Melasma is a common skin disorder of acquired hyperpigmentation that appears commonly on the face. Although asymptomatic, melasma causes psychosocial and emotional distress. This study aimed to assess melasma’s severity on people with darker skin types, evaluate the effects of melasma on the quality of life (QoL), and establish QoL predictors in affected individuals. This was a cross-sectional analytic study that enrolled 150 patients from three private dermatology clinics in Durban, South Africa who were diagnosed with melasma. The severity of melasma alongside QoL were measured using a melasma area and severity index (MASI) score and melasma quality of life scale (MELASQoL), respectively. The associations among factors and QoL were explored using multivariable methods and stepwise regression analysis. p-values less than 0.05 were considered significant. Enrolled patients were predominantly females (95%), of which 76% were of black African ethnicity, 9% were of Indian ethnicity, and 15% had mixed ancestry, with an average age of 47.30 years. Family history revealed that 61% had no prior melasma cases, while 39% had affected relatives, most commonly mothers (41%). The cheeks were the most common site for melasma. MASI score of Masi (β = 0.209, t = 2.628, p < 0.001), the involvement of cheeks (β = −0.268, t = −3.405, p < 0.001), level of education (β = −0.159, t = −2.029, p = 0.044), and being menopausal (β = −0.161, t = −2.027, p = 0.045) were found to be predictors of QoL. A regression model was created to forecast MELASQoL using these four predictors. This equation’s significance lies in its ability to enable the remote assessment of MELASQoL based on these four variables. It offers a valuable tool for researchers and medical professionals to quantitatively and objectively evaluate the impact of melasma on an individual’s quality of life.

The conventional use of medicinal plants is in part based on the widespread belief that plant crude extracts are non-toxic. In South Africa, traditional preparations of Cassipourea flanaganii used to treat hypermelanosis have accordingly been regarded by many as non-toxic. Whether that is so impacts on the potential of bark extracts to be developed as a commercial drug to treathypermelanosis, given their documented capacity to inhibit tyrosinase activity. Our study investigated the acute and subacute toxicity of the methanol extract of C. flanaganii bark in rats. Wistar rats were randomly assigned into different treatment groups. The rats received a daily oral gavage of crude extract for acute and subacute toxicity tests. Haematological, biomechanical, clinical and histopathology examinations were carried out to evaluate the possible toxicity of C. flanaganii. The results were subjected to the Student’s t-test and ANOVA. For both acute and subacute toxicity, there was no statistical difference between the groups. There were no clinical or behavioral signs of toxicity observed in the rats. No treatment-related gross pathology lesions and no histopathology were observed. The findings of this study demonstrate the absence of acute or subacute toxicity after oral treatment with C. flanaganii stem bark extracts in Wistar rats at the levels administered. Chemical profiling of the total extract using LC-MS tentatively identified eleven (11) compounds as the major chemical constituents.

Melasma is a common skin disorder of acquired hyperpigmentation that appears commonly on the face. Although asymptomatic, melasma causes psychosocial and emotional distress. This study aimed to assess melasma's severity on people with darker skin types, evaluate the effects of melasma on the Quality of Life (QoL), and establish QoL predictors in affected individuals. This was a cross-sectional analytic study that enrolled 150 patients who were diagnosed with melasma from three private dermatology clinics in Durban, South Africa. The severity of melasma and QoL were measured using a Melasma Area and Severity Index (MASI) score, and Melasma Quality of Life scale (MELASQoL), respectively. The factors associated with impaired QoL were also explored using the multivariate method and stepwise regression analysis. MASI score of Masi (β = 0.209, t = 2.628, p < .010), involvement of cheeks (β = -0.268, t = -3.405, p <.001), level of education (β = -0.159, t = -2.029, p =.044) and being menopausal (β = -0.161, t = -2.027, p =.045) were found to be predictors of QoL. A regression model to predict MELASQoL given these four predictors was developed. The significance of the equation can allow remote scoring of MELASQoL based on the four variables.

The conventional use of medicinal plants is in part based on the widespread belief that plant crude extracts are non-toxic. In South Africa, traditional preparations of Cassipourea flanaganii used to treat hypermelanosis have accordingly been regarded by many as non-toxic. Whether so, impacts on the potential of bark extracts to be developed as a commercial drug to treat melasma, given their documented capacity to inhibit tyrosinase activity. Our study investigated the acute and subacute toxicity of the methanol extract of C. flanaganii bark in rats. Wistar rats were randomly assigned into different treatment groups. The rats received daily oral gavage of crude extract for acute and sub-acute toxicity tests. Haematological, biomechanical, clinical and histopathology examinations were carried out to evaluate possible toxicity of C. flanaganii. Results were subjected to the Student’s t-test and ANOVA. For both acute and subacute toxicity, there was no statistical difference between groups. There were no clinical or behavioral signs of toxicity observed in the rats. No treatment-related gross pathology lesions as well as no histopathology was observed. The findings of this study demonstrate the absence of acute or subacute toxicity after oral treatment with C. flanaganii bark extracts in Wistar rats at the levels administered.

