The correlation between severity of melasma with facial wrinkles in Yogyakarta, Indonesia
Melasma is a common disfiguring condition involving acquired hyperpigmentation especially on the face, for which the pathogenesis is still uncertain, however histopathological studies showed that there is not only hyperpigmentation in the epidermis, but also solar elastosis or photo-aging due to abnormality of dermal extracellular matrix which contributes to clinical wrinkles. This study aimed to examine a link between the severity of melasma and facial wrinkles as a manifestation of photoaging in a tropical area. This study was an observational study with crosssectional design, conducted in Yogyakarta, Indonesia involving 51 patients with melasma aged 30-50 years who had fulfilled the inclusion and exclusion criteria. The melasma severity was measured clinically with the modified Melasma Severity Index (mMASI), and objectively with the Melanin Index (MI) and Erythema Index (EI) assessed with Mexameter Courage Khazaka. The wrinkle severity was measured clinically by scoring from forehead horizontal lines, crow’s feet, glabellar and nasolabial lines, and total scores were obtained from all of them. The correlation analysis was done statistically with Spearman’s rank tests. The results showed a weak positive but not significant correlation between the mMASI score and total facial wrinkle score (r: 0.165), and a weak positive non-significant correlation between EI and total facial wrinkle score (r: 0.06). There were significant positive moderate correlations between MI and total facial wrinkle score (r: 0.441), due to significant positive moderate correlations between MI and glabella wrinkle (r: 0.392), and between MI and nasolabial wrinkle (r: 0.339). In conclusion, a positive moderate correlation was found between MI and total facial wrinkle score, especially relating to glabellar and nasolabial wrinkles. However, there was no correlation between mMASI score and total facial wrinkle score.
2. Rathi, S. K D’Souza, P. Epidemiology Melasma. In : Lahiri, K., Charttejee, C.M., Sarkar, R. (Eds). Pigmentory Disorders A Comprehensive Compedium. New Delhi: Jaypee Brother Medical. 2014; 281-82
3. Soepardiman, L., Ruswan, S.A. Epidemiology of melasma in Asian Countries. In: Pigmentary Disorders from Global Perspective. Abstract book and final program of the satellite meeting of the 19th World Congress of Dermatology, Bali. 1997
4. Handel, A.C., Miot L.D.B., Miot, H.A. Melasma: a clinical and epidemiological review. Annual Bras Dermatology.2014; 89: 771-82
5. Ikino, J.K., Nunes, D.H., da Silva, V.P.M., Frode, T.S., Sens, M.M. Melasma and assessment of the Quality of Life in Brazilian Women. Annual Bras. Dermatol. 2015; 90:196-200
6. Nicolaidou, E., Katsambas, A.D. Pigmentation disorders: hyperpigmentation and hypopigmentation. Clinical Dermatology. 2014; 32: 66-72.
7. Pandya, A.G., Hynan, L.S., Bhore, R., Riley, F.C., Guevera, I.L., Grimes P., et al. Reliability assessment and validation of the Melasma Area and Severity Index (MASI) and a new modified MASI scoring method. Journal of the American Academy of Dermatology. 2011; 64:78-83
8. Lemperle G, Holmes RE, Cohen SR, Lemperle SM. A classification of facial wrinkles. Plastic and Reconstructive Surgery. 2001; 108 : 1735
9. Young Lee Ai. An updated review of melasma pathogenesis. 2014. Dermatologica Sinica, 32: 233-39
10. Abou-Taleb, Ahmed K, Eman MK. Reliability, validity, and sensitivity to change overtime of the Modified Melasma Area and Severity Index Score. Dermatology Surgery. 2017; 43:210–17
11. Clarys, P., Alewaeters, K., Lambrecht, R., Barel, A.O. Skin color measurements: comparison between three instruments: The Chromameter (R), the DermaSpectrometer (R) and the Mexameter (R). Skin Res Technolgy. 2000; 6, 230-38.
12. Jeong JH, Fan Y, You GY, Choi TH, Kim S. Improvement of photoaged skin wrinkles with cultured human fibroblasts and adipose-derived stem cells: a comparative study. 2015. Journal of Plastic, Reconstructive & Aesthetic Surgery, 68: 372-81
13. Gilchrest BA. Photoaging. Journal Investigative Dermatology. 2013: 133; E2–E6
14. Fabi SG, Massaki A, Eimpunth S, Pogoda J, Goldman MP. Evaluation of microfocused ultrasound with visualization for lifting, tightening, and wrinkle reduction of the décolletage. Journal American Academy of Dermatology. 2013; 69: 965-71.
15. Quan T, Qin Z, Xia W, Shao Y, John J, Voorhees, Gary J. Matrix-degrading metalloproteinases in photoaging. Journal of Investigative Dermatology Symposium Proceedings. 2009; 14: 20–4
16. Kim HH, Lee MJ, Lee SR, Kim KH, Cho KH, Eun HC, Chung JH. Augmentation of UV-induced skin wrinkling by infrared irradiation in hairless mice. Mechanisms of Ageing and Development. 2005; 126: 1170–77
17. Imokawa G. Mechanism of UVB-induced wrinkling of the skin: paracrine cytokine linkage between keratinocytes and fibroblasts leading to the stimulation of elastase. Journal of Investigative Dermatology Symposium Proceedings. 2009; 14
18. Kwon SH, Hwang YJ, Lee KS, Park KC. Heterogeneous pathology of melasma and its clinical implications. International Journal of Molecular Science. 2016; 17:824
19. Amano S. Characterization and mechanisms of photoageing-related changesin skin. Damages of basement membrane and dermal structures. Experimental Dermatology. 2016; 25: 14–9
20. Kang WH, Yoon KH, Lee ES, Kim J, Lee KB, Yim H, Sohn S. Melasma: histopathological characteristics in 56 Korean patients. British Journal of Dermatology. 2002; 146: 228-37.
21. Hernandez-Barrera, R., Torres-Alvarez, B., Castanedo-Cazares, J.P., Oros-Ovalle, C., Moncada, B. Solar elastosis and presence of mast cells as key features in the pathogenesis of melasma. Clinical Experiment of Dermatol. 2008; 33, 305-8
22. TsukaharaK, Tamatsu Y, Sugawara Y, Shimada K. Morphological study of the relationship between solar elastosis and the development of wrinkles on the forehead and lateral canthus. Arch Dermatology. 2012; 148 : 913-17
23. Calderone DC, Fenske NA. The clinical spectrum of actinic elastosis. Journal of American Academy of Dermatology. 1995; 32: 1016-24
24. Pandya A, Berneburg M, Ortonne J, et al. Guidelines for clinical trials in melasma. British Journal of Dermatology. 2007;156:21–28
25. Hatzis J. The wrinkle and its measurement – A skin surface profilometric method. Micron. 2004;35: 201-219
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