THYROID DISORDERS IN PATIENTS WITH MELASMA

Background and objectives: Melasma, a common pigmentary disorder is major cosmetic concernamong patients. The aim of our study was to determine the frequency of thyroid disorders in melasma cases.

Methodology: Thisobservational study was conducted at RIHS DermatologyDepartment Islamabad from 20^thFeb–20^thMay 2021. Diagnosed cases of melasma (>18 years) were selected via consecutive sampling technique.Themedically/surgically treated cases of thyroid, melasma secondary to other dermatosis, organ failure, Addisons disease, pregnancy and subclinical thyroid disorders were excluded. After detailed clinical evaluation, thyroid status documented on the basis of thyroid function tests. Data analysed by SPSS with significant p-value<0.05.

Results: Amongst 150 melasma cases 117(78%) females and 33(22%) males, mean age was 35.45+9.68 years. 36(24%) were euthyroid, 109(72.7%) hypothyroid and 5(3.3%) hyperthyroid. Mean TSH was 1.82+18.64 mIU/L. 75(50%) had epidermal, 38(25.3%) dermal and 37(24.7%) mixed melasma, hypothyroidism frequent in all three types. Dermal melasma frequent in 41-50 years, epidermal in 20-30 years and mixed in 31-40 years. Thyroid status had significant association with age group, hypothyroidism more common in 41-50 years and Euthyroid in <30 years. Obesity observed in 55(36.7%) having significant association with hypothyroidism. Mandibular melasma observed in 88%, malar 77.3%, centro-facial18.7% and neck melasma 9.3%.

Conclusion: Thyroid disorders, particularly hypothyroidism is frequent among melasma cases.Authors recommend to screen all melasma cases regardless of age or gender for thyroid disorders, in particular obese cases. The diagnosis and management of thyroid disease in melasma cases may improve quality of life, prevent thyroid related complications and improve outcome of melasma treatment.