The Influence of Serum Zinc and Copper Levels on Melasma Severity and Duration among a Group of Iraqi Patients

Abstract

Background: Several factors on melasma etiopathogenesis have been suggested, yet the exact pathophysiology of melasma is uncertain. However, controversial results exist now on Zn and Cu in serum of melasma patients. Objectives:  This study was done to measure the serum level of Zinc and Copper and to evaluate their influence on the duration and severity of melasma.  Patients and Methods: A Case- control study involved a total of 200 patients (melasma group 100 and equal number of healthy controls), The two groups were matched for age and sex. A sample of blood was taken from both cases and controls for assessment of serum zinc and serum copper, sent to the same lab and read by the same method for both groups, and then to compare the relation of these values with demographic data. Results: the serum zinc level was low in 51% of the patients with melasma, 47% had normal serum zinc level and only 2% had high serum zinc level. While only 5% had low serum copper level, 66% had normal serum copper level, and 29% had high serum copper levels. Analysis of means of serum zinc and serum copper levels revealed significant difference in means of serum zinc between cases and controls (p<0.001), and low serum zinc was highly associated with melasma cases (p<0.001). Furthermore, there was a significant association between duration of melasma and serum zinc level; duration ≤ 2 years was associated significantly with normal serum zinc level (P=0.03). However, there was no significant difference in means of serum copper between cases and controls (P=0.5). Conclusion: The results of the present study showed that there is a significant relation between serum zinc levels and melasma while showed no significant relation between serum copper and melasma. Low serum zinc level may be one of the risk factors that effects the melasma duration.