Abstract
BackgroundAbnormalities of facial pigmentation, or facial melanoses, are a common presenting complaint in Nepal and are the result of a diverse range of conditions.ObjectivesThe objective of this study was to determine the frequency, underlying cause and impact on quality of life of facial pigmentary disorders among patients visiting the Department of Dermatology and Venereology, Nepal Medical College and Teaching Hospital (NMCTH) over the course of one year.MethodsThis was a cross-sectional study conducted at the Department of Dermatology and Venereology, NMCTH. We recruited patients with facial melanoses above 16 years of age who presented to the outpatient department. Clinical and demographic data were collected and all the enrolled participants completed the validated Nepali version of the Dermatology Life Quality Index (DLQI).ResultsBetween January 5, 2019 to January 4, 2020, a total of 485 patients were recruited in the study. The most common diagnoses were melasma (166 patients) and post acne hyperpigmentation (71 patients). Quality of life impairment was highest in patients having melasma with steroid induced rosacea-like dermatitis (DLQI = 13.54 ± 1.30), while it was lowest in participants with ephelides (2.45 ± 1.23).ConclusionFacial melanoses are a common presenting complaint and lead to substantial impacts on quality of life. Accurate diagnosis and management can prevent or treat many facial melanoses, including those that lead to substantial loss of quality of life, such as melasma with steroid induced rosacea-like dermatitis. Health care systems in low and middle-income countries should dedicate resources to the identification, prevention and treatment of these conditions to improve quality of life.
Highlights
Abnormalities of facial pigmentation, or facial melanoses, are a common presenting complaint in Nepal and are the result of a diverse range of conditions
Accurate diagnosis and management can prevent or treat many facial melanoses, including those that lead to substantial loss of quality of life, such as melasma with steroid induced rosacea-like dermatitis
We investigated the pattern of facial pigmentary disorders and their impact on quality of life among patients presented to a dermatology clinic at a tertiary care centre in Nepal in order to describe the burden and impact of these conditions
Summary
Abnormalities of facial pigmentation, or facial melanoses, are a common presenting complaint in Nepal and are the result of a diverse range of conditions. Facial melanoses are a diverse range of disorders resulting in abnormal pigmentation of the facial region. The diagnosis and differentiation of these conditions are based on history and clinical examination supplemented in some cases by Wood’s lamp and histopathological evaluation. All these melanoses are associated with facial darkening, the heterogeneity of these conditions results in different levels of disease related impacts on quality of life. Several other indices have been developed to measure disease specific impact on quality of life, the DLQI remains a simple and effective tool to measure and compare the impact of dermatological disorders
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