Clinical and Dermoscopic Evaluation of Melasma in Men- An Observational Study at a Tertiary Health Care Centre in Western Odisha, India

Introduction: Melasma is one of the most common cause of facial hypermelanosis presenting as symmetrical hyperpigmented macules over sun exposed areas especially in women and sizeable proportion in men causing a detrimental effect on the quality of life.

Aim: To evaluate the clinical profile and dermoscopic features of melasma in men.

Materials and Methods: A single centre hospital-based observational cross-sectional study was conducted at Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Burla, Odisha, India, from November 2018 to October 2020. 245 men, clinically diagnosed with melasma were included in the study with due consent and evaluated for age, family history, skin type, drug intake history, duration, duration of sun exposure, disease pattern, Melasma Area Severity Index (MASI) Score and dermoscopic feature. Data was collected using questionnaire, managed by Microsoft excel 2016 and analysed using Statistical Package for Social Sciences (SPSS) 20.0.

Results: Melasma occurred most commonly in the age group of 31-35 years (37.9%) with mean age of occurrence being 34.5±7.9 years affecting most commonly Fitzpatrick skin type IV (47.3%). There was positive family history in 63 patients (29.7%) and history of Diabetes Mellitus (DM) type 2 in 24 cases (9.7%). There was increased occupational sun exposure in 93% of cases with average duration of exposure being 7-8 hours/day in 98 cases (42.9%). The most common clinical pattern observed was malar pattern in 156 cases (63.6%) and epidermal dermoscopic pattern in 128 cases (52.2%). Majority of cases had a MASI Score between 5-10 with mean being 8.7±7.7. On comparing MASI Score and sun exposure, the average sun exposure was highest for a MASI Score 20-25 i.e., 7.4 hours/day.

Conclusion: The most common age group affected by melasma in males is 20-40 years, with prevalence being greater in higher Fitzpatrick skin type (III, IV), with positive history of occupational sun exposure and positive family history. The severity of melasma in form of MASI score was formulated. The knowledge acquired through the study can help bridge the knowledge gap to improve its management and quality of life.