ABSTRACT
BACKGROUND: Periorbital hyperchromia (POH), popularly known as "dark circles," is a very frequent complaint in dermatological appointments. It affects all phototypes, genders, and ages, and it is associated with a tired and aged aspect to the face, which may lead to esthetic concerns and impairments in the quality of life. Its etiology is multifactorial, and it is believed that sleep disorders may be considered as precipitating or aggravating factors. AIMS: Our objective is to compare sleep quality (using the Pittsburgh Sleep Quality Index-PSQI) of patients with POH to patients without this complaint. METHODS: A single-center, case-control study. Patients from both genders were included. Cases were patients with POH, and controls had no POH. Demographic data, Dermatology Life Quality Index (DLQI), and PSQI were collected. A power of 80% and statistical significance when a P-value was lower than .05 were stipulated. RESULTS: Out of 303 patients, 149 cases and 154 controls, with a mean age of 35.83 ± 11.38 for cases and 37.52 ± 14.89 for controls, there was no significant difference between groups. The DLQI revealed a mean of 4.86 ± 4.89 for cases and 2.25 ± 3.73 for controls (P < .0001), which translates into a modest effect in life quality. The PSQI mean was 5.93 ± 2.52 for cases and 6.14 ± 3.58 for controls (P = .633), which characterizes the poor quality of sleep. CONCLUSIONS: Dark circles impact negatively on the quality of life of affected patients, especially in women. Contrary to what has been believed, sleep alone does not seem to influence the appearance of POH. NCT03393624.
Subject(s)
Quality of Life , Sleep Wake Disorders , Adult , Case-Control Studies , Esthetics , Female , Humans , Male , Middle Aged , Sleep , Sleep Wake Disorders/etiology , Surveys and Questionnaires , Young AdultABSTRACT
The aim of this study was to compare the efficacy and safety of a triple combination (TC) cream and monotherapy with hydroquinone (HQ) cream in the treatment of moderate to severe facial melasma. A total of 120 patients applied TC cream once daily or HQ cream twice daily for 8 weeks. Evaluations included static global severity assessment of melasma, improvement of melasma over time, local tolerability, and adverse events. TC cream was significantly more effective than HQ cream from week 4 onwards: lesions were approximately equivalent to the surrounding skin in 35% of all TC-treated patients, compared to 5% of those who used HQ cream (P = 0.0001). Improvement of more than 75% was achieved by 73% of TC cream patients and 49% of HQ cream patients (P = 0.007). The incidence of adverse events (erythema, burning sensation, and desquamation) was similar in both groups. No patient dropped out of the study because of drug-related adverse events. TC cream was more effective than the HQ cream for the treatment of moderate to severe facial melasma. Both products had similar safety profiles.
Subject(s)
Facial Dermatoses/drug therapy , Fluocinolone Acetonide/therapeutic use , Hydroquinones/administration & dosage , Melanosis/drug therapy , Tretinoin/therapeutic use , Administration, Topical , Adult , Drug Combinations , Emollients , Facial Dermatoses/diagnosis , Female , Follow-Up Studies , Humans , Male , Melanosis/diagnosis , Middle Aged , Probability , Reference Values , Severity of Illness Index , Single-Blind Method , Treatment OutcomeABSTRACT
Dermatoses, mainly those with important esthetic involvement, can produce a significant impact in the social, familiar and professional life of patients. Among these diseases, melasma is distinguished by its relapsing hyperchromic macules, with disappointing therapeutic results. Considering all these features, besides the objective evaluation of the therapeutic results, the dimension of the disease influence on the quality of life is considered of similar relevance. This influence is measured by validated questionnaires, most of them written in English. Its translation and cultural adaptation are necessary steps before being applied to people whom speak other languages. This study describes the translation and adaptation to Portuguese of the quality of life questionnaires developed for patients with Melasma (MELASQoL), according to the rules established by the World Health Organization. In summary: two independent literal translations to Portuguese; review by a health professionals bilingual group; application of the first version to 10 volunteer patients that agreed to report their opinion; discussion of items and administration procedures; back-translation to English; evaluation by the original author; review by the bilingual group and formatting of the final Portuguese questionnaire. The version and routine application of the MELASQoL instrument will allow a significant improvement on the individual evaluations as well as the participation on multi center studies, producing consistent and comparable results
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