Melasma (Chloasma)

by Carlo Raj, MD

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    00:01 Let’s take a look at other dermatologic disorders that are important for you.

    00:07 Melasma.

    00:08 As soon as you hear about melasma, the clinical pearl that you’re thinking about is a pregnant lady, in which upon here face, there might be hyperpigmentation.

    00:18 Why? Well, really not entirely understood.

    00:21 But so far, what we do know is overproduction of melanin.

    00:24 So I just said that it is a pregnant lady most likely and post partum.

    00:31 There is hyperpigmentation that might be taking place in sun-exposed areas involvement of hormonal stimuli perhaps.

    00:40 Usually associated with pregnancy, but in general, take a look at your conditions or predisposing issues.

    00:47 We have pregnancy, oral contraceptive pills or hormone replacement therapy.

    00:52 The common denominator in those three situations would be estrogen exposure.

    00:57 Exacerbated greatly by sun exposure, so therefore your management would be, for this patient, or to recommend that the patient stay out of UV rays and when exposed to UV rays, make sure that the patient has appropriate protection in terms of maybe hats, visors, or maybe even sunblock.

    01:20 The demographics, more common in persons of color, especially Hispanics.

    01:25 Lightly brown, homogenous macule, what does that mean to you? Unable to feel it upon palpation because it’s not elevation, it is just a macule, light brown.

    01:38 No elevated component so there is scaling that is involved, melasma.

    01:45 Here’s a picture of a patient, Hispanic lady, post partum, and the area that you’re looking for on the cheek here, would be areas that are hyperpigmented.

    01:55 You’ll notice that it is not erythema.

    01:57 Is that clear? Management: Discontinuance of provoking agent such as oral contraceptive pill or the source of estrogen if identified.

    02:11 Strict photoprotection as I was mentioning earlier.

    02:15 And bleaching creams such as hydroquinone for cosmetic purposes.

    About the Lecture

    The lecture Melasma (Chloasma) by Carlo Raj, MD is from the course Other Skin Diseases.

    Included Quiz Questions

    1. Avoidance of sun exposure
    2. Systemic steroids
    3. Topical antibiotics
    4. Oral antibiotics
    5. Topical antifungal agents

    Author of lecture Melasma (Chloasma)

     Carlo Raj, MD

    Carlo Raj, MD

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