Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- distribución centrofacial, malar o mandibular de hiperpigmentación de color marrón turbio a gris
Fatores de risco
- sexo femenino
- piel de Fitzpatrick tipos III a VI
- radiación ultravioleta
- píldora anticonceptiva oral
- embarazo
- antecedentes familiares de melasma
- fármacos fotosensibilizantes
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- examen con lámpara de Wood
Investigações a serem consideradas
- biopsia de piel
Novos exames
- microscopia confocal de reflectancia (MCR)
Algoritmo de tratamento
embarazadas
no embarazada
Colaboradores
Autores
Nazanin Saedi, MD
Director
Laser Surgery and Cosmetic Dermatology
Thomas Jefferson University Hospitals
Philadelphia
PA
Declarações
NZ has been on the advisory board of Cynosure, Cartessa, Allergan, and Alastin; used equipment from Cynosure and Cartessa; and been a consultant to Allergan and Alastin.
Agradecimentos
Dr Nazanin Saedi would like to gratefully acknowledge Dr Laura Korb Ferris and Dr Maria Liliana Marino, previous contributors to this topic.
Declarações
MLM and LKF declare that they have no competing interests.
Revisores
Chad M. Hivnor, Major, USAF, MC, FS
Chief
Outpatient & Pediatric Dermatology
59th Medical Wing/ SGOMD
Lackland Air Force Base
San Antonio
TX
Declarações
CMH declares that he has no competing interests.
Jashin Wu, MD
Chief Dermatology Resident
University of California
Irvine
CA
Declarações
JW declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Ball Arefiev KL, Hantash BM. Advances in the treatment of melasma: a review of the recent literature. Dermatol Surg. 2012 Jul;38(7 Pt 1):971-84. Resumo
Rajaratnam R, Halpern J, Salim A, et al. Interventions for melasma. Cochrane Database Syst Rev. 2010;(7):CD003583. Resumo
Kang HY, Ortonne JP. What should be considered in treatment of melasma. Ann Dermatol. 2010 Nov;22(4):373-8.Texto completo Resumo
Austin E, Nguyen JK, Jagdeo J. Topical treatments for melasma: a systematic review of randomized controlled trials. J Drugs Dermatol. 2019 Nov 1;18(11):S1545961619P1156X.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Ocronosis exógena
- Hiperpigmentación postinflamatoria
- Reacción fototóxica
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