J Drugs Dermatol. 2024 Aug 1;23(8):691-693. doi: 10.36849/JDD.8233.
In an effort to define the characteristics of populations affected by melasma, we utilized a large global health research network database from 108 health care organizations (TriNetx) to quantify the associations between race, ethnicity, and comorbidities.
We identified the cohort of all patients with melasma from the TriNetx database, and subsequently generated a control cohort. ICD-10 codes were used to identify the prevalence of various comorbidities associated with melasma.
A total of 41,283 patients with melasma (93% female, mean [SD] age 48.8 [12.6] year) were identified. The most frequently associated risk factors included hypertension (25% of the melasma cohort) and hormonal contraception (24%). Rosacea (OR=5.1), atopic dermatitis (OR=3.3), lupus (OR=2.5), history of skin cancer (OR=2.5), history of internal malignancy (OR=2.1), and hormonal contraception use (OR=2.1) possessed the highest odds ratios for development of melasma (all P< 0.01). A statistically significant association was identified for melasma in Asian or Other/Unknown races (OR=2.0 and OR=1.7, P< 0.01), as well as Hispanic ethnicity (OR=1.3, P< 0.01). White, Black/African American, and Not Hispanic groups all revealed slightly lower odds (all 0.8, P< 0.01).
This latest global update on the etiopathology of melasma further supports findings from prior epidemiologic study reporting preference in melanized phenotypes (Fitzpatrick skin type III-V), but less so in extreme skin types (I, II, VI). Increased associations with rosacea, atopic dermatitis, and history of cancer may emphasize the importance of treating concurrent inflammatory environments and the consideration of more frequent malignancy surveillance. J Drugs Dermatol. 2024;23(8):691-693. doi:10.36849/JDD.8233.
为了明确受黄褐斑影响的人群特征，我们利用来自 108 家医疗保健机构的大型全球健康研究网络数据库（TriNetx）来量化种族、民族和合并症之间的关联。
我们从 TriNetx 数据库中确定了所有黄褐斑患者的队列，并随后生成了一个对照组。使用 ICD-10 代码来确定与黄褐斑相关的各种合并症的患病率。
共确定了 41283 例黄褐斑患者（93%为女性，平均[标准差]年龄 48.8[12.6]岁）。最常见的相关危险因素包括高血压（黄褐斑队列的 25%）和激素避孕（24%）。酒渣鼻（OR=5.1）、特应性皮炎（OR=3.3）、狼疮（OR=2.5）、皮肤癌史（OR=2.5）、内部恶性肿瘤史（OR=2.1）和激素避孕（OR=2.1）的发生发展具有最高的优势比（均 P<0.01）。在亚洲或其他/未知种族（OR=2.0 和 OR=1.7，P<0.01）以及西班牙裔（OR=1.3，P<0.01）中发现黄褐斑有统计学显著关联。白种人、黑种人/非裔美国人以及非西班牙裔人群的几率均略低（均为 0.8，P<0.01）。
这项关于黄褐斑病因学的最新全球更新进一步支持了先前流行病学研究报告的结果，即黑色素表型（Fitzpatrick 皮肤类型 III-V）更易患病，但极端皮肤类型（I、II、VI）则较少患病。与酒渣鼻、特应性皮炎和癌症史的关联增加可能强调了治疗并发炎症环境和考虑更频繁的恶性肿瘤监测的重要性。J 皮肤病药物杂志。2024;23(8):691-693。doi:10.36849/JDD.8233.
