Banchhor Saumya, Gupta Sanjeev, Mahendra Aneet
Dermatology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, IND.
Cureus. 2024 Nov 27;16(11):e74625. doi: 10.7759/cureus.74625. eCollection 2024 Nov.
Periorbital melanosis (POM) is a poorly defined condition that is becoming an increasing aesthetic concern. With its multifactorial origin, it necessitates a thorough assessment of targeted multimodal treatments. The psychological impact and underlying pathogenesis have been underexplored, as evidenced by the gap between the roughly 100 indexed articles and the 150 million search engine results on treatments for dark circles. This descriptive study aims to explore the clinical and dermoscopic evaluation of POM and its impact on quality of life.
This descriptive prospective, tertiary hospital-based study included 250 patients with POM attending the Dermatology Outpatient Department. After obtaining informed consent, patients were subjected to clinical assessment, hematological investigations, and Wood's lamp (by Dermaindia, Chennai, India) examination. The dermatoscopic examination was done using a Dino-Lite video dermatoscope AF4515ZT+WF-20 (AnMo Electronics Corporation, Taipei, Taiwan). Quality of life was measured using the Melasma Quality of Life (MELASQoL) scale, and the psychological impact was assessed using the Perceived Stress Scale (PSS) and Body Dysmorphic Disorder Questionnaire-Dermatology Version (BDDQ-DV).
Among 250 patients, 179 (71.6%) were female and 71 (28.4%) were male, with a mean age of 30.53±9.29 years and a disease duration of 6.82±5.04 years. Constitutional POM was the most common type observed in 219 (87.6%) patients. Dermoscopy showed blotches in 166 (66.4%), telangiectasia in 211 (84.4%), and exaggerated skin markings in 17 (6.8%), and no atrophic changes were observed. Mean MELASQoL and PSS scores were 25.63±10.52 and 16.64±3.27, respectively; four (1.6%) patients had body dysmorphic disorder.
POM has a complex etiology with multiple underlying mechanisms. Thorough clinical assessment enables accurate diagnosis and a targeted treatment approach. Thus, unnecessary medications and procedures can be avoided by first understanding the underlying pathophysiology. Further studies are warranted in the Indian population with POM, as the skin type, demography, and socioeconomic status are diverse. Various proposed classifications are available but do not cater to the Indian skin type; hence, further research is due.
眶周色素沉着（POM）是一种定义尚不明确的病症，日益引起美学方面的关注。由于其病因多因素，需要对有针对性的多模式治疗进行全面评估。心理影响和潜在发病机制尚未得到充分研究，这一点从关于黑眼圈治疗的约100篇索引文章与1.5亿条搜索引擎结果之间的差距可见一斑。这项描述性研究旨在探讨POM的临床和皮肤镜评估及其对生活质量的影响。
这项基于三级医院的描述性前瞻性研究纳入了250名到皮肤科门诊就诊的POM患者。在获得知情同意后，对患者进行临床评估、血液学检查和伍德灯（由印度钦奈的Dermaindia公司提供）检查。皮肤镜检查使用Dino-Lite视频皮肤镜AF4515ZT+WF-20（台湾台北的安谋电子股份有限公司）。使用黄褐斑生活质量（MELASQoL）量表测量生活质量，使用感知压力量表（PSS）和躯体变形障碍问卷-皮肤科版（BDDQ-DV）评估心理影响。
250名患者中，179名（71.6%）为女性，71名（28.4%）为男性，平均年龄为30.53±9.29岁，病程为6.82±5.04年。体质性POM是最常见的类型，见于219名（87.6%）患者。皮肤镜检查显示166名（66.4%）有斑点，211名（84.4%）有毛细血管扩张，17名（6.8%）有皮肤纹理增粗，未观察到萎缩性改变。MELASQoL和PSS的平均得分分别为25.63±10.52和16.64±3.27；4名（1.6%）患者患有躯体变形障碍。
POM病因复杂，有多种潜在机制。全面的临床评估有助于准确诊断和采取有针对性的治疗方法。因此，通过首先了解潜在的病理生理学，可以避免不必要的药物和治疗程序。鉴于印度人群的皮肤类型、人口统计学和社会经济状况各不相同，有必要对印度的POM患者进行进一步研究。现有的各种分类方法并不适用于印度的皮肤类型，因此需要进一步研究。
