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
Declaraciones
¿Ha recibido algún tipo de financiamiento para realizar su investigación sobre esta temática?
No
¿Ha recibido algún pago, honorario u otra compensación por su trabajo acerca de esta investigación?
No
¿Tiene vínculos financieros con alguna entidad que podría llegar a competir estrechamente con los medicamentos, materiales o instrumentos tratados en su investigación?
No
¿Posee o ha solicitado una patente relacionada a los materiales, productos o instrumentos utilizados en su investigación?
No
Este trabajo no cuenta con el apoyo de ningún financiamiento directo o indirecto. El autor asume plena responsabilidad sobre el mismo.