Melasma, Periodontitis, Vitamin D Abnormalities, Anaemia Clinical Trial
Official title:
A Cross Sectional Observational Study
Melasma is a commonly pigmention characterized by melanotic patches on the face. literature
searched revealed that periodontitis and vitamin D deficiency have occurred along with
anemia. Actinic associated factors may be indirectly related to vitamin D, melasma
contributes to sun exposed area of face.To correlate melasma with clinical evidence of
periodontitis and vitamin D serum analysis along side hb %. Patients with facial melasma
between 30-70yrs of either gender formed Group A (95). Anaemia and periodontitis were
Clinically checked. Additionally serum analysis of vitamin D and hb percentage were analysed.
Similar procedure was carried out on controls which had Group B (95) patients with no melasma
on face.
The study revealed significant correlation between melasma and periodontitis with vitamin D
abnormalities (p value<.05), where as insignificant correlation between melasma and Hb%. The
correlation between melasma, vitamin d changes and periodontitis may prompt the clinician to
check for any such changes in any patient. Melasma in patients with periodontitis and serum
vitamin D changes might be a considered as a syndrome.
Melasma, is a relatively common chronic pigmentation of the face, although it may be
localized also on the neck and forearms. It is also called as chloasma or mask of pregnancy.
It has higher prevalence in women and occurs less commonly in men. It most commonly affects
the sun-exposed areas of skin of face. Three patterns of presentation have been reported:
Centro-facial, malar and mandibular forms. The interplay of various risk factors are known to
contribute in the pathogenesis of melasma such as genetic predisposition, ultraviolet
radiation, hormonal factors, oral contraceptives and drugs like phenytoin. Thyroid
abnormalities were reported to occur with melasma. Skin pigmentation is a common
manifestation in nutritional deficiencies and frequently associated with deficiency of
vitamin B12 . Increased iron may affect the pattern and course of pigmentation, however it is
unclear how they coexist. Vitamin D3 (cholecalciferol) is synthesized from
7-dehydrocholesterol by photochemical process in the skin and through successive
hydroxylation to its active metabolite. 1, 25-dihydroxyvitamin D3 [1, 25(OH)2D3; calcitriol]
is formed in liver and kidney. Intracellular receptor (VDR) helps in binding of vitamin D
which helps the epithelial cells and melanocytes a target for vitamin D. Although vitamin D
is used in the treatment of melanoma and psoriasis and active role of 1, 25(OH)2D3 in skin no
reports of melasma associated with vitamin D reported. The dysfunction of 1,25(OH)2D3 - VDR
system may lead to periodontal disease . Mineral bone density could be directly related to
deficiency of vitamin D which also progress to osteoporosis. Studies have reported that
anemia may predispose to periodontitis but the correlation was not determined. Until date, no
studies reported any correlation or mere association between melasma, periodontitis and serum
vitamin D abnormalities as well as decreased Hb levels. The present study was intended to
assess the presence of periodontitis and vitamin D deficiency in melasma patients and
evaluate clinical presence of periodontitis, which may occur in conjunction with melasma and
vitamin D deficiency. The mere presence of melasma may help to investigate for further oral
issues such as periodontitis and anemia which may or may not be associated with vitamin D
abnormalities.
Patients visiting the Dept. of Oral medicine, with melasma on face within the age group of
30-70yrs in either gender were included in the study, matched with similar control group
without melasma after obtaining informed consent.
The patients were divided into 2 groups. Group A, had Patients with melasma in whom 2 ml of
blood was collected for estimation of serum-vitamin D levels, and complete blood picture was
estimated for Haemoglobin percentage and clinical oral examination was evaluated for
periodontitis. Group B served as control arm, where same procedure of blood parameter
estimation and clinical examination protocol was followed as in group A.
Total number of 100 patients participated in the study, 50 in each group. The samples that
resulted out of recruitment were tabulated and appropriate statistical analysis was done
comparing the both groups with the presence or absence of periodontitis and serum vitamin D
abnormalities and serum Hb% levels.
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