Background: In rural areas of KwaZulu-Natal and Eastern Cape Provinces, South Africa, women have traditionally used bark extracts from Cassipourea flanaganii, C. malosana, and C. gummiflua for skin lightening and sun protection. This study investigates the anti-tyrosinase and antioxidant activities of methanolic bark extracts from these species, aiming to validate their traditional use and identify potential lead compounds for the treatment of skin hyperpigmentation. Methods: Anti-tyrosinase activity was evaluated using half-maximal inhibitory concentration (IC₅₀) values, and antioxidant capacity was measured through FRAP, DPPH, and TEAC assays. Polyphenol and flavanol contents were quantified using Folin-Ciocalteu method. Potential lead compounds were identified through molecular docking, pharmacokinetic analysis, and molecular dynamics (MD) simulations. Statistical analyses, including ANOVA and post-hoc tests, compared extract activities. Results: C. flanaganii exhibited the most potent anti-tyrosinase activity (IC₅₀: 37.10 μg/mL), though statistical differences among species were non-significant. C. gummiflua showed the highest polyphenol (143.68 mg GAE/g) and flavanol (14.67 mg QE/g) content, correlating with superior antioxidant activity (FRAP: 526.07 μmol AAE/g; DPPH: 390.26 μmol TE/g; TEAC: 596.98 μmol TE/g). The isolated compound 7-methoxygeranin A demonstrated lower anti-tyrosinase activity (IC₅₀: 45.16 μg/mL) compared to C. flanaganii extract, suggesting the presence of more potent metabolites. Molecular docking and MD simulations identified emodin 6,8-dimethyl ether as a thermodynamically stable lead compound (binding free energy: − 39.88 kcal/mol), interacting with key catalytic residues over 150 ns. The compound demonstrated prolonged residence at the active site of tyrosinase, indicating strong-binding stability. Conclusion: While C. flanaganii demonstrated the strongest anti-tyrosinase activity, C. gummiflua showed the highest antioxidant potential. Emodin 6,8-dimethyl ether emerged as a promising candidate for skin-lightening applications, warranting further in vitro and in vivo validation. These findings support the traditional use of Cassipourea species and highlight their potential for developing natural skin health products. Further studies are needed to explore the pharmacokinetics, safety, and efficacy of these compounds in clinical settings.

Background Uterine fibroids are the leading cause of hysterectomies among women of childbearing age. This study aims to elicit the knowledge, attitude and perceptions of childbearing women towards uterine fibroids in order to provide empirical evidence informing relevant interventions oriented toward health promotion in this regard. Methods A quantitative, cross-sectional descriptive design was used and data were collected from a sample of 362 women of reproductive age residing in a selected township in KwaZulu-Natal, South Africa. Ethical approval to conduct the study was obtained from the Durban University of Technology’s Institutional Research Ethics’ Committee (IREC – Ref No. BIREC 014/21). A pre-tested survey was conducted to gather data on knowledge, attitudes, and perceptions concerning uterine fibroids. The collected data were analyzed using SPSS version 27, employing descriptive statistics. Inferential statistics were also conducted to examine associations between key variables and respondents who self-reported being diagnosed with uterine fibroids. Results Most participants, 73.8% (n=267), had no awareness of uterine fibroids. Participants also demonstrated poor knowledge regarding the aetiology and symptoms of the condition. However, most participants, 49.2% (n=178), perceived uterine fibroids to be of spiritual origin, citing evil spirits and witchcraft as the cause. Participants subsequently reported that treatment would require herbal approaches and consultation with spiritualists such as traditional healers and seers. In summary, the study highlights various factors influencing self-reporting behaviours, including age, education level, employment status, marital status, number of children, awareness of the condition, perception of requiring treatment, family history, and symptom severity. Discussion and conclusion The study findings seem to suggest that women in the selected township lack accurate knowledge about uterine fibroids. These insights are valuable for shaping targeted health interventions and policies. Recognizing the complexities of self-reporting is crucial for improving health outcomes through early detection and tailored interventions.