The Correlation Between Malondialdehyde Serum Levels and the Duration of Sun Exposure; and Melasma Area and Severity Index in Patients with Melasma in Makassar
American Journal of Clinical and Experimental Medicine
Volume 4, Issue 3, May 2016, Pages: 68-75
Received: Apr. 21, 2016; Accepted: May 3, 2016; Published: May 13, 2016
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Fadlina Zainuddin, Department of Dermatology, Medical Faculty, Hasanuddin University, Makassar, Indonesia
Anis Irawan Anwar, Department of Dermatology, Medical Faculty, Hasanuddin University, Makassar, Indonesia
Khairuddin Djawad, Department of Dermatology, Medical Faculty, Hasanuddin University, Makassar, Indonesia
Arifin Seweng, Department of Biostatistic, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
Rizalinda Sjahril, Department of Microbiology, Medical Faculty, Hasanuddin University, Makassar, Indonesia
Anni Adriani, Department of Dermatology, Medical Faculty, Hasanuddin University, Makassar, Indonesia
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Ultraviolet (UV) plays an important role in the pathogenesis of melasma. Ultraviolet rays can cause lipid peroxidation in cell membranes that trigger the generation of free radicals that can stimulate melanocytes to produce many melanin. Malondialdehyde (MDA) is the end product of lipid peroxidation in the body. MDA is an important indicator of lipid peroxidation. There are a lot of research has been done in linking MDA to the severity of melasma. But there has not yet any research connecting it with sun exposure in patients with melasma. This study aims to find out the relationship between MDA serum levels and the duration of sun exposure; and Melasma Area and Severity Index (MASI) scores in patients with melasma. The research method was the case control study. It used 84 samples divided into two groups: a melasma group consisting of 42 people and a control group consisting of 42 people. The examination was performed with anamnesis, questionnaires, duration score of sun exposure, physical examination and the assessment of MDA serum levels with Thiobutiric acid-reactive substance test reaction. The data were analysed using independent t test, Mann Whitney, and Spearman correlation test. The results show that there is a significant correlation between the levels of MDA with the duration of sun exposure, but the duration of sun exposure is not associated with MASI score. It means that MDA levels are not significantly associated with MASI scores. Free radicals are significantly associated with the duration of sun exposure, but the severity of melasma is not affected by the duration of sun exposure. The severity level of melasma is still much influenced by some other risk factors associated with the pathogenesis of melasma.
Length Sun Exposure, Melasma, Malondialdehyde, MASI Scores
To cite this article
Fadlina Zainuddin, Anis Irawan Anwar, Khairuddin Djawad, Arifin Seweng, Rizalinda Sjahril, Anni Adriani, The Correlation Between Malondialdehyde Serum Levels and the Duration of Sun Exposure; and Melasma Area and Severity Index in Patients with Melasma in Makassar, American Journal of Clinical and Experimental Medicine. Vol. 4, No. 3, 2016, pp. 68-75. doi: 10.11648/j.ajcem.20160403.16
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Sarkar, R., Arora, P., Garg, VK, Sonthalia, S. & Gokhale, N. Melasma Update. Indian Dermatol Online J. 2014; 5: 426-35.
Gupta, AK, Gover, MD, Nouri, K. & Taylor, S. The treatment of melasma: A review of clinical trials. J Am Acad Dermatol, 2006; 55: 1048-65.
Soepardiman, L. Melasma. In: PERDOSKI, KSDKI (ed.) Symposium, Demo, Training and Exhibition of Cosmetic Dermatology Everything about skin pigmentation. Jakarta: KSDKI.. 2009.
Handel, AC, Miot, LDB & Miot, HA. Melasma: a clinical and epidemiological review. An Bras Dermatol, 2014; 89: 771-82.
Sheth, VM & Pandya, AG. Melasma: A comprehensive update Part I. J Am Acad Dermatol, 2: 011; 65: 689-97.
Roberts, WE. Melasma. In: Kelly, AP & Taylor, SC (eds.) Dermatology for Skin of Color. 1 ed. New York: McGraw-Hill; 2009.
Shweta, K., Khozema, S., Meenu, R., Anupama, S., SK, S. & Neelima, S. A Systemic Review on Melasma: A Review. Int J Cur Bio Med Sci.,. 2011; 1: 63-8.
Park, H.-Y. & Yaar, M.. Biology Of melanocytes. In: Goldsmith, LA, Katz, SI, Gilchrest, BA Paller, AS, Leffel, DJ & Wolff, K. (eds.) Fitzpatrick's Dermatology in Genereal Medicine, 8th ed. New York: McGraw-Hill; 2012
Krajcovicova-Kudlackova, Paukova, M., Bacekova, V. & Dusinska, M.. Lipid peroxidation in relation to vitamin C and vitamin E levels. Cent. Eur. J. Publ. Health, 2004; 12: 46-8.
