G. Melasma improving spontaneously upon switching from a combined oral contraceptive to a hormone-releasing intrauterine device: a report of four cases. Acta Derm Venereol. 2015;95:624-25.
  • Ago HS, Tesalonika SGS. The relationship between sleep quality and students' acne vulgaris severity at Medical Faculty Universitas Kristen Indonesia. Journal of Advanced Research in Dynamical and Control System. 2020;12:186-91.
  • Vilar GN, Santos LAD, Sobral Filho JF. Quality of life, self-esteem andpsychosocial factors in adolescents with acne vulgaris. An Bras Dermatol. 2015;90:622-9.
  • Gupta A, Sharma YK, Dash KN, Chaudhari ND, Jethani S. Quality of life in acne vulgaris: relationship clinical severity and demographic data. Indian J Dermatol Venereol Leprol. 2016:82:3;292-7.
  • Sarkar R, Bansal A, Ailawadi P. Future therapies in melasma: what lies ahead? Indian J Dermatol Venereol Leprol. 2020;86:8-17.
  • Palma L, Marques LT, Bujan J, Rodrigues LM. Dietary water affects human skin hydration and biomechanics. Clin Cosmet Investig Dermatol. 2015;8:413-21.
  • Chambers ES, Vukmanovic-Stejic M. Skin barrier immunity and ageing. Immunology. 2020;160:116-25.
  • Oh SM, Lee YE, Ko MJ, Baek JH, Shin MK. Proposal of facial pigmentary unit and facial hyperpigmentation type for Fitzpatrick skin types II-IV. Skin Res Technol. 2023;29:e13251.
There are 32 citations in total.

Details

Primary Language English
Subjects Dermatology, Clinical Sciences (Other)
Journal Section Research
Authors

Ayşe Gül Kabakcı 0000-0001-7144-8759

Çağlar Cengizler 0000-0002-6699-5683

Memduha Gülhal Bozkır 0000-0003-4164-4227

Publication Date June 30, 2024
Submission Date January 24, 2024
Acceptance Date April 30, 2024
Published in Issue Year 2024 Volume: 49 Issue: 2

Cite

MLA Kabakcı, Ayşe Gül et al. “Anatomic Analysis of Etiology and Incidence of Melasma Development in Women”. Cukurova Medical Journal, vol. 49, no. 2, 2024, pp. 343-52, doi:10.17826/cumj.1424519.