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Research Letter |

Interpretability of the Modified Melasma Area and Severity Index (mMASI)

Michelle Rodrigues, MBBS, FACD1,2; Ana Sofía Ayala-Cortés, MD3; Adriana Rodríguez-Arámbula, MD4; Linda S. Hynan, PhD5; Amit G. Pandya, MD6
[+] Author Affiliations
1Department of Dermatology, St Vincent´s Hospital, Melbourne, Australia
2Department of Dermatology, Royal Children´s Hospital, Melbourne, Australia
3Department of Dermatology, University Hospital “José Eleuterio González,” Universidad Autónoma de Nuevo León, Monterrey, México
4Department of Dermatology, Hospital Central “Dr Ignacio Morones Prieto,” Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
5Departments of Clinical Sciences–Biostatistics and Psychiatry, University of Texas Southwestern Medical Center, Dallas
6Department of Dermatology, University of Texas Southwestern Medical Center, Dallas
JAMA Dermatol. 2016;152(9):1051-1052. doi:10.1001/jamadermatol.2016.1006.
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This review of a case series of patients with melasma provides a framework to facilitate meaningful clinical interpretation of modified Melasma Area and Severity Index scores.

Melasma is a disorder of pigmentation commonly affecting women with darker skin types.1 Owing to the recalcitrant nature of melasma, more randomized controlled clinical trials of new treatment modalities are needed. These trials require precise categorization of disease severity to select appropriate patients for enrollment and determine response to treatment. The Melasma Area and Severity Index (MASI) is the most common outcome measure used for melasma studies, and was validated 20 years after it was first reported.2,3 This validation process eliminated homogeneity as a part of the MASI, resulting in the new modified MASI score (mMASI).3

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MASI and Modified MASI (mMASI) Scores

Correlated with the melasma severity score (MSS) showing ranges for mild, moderate, and severe melasma. Error bars indicate 95% CIs. MASI indicates Melasma Area and Severity Index.

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