The Relationship between Triiodothyronine and Thyroid StimulatingHormone Serum Level into Melasma Severity

Abstract

Background: Melasma is a chronic acquired hypermelanosis of the skin and relatively common skin disorder that primarily affects sunlight-exposed areas in women. While etiology of melasma is not yet well understood, a possible factor is thyroid hormones. Few studies have been conducted in order to find the relationship between melasma and thyroid disorders with varying results. This study is conducted to investigate the association between thyroid parameters (triiodothyronine and thyroid stimulating hormone) and melasma severity. 

Aim:To determine the relationship between triiodothyronine (T3) and thyroid stimulating hormone (TSH) serum level into severeity of melasma. 

Subject and method: Thirty six women with melasma aged >18 years old are included in the study group indoor at Dr. M. Djamil Hospital Padang. Exclusion criteria: pregnancy/lactation, using oral contraception, using hormonal therapy, taking photosensitizer systemic antifungi and anticonvulsant and taking topical/systemic of melasma treatment. History of sun protection usages and MASI score are recorded. Triiodothyronine and TSH level are measured by electrochemiluminescence-immunoasay (ECLIA) method. 

Result: Mean age of melasma patients in this study: 47.52±8.11 years old. Malar type is more common than centrofacial (61,1%) and we did not find mandibular type. The most common severity of melasma: mild (19 out of 36 people). MASI score: 21.46±10.40. Mean serum level of T3 and TSH: 1.578±0.282 nmol/L and 1.773±1.457 μIU/L (p>0,05). 

Conclusion: Mean serum levels of T3 and TSH hormones are not related to the severeity of melasma. Nevertheless, increasing levels of hormones are in accordance with the increase of melasma’s severeity degree, although it is not statistically significant. Further study could be done by adding hypothyroidism to patients who have melasma and comparing them with control group by using cross-sectional comparative sampling. An equal sample number of each severity degree of melasma would be ideal and then evaluate psychological/stress factors to the subjects.