Tesis

Korelasi skor telangiektasis dengan derajat pigmentasi lesi melasma = Correlation between telangictases score and pigmentation degree in melasma lesions.

Latar belakang : Melasma adalah kelainan kulit hiperpigmentasi simetris, didapat, umumnya
ditandai oleh makula coklat hingga coklat gelap pada daerah kulit yang terpajan
sinar matahari. Patogenesis melasma masih belum diketahui dengan jelas.
Berdasarkan perkembangan terkini, interaksi antara vaskularisasi kulit dan
melanosit diduga memiliki peranan pada lesi melasma.
Tujuan : Untuk megetahui proporsi telangiektasis pada pasien melasma dan menilai
korelasi skor telangiektasis dengan derajat keparahan pigmentasi lesi melasma.
Metode : Sejumlah 48 wanita dengan melasma diikutsertakan apada penelitian
observasional potong lintang ini. Mereka dipilih berdasarkan metode consecutive
sampling. Wajah dari masing-masing subyek penelitian (SP) diperiksa dan
kemudian dibagi dalam 4 area: dahi, malar kiri, malar kanan, dan dagu.
Keparahan pigmentasi lesi melasma dievaluasi menggunakan skor pigmentasi
berdasarkan Melasma Area and Severity Index (MASI). Skor telagiektasis dinilai
menggunakan 5-point dermoscopic scale yang telah tervalidasi, dengan bantuan
alat dermoskopi. Analisis statistik dilakukan untuk menilai hubungan antara skor
telangiektasis dengan derajat keparahan pigmentasi lesi melasma.
Hasil : Dengan bantuan dermoskopi, ditemukan telangiektasis pada 35,4% (n=17/48) SP.
Dari total 192 area wajah yang diperiksa, 124(64,5%) di antaranya memilik lesi
pigmentasi. Derajat pigmentasi 1 sejumlah 64,8%, derajat 2 sebanyak 26,4%,
dan derajat 3 sejumlah 8,8%. Dari 124 lesi pigmentasi didapatkan 29(23,3%) lesi
dengan telangiektasis. Skor telangiektasis 1 pada 7,2% lesi, skor 2 pada 13,6%
lesi, dan skor 3 pada 2,4% lesi pigmentasi. Berdasarkan analisis statistik, terdapat
korelasi positif bermakna antara derajat pigmentasi dengan skor telangiektasis
melasma (r = 0.474, p < 0.0001).
Kesimpulan : Telangiektasis dapat ditemukan sebagai salah satu temuan klinis pada lesi
melasma. Keparahan pigmentasi berkorelasi positif dengan keparahan
telangiektasis pada lesi melasma.
Kata kunci: melasma, telangiektasis, dermoskopi


Background : Melasma is a common acquired symmetrical hypermelanosis characterized by
irregular light to dark brown macules and patches on sun-exposed areas of the
skin. The pathogenesis of melasma is still poorly understood. Recently,
interaction between skin vascularity and melanocytes has been proposed to have
influence in melasma pigmentation.
Purpose : To investigate the proportion of telangiectases in melasma and its correlation with
pigmentation severity of melasma.
Methods: A total of 48 woman with melasma were included in this cross-sectional
observational study. They were selected based of consecutive sampling method.
The face of each subject were examined and divided into 4 regions: forehead, left
malar, right malar, and chin area. Pigmentation severity of facial melasma skin
was evaluated using the pigmentation score of Melasma Area and Severity Index
(MASI). Telangictases score was assessed using a validated 5-point dermoscopic
scale with the aid of a hand-held noncontact polarized dermoscope. Statistical
analyses were performed to assess the association between pigmentation severity
and telangiectases score.
Results : Using dermoscope, we found telangiectases with various severity in
35.4%(n=17/48) of the subjects. Of the total 192 facial areas examined,
124(64,5%) of which, have melasma pigmentation. The percentage of
pigmentation degree is 64,8% for grade 1, 26,4% for grade 2, dan 8,8% for grade
3. Of these area with pigmentation, 29(23,3%) had telangiectases. Telangiectases
score of 1, 2, and 3 present in 7,2%, 13,6%, dan 2,4% of pigmentation lesion,
respectively. There was significant relationship between telangiectases and
pigmentation in melasma, as increased pigmentation was correlated modestly with
telangiectases score (r = 0.474, p < 0.0001).
Conclusions : This study showed that telangiectases can be found as one of clinical finding in
some lesions of melasma. Increased pigmentation severity was positively
associated with the presence and severity of telangiectases. Telangiectases might
be one of the factors that influence the severity of melasma.
Keywords: melasma, telangiectases, dermoscope