Association of Melasma in Patients with Thyroid Dysfunction and their Clinical Profile: A Cross-sectional Observational Study

Abstract

Introduction: Melasma may occur in thyroid diseases, and its manifestations may be the first presenting sign or even precede the diagnosis by many years. Melasma is difficult to treat. An initial screening of thyroid dysfunction will help in better management of both thyroid disorders and melasma. Aim: To detect the proportion of thyroid dysfunction in patients with melasma and describe the clinical profile of such patients. Materials and Methods: This was a cross-sectional, observational study carried out in the Department of Dermatology, Venereology and Leprosy, of a tertiary care teaching hospital of Karnataka, India from September 2020 to February 2022. Patient above or equal to 18 years of age with newly diagnosed melasma alone and no history of thyroid dysfunction were included in the study. A detailed history, using a preformed questionnaire, was taken. Wood’s lamp examination, to know the depth of pigmentation, along with thyroid dysfunction test, and antiThyroid Peroxidase (TPO) antibody was evaluated. Descriptive statistics data were analysed using a Statistical Package for the Social Sciences (SPSS) software version 20.0. Results: There were 100 patients with a mean age of 35.9 years, with a predominance of female (86%) and the majority (48%) of population were housewives. The distribution of lesion was either dermal (55%) or epidermal (44%). There were 65 patients with positive antiTPO; with men (85.7%) being significantly more than women (61.6%). The distribution of pigmentations was higher for the dermal pattern (55%), among females (46) and males (9), while only one mixed pattern was seen in males. Conclusion: Male melasma patients had higher positivity of antiTPO positivity than females, with significant antiTPO positivity. These patients showed more dermal pigmentations on Wood’s lamp examination.