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The clinicoaetiological, hormonal and histopathological characteristics of melasma in men
Author(s) -
Handa S.,
De D.,
Khullar G.,
Radotra B. D.,
Sachdeva N.
Publication year - 2018
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/ced.13234
Subject(s) - melasma , medicine , family history , dermatology , hormone , etiology , skin biopsy , immunohistochemistry , pathology , endocrine system , biopsy
Summary Background Melasma is relatively uncommon in males, and there is a paucity of data on male melasma, including its clinical pattern, triggering factors, endocrine profile and histopathological findings. Aim To characterize the clinical findings and aetiological factors, including hormonal and histopathological features, of male melasma. Methods Male patients with melasma and age‐ and sex‐matched healthy controls ( HC s) were recruited. Demographic profile, risk factors, clinical pattern and Wood lamp findings of patients were recorded. Sera were obtained from patients and HC s to determine hormone levels. Biopsy specimens were obtained from lesional and adjacent nonlesional skin. Results In total, 50 male patients with melasma and 20 HC s were recruited into the study. Mean age of patients was 27.58 ± 4.51 years. The most common clinical pattern of melasma was malar, which occurred in 52% of cases. Positive family history was present in 16% of patients, while 34% had disease aggravation with sun exposure and 62% used mustard oil for hair growth and/or as an emollient. Wood lamp examination revealed epidermal‐type melasma in 54% of patients. There were no significant differences in hormone levels between patients and HC s. Histologically, epidermal melanin, elastotic degeneration, vascular proliferation and mast cells were more pronounced in lesional compared with nonlesional skin. Absent to weak expression of oestrogen receptors, progesterone receptors and stem cell factor was observed in lesional skin. Conclusion Ultraviolet light and mustard oil are important causative factors in male melasma. Although stress and family history may contribute, hormonal factors possibly have no role. Quantitative analysis of immunohistochemical markers would provide insight in understanding the pathogenesis of melasma.