Download - MELASMA (Ardy,Kintan,Fransisca)
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MELASMA
Presenter
Ardy Gisnawan, Kintan Ramadhani & Fransisca B. Kuron
Advisor
dr. Irene Tantia Utami
Supervisor
dr. Asnawi Madjid. Sp. KK. MARS
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Preface
Melasma is a commonhypermelanosis that typically
occur on sun exposed area onface.
Definition
By Brown patches, typically onthe malar prominences andforehead
Characterized
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Epidemiology
14-54 years oldAge
:= 4 : 1Sex
Asian and Black SkinRace orgeographic area
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Etiology
Etio-
Pathoge
nesis
Ultraviolet
RadiationGenetetic
Predisposition
Pregnancy
Race
Cosmetics
Hormonal
Drugs
Idiophatic
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Examination
Examination
Wood Lamp
Histopathology
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Diagnoses
Melasma diagnosis from clinical
examination
Appears: symmetrical hyperpigmentedmacules, may form confluent or striped.
Lesions: macular light brown or dark brown
demarcated with irregular edges.
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Count.
Predilection :
Cheeks,
upper lip,chin,
Forehead
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Histophatology
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Diagnosis
Anamnesis
Physycal examination
Eliminating other
disease
Histopathology Wood lamp
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Differential Diagnoses
1. Post-inflammatory hyperpigmentation
2. Lentigines
3. Addison disease
4. Drug-induced photosensitivity
5. Lupus erythematosus, discoid
6. Mastocytosis
7. Poikiloderma
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Melasma PIH Lentigines Addison Deases
Etiology Sunshine (UV), hormone,
drugs, race (black skin
peoples), genetics,
cosmetics, idiopathic
Infection, allergic reactions,
mechanical injuries,
reactions to medications,
phototoxic eruptions, trauma
(eg, burns), and
inflammatory diseases (eg,
lichen planus)
History of exposures,
Genetic,
race (light-skinned ),
Infection of the adrenal
gland
Age 14-54
>any age
children and adults;
The highest prevalence :30-
50
=
Predilection Forehead, nose, cheeks, the
upper lip, chin
Depending on the location of
infection
buccal mucosa, gums, hard
palate, lips, face, hands and
feet
Skin and mucous membranes
Color of the Lesion Macula (nut brown -deep
brown)
light brown -black Macula (brown -black) (blackish brown)
Eff. Macular hyperpigmentation brown macules or patches
often with a poorly defined
border, irregular in outline
and usually with little surface
change
Macular hyperpigmentation Macular hyperpigmentation
Shape of the Lesion symmetric (irregular) Asymmetric Asymmetric (oval /
irregular)
Asymmetric
Pain in the Lesions -
Itching of the Lesions -
Burning Sensation of the
Lesion
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Hyperasthesia -
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Melasma DIP LED Mastocytosis Poikiloderma
Etiology Sunshine (UV),
hormonal, drugs, race
(heavily pigmented
skin), genetics,
cosmetics, idiopathic
Chemicals
photosensitizing, race
(heavily pigmented
skin)
Trauma : sunshine,
chill, wind, friction;
race (fair-skinned);
descent
race (fair-skinned), Sunshine (UV),
chemicals
photosensitizing,
hormonal(low estrogen
levels), race (fair-
skinned), genetics
Age 14-54>
any age>
The highest prevalence: 40-60
>
The highest prevalence:30-49
=
Middle-aged or elderlywomen
Predilection Forehead, nose, cheeks,
the upper lip, chin
Face, body, extemity Face, ears, chest, arm,
head, back eyes
Scalp, face, extremity,
palms and soles
Lateral cheek and neck
Color of the Lesion Macula (nutbrown -
deep brown)
Reddish Macula (Reddish -
blackish brown)
Macula (yellow-tan to
red-brown)
reddish brown
Eff. Macular
hyperpigmentation
Macular erythematous Macular erythematous,
hyperpigmented
macules numular -
placards (butterfly
app.), teleangiektasis ,
follicular occlusion.
papules, nodules, and
plaques , blisters and
bullae
Reticulate pigmentation
with atrophy and
telangiectasia
Shape of the Lesion symmetric (irregular) Asymmetric symmetric Symmetric (regular:
circle / oval)
symmetric
Pain in the Lesions -
Itching of the Lesions -
Burning Sensation of
the Lesion
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Hyperasthesia -
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Treatment
Hydroquinone Tretionin
Azelaic Acid Silymarin cream Glycolic acid
Topical
Chemical Peels Laser Therapy Dermabration Skin Needling
ClinicTherapy
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Thank You
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Chemical Peeling
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Laser Therapy
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Dermabration
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Skin Needling
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