Hyperpigmentation

Hyperpigmentation have many causes and can occur focal or diffuse. There is usually an increased melanin production and deposition.

(See also Overview pigmentation.)

Hyperpigmentation have many causes and can occur focal or diffuse. There is usually an increased melanin production and deposition. (See also Overview pigmentation.) Focal hyperpigmentation caused mainly postinflammatory, after injuries (eg. As cuts and burns) or other causes an inflammatory response (eg. As acne, lupus erythematosus). Linear focal hyperpigmentation is often due to phytophotodermatitis, a phototoxic reaction produced by UV-light in combination with psoralens (particularly furocoumarins) in plants (eg. B. limes, parsley, celery Chemical sensitivity to light). Focal hyperpigmentation can (eg. By neoplastic processes as lentigines, melanoma, melasma, freckles or cafe-au-lait spots occur. Acanthosis nigricans caused focal hyperpigmentation and a velvety plaque, most commonly on the armpits and on the back neck. Diffuse hyperpigmentation can result from drugs and systemic and neoplastic causes (especially lung carcinomas and melanomas with systemic involvement). After the elimination of drugs as a cause of diffuse hyperpigmentation, patients should be tested for the most common systemic causes. These reasons are in Addison , haemochromatosis and primary biliary cirrhosis. cutaneous findings are non-diagnostic, therefore, a skin biopsy is not required or useful. melasma (chloasma) the melasma lie in face dark brown, sharply defined, et wa symmetrical hyperpigmented spots before (usually on the forehead, temples, cheek, upper lip, or nose). It occurs in pregnant women preferred to (melasma gravidarum or pregnancy mask) or while taking oral contraceptives. Ten percent of cases involve non-pregnant women and dark-skinned men. Melasma is frequent and lasts longer in people with dark skin. Because the melasma risk with increasing sun exposure increases, the mechanism involves probably an over-production of melanin by melanocytes Hyperfunctional. In addition to sunlight more aggravating factors Autoimmune thyroid disease drugs are Photosensitizing In women, melasma fades slowly and incompletely after childbirth or termination of the hormone ingestion. In men, it rarely disappears. Treatment depends on whether it is an epidermal or dermal pigmentation. Epidermal pigment deposits are clearly visible under Wood’s light and can be diagnosed by biopsy. Only the epidermal pigmentation responds to treatment. First-line therapy and often effective is a combination of 2 to 4% hydroquinone, from 0.05 to 1% tretinoin, topical corticosteroids and a class V-VII (see Table: Relative potency of selected topical corticosteroids). Often, the twice daily application of 3 to 4% Hydroquinone is effective, with most long treatment cycles are required; 2% hydroquinone is useful for maintenance therapy. