The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 19 , ISSUE 10 ( 2018 ) > List of Articles


Melasma Associated with Periodontitis, Anemia, and Vitamin D Abnormalities: A Chance Occurrence or a Syndrome

Nallan C Chaitanya, Danam R Priyanka, Nithika Madireddy, Jampani N Priyanka, Madathanapalle Ramakrishna, Mujja Ajay, Ancy V Ignatius

Keywords : Hemoglobin percentage, Melasma, Periodontitis, Vitamin D.

Citation Information : Chaitanya NC, Priyanka DR, Madireddy N, Priyanka JN, Ramakrishna M, Ajay M, Ignatius AV. Melasma Associated with Periodontitis, Anemia, and Vitamin D Abnormalities: A Chance Occurrence or a Syndrome. J Contemp Dent Pract 2018; 19 (10):1254-1259.

DOI: 10.5005/jp-journals-10024-2413

License: CC BY-NC 3.0

Published Online: 01-08-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Aim: To correlate the possible association between melasma, periodontitis, vitamin D abnormalities, and anemia. Materials and methods: A total of 192 subjects, of either gender within the age group of 30 to 70 years were divided equally into two groups, group I (case group, patients with melasma) and group II (control group, patients without melasma). In all the subjects, anemia and periodontitis were checked clinically, along with biochemical evaluation of serum vitamin D levels and hemoglobin (Hb) percentage. Results: Student's t-test was performed with group statistics and chi-square for intervariable correlation was carried out. A significant correlation was found between patients having melasma and serum vitamin D levels with a p-value of 0.050. Between patients with melasma and periodontitis, there was a very significant correlation between the variables, with a p-value of 0.001. Conversely, the correlation between melasma and Hb percentage was found to be insignificant with the p-value 0.243, and all of the p-values remained at <0.05.The study thus demonstrated significant correlation between melasma, vitamin D abnormalities, and clinical periodontitis (p-value < 0.05), and no significant correlation between melasma and Hb. Conclusion: The cross-sectional study revealed that patients with melasma may have abnormal serum vitamin D and clinical periodontitis. This presence may be considered a syndromic occurrence. Clinical significance: The present study was done to correlate and also evaluate periodontitis, vitamin D abnormalities, and anemia in patients with melasma. It is primarily an observational study, attempting to evaluate the co-occurrence of the abovementioned variables. The findings may prompt us to further investigate melasma for the presence of periodontitis, anemia, and vitamin D abnormalities.

