Objectives: Melasma is a frequent cause of hyperpigmentation and still remains difficult to treat. The diagnosis of melasma is clinical but several pigmentary disorders can lead to a similar pattern and may be misleading. However, in most cases a precise diagnosis can be done thanks to the study of the clinical history and a careful examination of the pigmentation and the entire skin surface. Such as systematic approach is necessary to make the right diagnosis and provide the most adapted treatment.
Introduction: Check list in front of a hyperpigmentation of the face:
- precise analysis of history (familial history, age and factors of onset)
- treatments
- others clinical signs (asthenia…)
- phototype
- complete physical examination of the entire skin and mucosal areas
- improvement or not with solar eviction (during winter)
- improvement or not with triple topical therapy (if already done)
- blood check-up (inflammatory, immnunology, endocrinology…) might be useful in some case depending on the clinical examination
- histology might be also useful
Materials / method: Main differential diagnosis
- Post inflammatory hyperpigmentation
After a procedure (laser, peeling…)
Underlying photosensitive pathologies on dark phototypes: lupus erythematosus, drug photosensitization
Facial dermatosis on dark phototype: eczema, lichen, contact dermatitis
- Acquired bilateral nevus of Ota-like macules (ABNOM)
- Endocrinopathy: Addison’s disease (hyperthyroidism)
- Drug-induced eruptions: amiodarone, minocycline, cytotoxic agents, anti-epileptic agents…, radiotherapy
Results: - Rare diseases
o Linea fusca
o Perioral hypermelanosis (Brocq disease)
o Riehl melanosis
o Metabolic or exogenous deposit diseases
o Deficiency: Pellagra and pellagrous syndrome, scurvy
o Infectious, parasitism
o Tumors
o Hemopathy
Conclusion: Personal clinical cases for diagnosis will be presented
Disclosures
Did you receive any funding to support your research for this TOPIC?
No
Were you provided with any honoraria, payment or other compensation for your work on this study?
No
Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No
Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No
This work was not supported by any direct or non direct funding. It is under the author's own responsability