Melasma and assessment of the quality of life in Brazilian women

To assess the impact on the quality of life of women living in Florianópolis, Brazil, through questionnaire (MelasQol), and investigate the clinical aspects and risk factors for melasma, correlating them with the MelasQol scores.

METHODS:

This study was performed on 51 melasma patients cared for at the University Hospital of the Universidade Federal de Santa Catarina. The variables included were: age, gender, age of onset of melasma, Fitzpatrick phototype (I-VI), duration and family history of melasma, onset of melasma during pregnancy, use of hormonal contraceptive, thyroid disorder and distribution of melasma. The MelasQoL questionnaire, validated for Brazilian Portuguese (MelasQoL-BP), was applied.

RESULTS:

The mean age was 38.43±6.75 years. All patients were women. The most common Fitzpatrick skin phototypes were III (49.02%) and IV (33.33%). Melasma had a mean age of onset of 29.18±7.05 years and a mean duration of 9.25±6.18 years. The majority of patients did not have familial history of melasma (50.98%). Melasma onset was associated with pregnancy (45.10%). The MelasQoL-BP analysis revealed significant emotional impact on patients, such as feeling bothered (94.11%), frustrated and embarrassed (64.71%), and depressed (52.94%) about their skin appearance, as well as unattractive (78.43%). No social impact was observed (P>0.05).

CONCLUSION:

Melasma has a strong emotional impact on quality of life, resulting especially from feelings about skin appearance.

Melanosis; Quality of life; Questionnaires

Subjects (N = 51)
Age mean (standard deviation )	38.43 y (±6.75)
Age at onset of melasma
Mean (standard deviation)	29.18 y (±7.05)
Fitzpatrick skin phototype	N (%)
I	0
II	2 (3.92%)
III	25 (49.02%)
IV	17 (33.33%)
V	7 (13.73%)
VI	0 (0%)
Duration of melasma (mean ± standard deviation)	9.25 y (±6.18)
(median)	9.0 y
Familial History
Yes	25 (49.02%)
No	26 (50.98%)
Onset during pregnancy
Yes	23 (45.10%)
No	28 (54.90%)
Onset after hormonal contraception
Yes	5 (9.80%)
No	46 (90.20%)
Thyroid disorder
Yes	4 (7.84%)
No	47 (92.16%)

	Not bothered at all (%)	Not bothered most of the time (%)	No feelings either way(%)	Sometimes bothered (%)	Bothered most of the time (%)	Constantly Bothered (%)
Skin appearance	3.92	1.96	0	25.49	11.76	56.86
Frustration due to skin condition	31.37	0	3.92	17.65	19.61	27.45
Embarrassment at skin condition	31.37	0	3.92	23.53	15.69	25.49
Depressed by skin condition	39.22	0	7.84	23.53	17.65	11.76
Effects of the skin condition on relations with other people	68.63	0	3.92	15.69	7.84	3.92
Effects of the skin condition on the desire to be with people	70.59	0	7.84	17.65	1.96	1.96
Difficulty in showing affection	86.27	0	5.88	3.92	1.96	1.96
Feeling unattractive due to skin blemishes	19.61	0	1.96	29.41	27.45	21.57
Reduced sense of importance/productivity	66.67	0	5.88	15.69	3.92	7.84
Restricted sense of freedom	74.51	0	3.92	11.76	9.80	0

	OR	(95% CI)	P values
Age
<38 years	0.87	(0.48-1.58)	0.78
>38years	1.13	(0.67-1.90)
Fitzpatrick
Skin phototype
< 3	1.22	(0.08-1.84)	1.0
>3	0.99	(0.88-1.11)
Duration of melasma
< 9 years	0.87	(0.48-1.56)	0.78
> 9 years	1.13	(0.67-1.89)
Familial history
Yes	0.96	(0.54-1.68)	1.0
No	1.04	(0.61-1.79)
Onset during pregnancy
Yes	0.78	(0.41-1.47)	0.57
No	1.22	(0.74-1.99)
Onset after hormonal contraception
Yes	1.83	(0.33-10)	0.65
No	0.94	(0.78-1.13)
Thyroid disorder
Yes	1.21	(0.18-7.98)	1.0
No	0.98	(0.83-1.15)

	Age	Duration	R
	(Pvalues)	(Pvalues)
Skin appearance	0.014^* * = Significance. R = Pearson test correlation	0.283	-0.34
Frustration due to skin condition	0.934	0.161	-0.01
Embarrassment at skin condition	0.197	0.053	-0.18
Depressed by skin condition	0.318	0.717	-0.14
Effects of skin condition on relationswith other people	0.598	0.621	0.07
Effects of skin condition on the desire to be with people	0.318	0.827	-0.14
Difficulty in showing affection	0.787	0.973	0.03
Feeling unattractive due to skin blemishes	0.005^* * = Significance. R = Pearson test correlation	0.010^* * = Significance. R = Pearson test correlation	-0.38
Reduced sense of importance/productivity	0.927	0.811	0.01
Restricted sense of freedom	0.408	0.685	-0.11

Sociedade Brasileira de Dermatologia Av. Rio Branco, 39 18. and., 20090-003 Rio de Janeiro RJ, Tel./Fax: +55 21 2253-6747 - Rio de Janeiro - RJ - Brazil
E-mail: revista@sbd.org.br

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[1] MAILING ADDRESS: Tania Silvia Fröde, Dermatology Service Hospital Universitário Universidade Federal de Santa Catarina Campus Universitário - Trindade, 88040-970 - Florianópolis - SC Brazil. E-mail: tania.frode@ufsc.br

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Melasma and assessment of the quality of life in Brazilian women* * Work performed at the Dermatology Service Hospital Universitário - Universidade Federal de Santa Catarina (UFSC) - Florianopolis (SC), Brazil.

BACKGROUND:

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Melasma and assessment of the quality of life in Brazilian women^* * Work performed at the Dermatology Service Hospital Universitário - Universidade Federal de Santa Catarina (UFSC) - Florianopolis (SC), Brazil.