Paudel Sushil, Acharya Poudel Indu, Upadhyay Priti, Kumar Shah Manish, Pokharel Shruti, Sharma Rabindra
Department of Dermatology, Civil Service Hospital, Kathmandu, Nepal.
Civil Service Hospital, Kathmandu, Nepal.
J Nepal Health Res Counc. 2022 Nov 2;20(2):316-320. doi: 10.33314/jnhrc.v20i02.3875.
Melasma is an acquired pigmentation disorder of the sun exposed parts of the body, particularly face. It is a significant cosmetic concern for the young adults, which is the most frequently affected age-group. Finding the level of impairment in quality of life in melasma patients and correlating with the severity.
All consenting patients with melasma visiting our out-patient from December 2020 to June 2021 were enrolled. Clinical evaluation was done by the same single reviewer in all cases using modified Melasma Area and Severity Index. Dermatology Life Quality Index (Nepali version) was asked to complete to the patient. Data were collected and analyzed. Frequency and mean were calculated for all variables, comparison of means by Mann-Whitney U test and correlation analyses by Spearman's correlation test were performed.
Females were 82.5%(99) of total cases. Among these 70.8%(85) were married, 68.3%(82) had family history of melasma and 65%(78) had centro-facial phenotype. Mean Dermatology Life Quality Index score was 10.25±0.54. Mean score of females was higher than that of males. The daily activities sub-domain was the worst affected with 50.67% of impairment. Females suffered significantly more than males in symptom and feeling sub-domain. Modified Melasma Area and Severity Index was significantly higher in males (7.12±.56 Vs. 5.66±.28). The severity and duration of melasma did not correlate to the quality of life.
Melasma had a moderately negative impact in the quality of life of the patients. Females suffered more due to melasma. The clinical severity of melasma did not correlate with the quality of life impairment. Thus, psychological assessment to all the melasma patients seem to be an important aspect of management.
黄褐斑是一种发生于身体暴露于阳光下部位尤其是面部的后天性色素沉着紊乱疾病。它是年轻成年人极为关注的美容问题，而这一年龄段是受影响最频繁的群体。探寻黄褐斑患者的生活质量受损程度并与严重程度相关联。
纳入2020年12月至2021年6月期间前来我院门诊就诊且同意参与的所有黄褐斑患者。所有病例均由同一位单一评审员使用改良的黄褐斑面积和严重程度指数进行临床评估。要求患者完成皮肤病生活质量指数（尼泊尔语版）。收集并分析数据。计算所有变量的频率和均值，通过曼 - 惠特尼U检验进行均值比较，并通过斯皮尔曼相关检验进行相关性分析。
女性占总病例数的82.5%（99例）。其中，70.8%（85例）已婚，68.3%（82例）有黄褐斑家族史，65%（78例）为中央面部型。皮肤病生活质量指数平均得分为10.25±0.54。女性的平均得分高于男性。日常活动子领域受影响最严重，受损率为50.67%。在症状和感受子领域，女性比男性遭受的痛苦明显更多。男性的改良黄褐斑面积和严重程度指数显著更高（7.12±0.56对5.66±0.28）。黄褐斑的严重程度和病程与生活质量无关。
黄褐斑对患者的生活质量有中度负面影响。女性因黄褐斑遭受的痛苦更多。黄褐斑的临床严重程度与生活质量受损无关。因此，对所有黄褐斑患者进行心理评估似乎是治疗的一个重要方面。