PDF Share
  1. Bagherani N, Gianfaldoni S, Smoller B. An overview on melasma. J Pigment Disord 2015 Sep;2:216.
  2. Sarkar R, Arora P, Garg VK, Sonthalia S, Gokhale N, Melasma update. Indian Dermatol Online J 2014 Oct;5(4):426-435.
  3. Najad SB, Khodaiiani E, Herizchi H, Mehrabi P. Frequency of iron deficiency anemia, folate and vitamin B12 deficiency in patients with melasma. Med J Tabriz Univ Med Sci 2012 Jun-Jul;34(2):1-8.
  4. Behrangi E, Baniasadi F, Esmaeeli S, Hedayat K, Goodarzi A, Azizian Z. Serum iron level, ferritin and total iron binding capacity level among nonpregnant women with and without melasma. J Res Med Sci 2015 Mar;20(3):281-283.
  5. Anand N, Chandrasekaran SC, Rajput NS. Vitamin D and periodontal health: current concepts. J Indian Soc Periodontol 2013 May;17(3):302-308.
  6. Nair SK, Faizuddin M, Jayanthi D. Anemia and periodontitis: an enigma? IOSR J Dent Med Sci 2013 Nov-Dec;11(4):71- 78.
  7. Ranson M, Posen S, Mason RS. Human melanocytes as a target tissue for hormones: in vitro studies with 1 alpha-25, dihydroxyvitamin D3, alphamelanocyte stimulating hormone, and beta-estradiol. J Invest Dermatol 1988 Dec;91(6):593-598.
  8. Milde P, Hauser U, Simon T, Mall G, Ernst V, Haussler MR, Frosch P, Rauterberg EW. Expression of 1,25-dihydroxyvitamin D3 receptors in normal and psoriatic skin. J Invest Dermatol 1991 Aug;97(2):230-239.
  9. Kuroki T. Possible functions of 1 alpha,25-dihydroxyvitamin D3, an active form of vitamin D3, in the differentiation and development of skin. J Invest Dermatol 1985 Jun;84(6):459-460.
  10. Mansur CP, Gordon PR, Ray S, Holick MF, Gilchrest BA. Vitamin D, its precursors, and metabolites do not affect melanization of cultured human melanocytes. J Invest Dermatol 1988 Jul;91(1):16-21.
  11. Jablonski NG. The evolution of human skin and skin color. Annu Rev Anthropol 2004 Oct;33:585-623.
  12. Andresen C, Olson E, Nduaka CI, Pero R, Bagi CM. Action of calciotropic hormones on bone metabolism – role of vitamin D3 in bone remodeling events. Am J Immunol 2006 Feb;2(2):40-51.
  13. Cozzolino M, Lu Y, Finch J, Slatopolsky E, Dusso AS. p21WAF1 and TGF-alpha mediate parathyroid growth arrest by vitamin D and high calcium. Kidney Int 2001 Dec;60(6):2109-2117.
  14. Zittermann A. Vitamin D in preventive medicine: are we ignoring the evidence? Br J Nutr 2003 May;89(5):552-572.
  15. Johnston GA, Sviland L, McLelland J. Melasma of the arms associated with hormone replacement therapy. Br J Dermatol 1998 Nov;139(5):932.
  16. O'Brien TJ, Dyall-Smith D, Hall AP. Melasma of the forearms. Australas J Dermatol 1997 Feb;38(1):35-37.
  17. Parmley T, O'Brien TJ. Skin changes during pregnancy. Clin Obstet Gynecol 1990 Dec;33(4):713-717.
  18. Snell RS. The pigmentary changes occurring in the breast skin during pregnancy and following estrogen treatment. J Invest Dermatol 1964 Sep;43:181-186.
  19. Im S, Lee ES, Kim W, On W, Kim J, Lee M, Kang WH. Donor specific response of estrogen and progesterone on cultured human melanocytes. J Korean Med Sci 2002 Feb;17(1):58-64.
  20. Lieberman R, Moy L. Estrogen receptor expression in melasma: results from facial skin of affected patients. J Drugs Dermatol 2008 May;7(5):463-465.
  21. Sheth VM, Pandya AG Melasma: a comprehensive update: part I. J Am Acad Dermatol 2011 Oct;65(4):689-697.
  22. Lainson PA, Brady PP, Fraleigh CM. Anemia, a systemic cause of periodontal disease? J Periodontol 1968 Jan;39(1): 35-38.
  23. Hutter JW, van der Velden U, Varoufaki A, Huffels RA, Hoek FJ, Loos BG. Lower numbers of erythrocytes and lower levels of haemoglobin in periodontitis patients compared to control subjects. J Clin Periodontol 2001 Oct;28(10):930-936.
  24. Gokhale SR, Sumanth S, Padhye AM. Evaluation of blood parameters in patients with chronic periodontitis for signs of anemia. J Periodontol 2010 Aug;81(8):1202-1206.
  25. Naik V, Acharya A, Deshmukh VL, Shetty S, Shirhatti R. Generalized, severe, chronic periodontitis is associated with anemia of chronic disease: a pilot study in urban Indian males. J Invest Clin Dent 2010 Nov;1(2):139-143.
  26. Aljohani HA. Association between hemoglobin level and severity of chronic periodontitis. JKAU Med Sci 2009 Dec;17(1):53-64.
  27. Wakai K, Kawamura T, Umemura O, Hara Y, Machida J, Anno T, Ichihara Y, Mizuno Y, Tamakoshi A, Lin Y, et al. Associations of medical status and physical fitness with periodontal disease. J Clin Periodontol 1999 Oct;26(10):664-672.
  28. Sim JJ, Lac PT, Liu ILA, Meguerditchian SO, Kumar VA, Kujubu DA, Rasgon SA. Vitamin D deficiency and anemia: a cross-sectional study. Ann Hematol 2010 May;89(5):447-452.
  29. Monlezun DJ, Camargo CA Jr, Mullen JT, Quraishi SA. Vitamin D status and the risk of anemia in community-dwelling adults: results from the National Health and Nutrition Examination Survey 2001-2006. Medicine (Baltimore) 2015 Dec;94(50): e1799.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.