Factors influencing the severity of melasma: a prospective study in 197 Tunisian patients

The put-pose of this study was to describe factors that influence the severity of melasma in a large Tunisian population of 197 patients. Descriptive and exploratory analyses of the factors affecting the severity of the disease were carried out using comparison tests and factor analysis. The population was composed of 188 women and 9 men, aged between 19 and 60 years. The Melasma Area and Severity Index (MASI) was calculated for each patient. Significant links were found between the MASI and phototype, age, photoageing, the intensity of lifetime Sun exposure and the quality of life. This study confirmed that the most severe forms commonly appear in patients with dark phototypes, in the oldest patients and those who were particularly exposed to the sun during their lives; these forms of melasma generally leading to a deterioration in patient's quality of life.