Evangeline B. Handog and Maria Juliet Enriquez-Macarayo (eds.)Melasma and Vitiligo in Brown Skin10.1007/978-81-322-3664-1_10

10. Melasma and Comorbidities

Ncoza C. Dlova¹ and Levashni Naidoo¹

(1)

Department of Dermatology, Nelson R Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa

Ncoza C. Dlova

Email: Dlovan@ukzn.ac.za

Keyword

Melasma comorbidities

10.1 Introduction

The concurrence of multiple diseases or disorders in association with melasma has not been widely reported, and the precise interplay amongst contributory factors that generate this hypermelanization remains the focus of ongoing studies.

Key associated factors identified thus far include endocrine, psychological and emotional disturbance.

10.2 Menstrual Cycle Irregularities

Middle Eastern studies have documented the association of menstrual cycle changes associated with conditions like polycystic ovarian syndrome and insulin resistance, finding them to occur more commonly in patients with melasma [1, 2].

A more recent study from Brazil supported this reporting a greater association with menstrual irregularities and patients diagnosed with melasma. This relationship bordered on significant where a subgroup analysis of females with greater BMI was undertaken [3].

10.3 Thyroid Dysfunction

Mild thyroid dysfunction has been found in some studies on females with melasma. The study by Lufti et al. classified melasma patients into two groups: idiopathic versus association with occurrence in pregnancy or subsequent to contraceptive pill use [4]. An association with thyroid abnormalities was found to be higher in the latter group (70 % in the latter versus 39 % in the former group) leading the authors to propose a positive association with thyroid autoimmunity in the setting of pregnancy or contraceptive use.

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