melasma (ardy,kintan,fransisca)

8/12/2019 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

-

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

-

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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melasma (ardy,kintan,fransisca)

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