Jetawattana, S. Malondialdehyde (MDA), a lipid oxidation product. Free Radicals in Biology and Medicine,. 2005; 77: 1-10.
Hamadi, Mohammed, SA, Mahammed, Aljaf, M., N., A. & ALI, A. The Role of Topical and OralMelatonin in Management of Patients Melasma Journal of Arab Universities for Basic and Applied Sciences. 2009; 8: 30-42.
Seckin, HYLZ, Kalkan, GK, Bas, YN, Akbas, A., nder, YNO, Zyurt, HSO & ¸ Sahin, M. Oxidative stress status in Patients with melasma. Cutan Ocul Toxicol. 2013; 33: 212-17.
Sari, AAIAN. Positive Correlation between Levels of malondialdehyde Serum with Melasma Area And Severity Index. Magister, Udayana University. 2014.
Bhor, U. & Pande, S.. Scoring systems in dermatology. Indian J Dermatol Venereol Leprol, 2006; 72: 315-21.
Pandya, A. G., Lindas.Hynan, Bhore, R., Riley, F. C., Guevara, I. L., Grimes, P., Nordlund, J. J., Rendon, M., Taylor, S., Gottschalk, R. W., Agim, N. G. & Ortonne, J.-P. Reliability assessment and validation of the Melasma Area and Severity Index (MASI) and a new modified MASI scoring method. J Am Acad Dermatol. 2011; 64: 78-83.
Ortonne JP, et al.. "A global survey of the role of ultraviolet radiation and hormonal influences in the development of melasma." JEADV 2009; 23: 1254-62.
Rikyanto. 2004. The customer profile cases of melasma in cosmetic clinic of the Yogyakarta hospitals. Perdoski [Internet]. Available
Febrianti T, Soedarmono A, Rata IGAK, Bernadette I. 2004. Epidemiology of melasma in the outpatients clinics department of dermatology and venereology Cipto Mangunkusumo Hospital. 2004. Perdoski [Internet]. Available at: www. Perdoski.or Id. /index.php/public/information/mdvi-detail-content/86.
Baumann, L. & Saghari, S. Skin Pigmentation and Pigmentation Disorders. In: Baumann, L. (ed.) Cosmetic Dermatology Principles and Practices. 2nd ed. New York: Mc-Graw Hill; 2009.
Goh, CL., Dlova, CN. A retrospective study on the clinical presentation and treatment outcome of Dermatological melasma in a tertiary referral center in Singapore. Singapore Med J.1999; 40: 455-8.
Tamler, C., Fonseca, RRR, Pereira, FBC, Barcaul, CB. Classification of melasma by dermoscopy: comparative study with Wood' s lamp. Surgical and Cosmetic Dermatology. 2009; 13: 115-9.
Kim, NH, Oliviera, MC, Brain, RP, Marghoob, AA, Rabinovits, HS. Atlas of dermoscopy. Marghoob, AA, Malvehy, J., Braun, RP: United Kingdom; 2012.
Hindritiani, R. Melasma. In Wasitaatmadja, S. (eds): Skin Pigmentation. Study Group of Cosmetic Dermatology Indonesia, 114-125; 2015.
Winarsih, H. Natural Antioxidants and Free Radicals, Jogjakarta, Canisius; 2007.
Diaconu, RE., Macarie, AE., Orasan, R. The Analysis of of oxidative stress in the sun-exposed and unexposed skin. Human and Veterinary Medicine, 2014; 6: 153-7.
Costin, G.-E. & Hearing, VJ. Human skin pigmentation: melanocytes modulate skin color in response to stress. FASEB J.2007; 21: 976-94.
Miranti, A., Anwar, AI., Djawad, K., Patellongi, I., Wahab, S., Abdullah, N. The analysis of the estradiol hormone to several risk factors melasma. Magister, University of Hasanuddin; 2016.
Damevska, K. New aspects of melasma. Serbian J Dermatol Venereol.2014; 6: 5-18.
Rahman, T., Hosen, I., Islam, MMT., Sekhar, HU. Oxidative stress and human health. Adv Biosci. Biotechnol., 2012;3: 997-1019.
Palmieri, B. & Sblendorio, V. Oxidative stress tests: overview on reliability and use part 1. Eur Rev sMed Pharmacol Sci., 2007; 11: 309-42.
Ayala, A., Munoz, MF., Arguelles, S. Lipid peroxidation: production, metabolism, and signaling mechanisms of malondialdehyde and 4-hydroxy-2-neonal. Oxid Med Cell Longev. 2014; 5: 1-31.
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