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Melasma: A Review

Abstract

Objective

To better understand melasma, a review of its etiologic factors, classification, pathogenesis, and treatment was undertaken.

Methods

Articles discussing the above aspects of melasma were used to demonstrate what is currently known about the disease and how to treat it.

Results

Melasma is associated with many etiologic factors, most importantly, sun exposure. It occurs in three distributions and has four reported patterns of pigmentation. Among the many differences between melasma and normal skin, melasma skin contains increased melanin, melanocytes, and melanosomes, as well as increased synthesis of tyrosinase. Its pathogenesis remains largely unknown. Treatment consists of phenolic and nonphenolic depigmenting agents, chemical peels, lasers, and dermabrasion.

Conclusion

Melasma is a common skin disorder. Although melasma has been studied, its pathogenesis remains largely unknown and its treatment is still met with difficulty. Randomized controlled trials involving larger numbers of patients and comparing treatments, as well as studying combination therapies, would be beneficial.

Sommaire

Objectif

Afin d’améliorer notre compréhension des mélasmes, nous avons examiné leurs facteurs étiologiques, leur classification, leur pathogenèse et leurs traitements.

Méthode

Des articles traitant des aspects sus-mentionnés des mélasmes ont été utilisés afin de définir ce que nous savons déjà sur cette affection et les moyens de la traiter.

Résultats

Les mélasmes sont associés à un grand nombre de facteurs étiologiques, surtout I’exposition au soleil. Trois sites et quatre types de pigmentation ont été recensés. Parmi les nombreuses différences entre une peau saine et une peau affectée, notons que la peau présentant des mélasmes contient un taux plus élevé de mélanine, de mélanocytes et de mélanosomes, ainsi qu’une plus forte synthèse de la tyrosinase. Sa pathogenèse reste généralement inconnue. Parmi les traitements on retrouve les agents dépigmentants phènoliques et non phénoliques, le peeling chimique, le traitement au laser et la dermabrasion.

Conclusion

Le mélasme est une affection cutanée commune. Malgré toutes les études, sa pathogenèse demeure inconnue et il reste difficile à traiter. Des essais contrôlés randomisés sur un plus grand nombre de patients, qui permettent la comparaison des résultats, de même que I’étude des polythérapies seraient bénéfiques.

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Correspondence to Babar Rao.

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Victor, F.C., Gelber, J. & Rao, B. Melasma: A Review. JCMS 8, 97–102 (2004). https://doi.org/10.1007/s10227-004-0158-9

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Keywords

  • Hydroquinone
  • Tretinoin
  • Glycolic Acid
  • Azelaic Acid
  • Kojic Acid