Correlation of Estradiol and Estriol Serum Levels to Melasma Severity in Pregnant Women

Abstract

Combination of hormonal change, ultraviolet radiation and genetics are the most responsible factors in melasma. One of pigmentation change caused by pregnancy is melasma. The critical key to describe hyperpigmentation process is increased levels of estradiol and estriol. This study is aimed to determined correlation of serum levels of estradiol and estriol to melasma severity in pregnant women. This cross-sectional study was conducted with consecutive sampling in pregnant women with melasma. This study was conducted from June to July 2017 at Dr. Saiful Anwar Regional Hospital, Malang, East Java, Indonesia. Pregnant woman with melasma (15-49 years) was included and pregnant women with the history of melasma not caused by pregnancy, which used hormonal contraception or oral hormone therapy containing estrogen and took oral phototoxic drugs, were excluded. Anamnesis, physical examination, Wood Lamp, MASI (Melasma Area and Severity Index) Score and blood was drawn to measure serum levels of estradiol and estriol by using ELISA to 25 pregnant women with melasma. Data analysis was done with Pearson correlation test and multiple linear regressions. The result showed serum levels of estradiol was significantly positive correlated with MASI Score (r=0.462; p 0.05). Multiple linear regression revealed R2=0.244 (p<0.05), which means that serum levels of estradiol and estriol had 24.4% effects to MASI Score, while the rest 75.6% was influenced by others variables that were not included in this study. The conclusion is that there is a positive correlation between serum levels of estradiol with melasma severity in pregnant women, but serum levels of estriol are not correlated with melasma severity. Another factor besides serum levels estradiol and estriol might influence melasma severity.