Kimbrough-Green et al used the Melasma Area and Severity Index (MASI) to evaluate a patient with melasma. This can be used to monitor the patient over time and to evaluate the response to therapy. The authors are from the University of Michigan.
Patient selection: melasma
Parameters:
(1) region of face as fraction of total facial skin area
(2) percent of portion showing melasma (scored from 0 to 6)
(3) darkness (scored from 0 to 4)
(4) homogeneity (scored from 0 to 4)
Region of Face
Fraction of Facial Area
forehead
0.3
right malar
0.3
left malar
0.3
chin
0.1
Parameter
Finding
Points
percent
0%
0
1 to 9%
1
10 to 29%
2
30 to 49%
3
50 to 69%
4
70 to 89%
5
90-100%
6
darkness
absent/none
0
slight
1
mild
2
moderate/marked
3
maximum
4
homogeneity
absent/none
0
slight
1
mild
2
moderate/marked
3
maximum
4
subscore =
= (fraction of total area) * (points for percent) * ((points for darkness) + (points for homogeneity))
total score = SUM(subscore for 4 zones)
Interpretation:
• minimum MASI: 0
• maximum MASI: 48
• The higher the MASI the more severe the melasma.
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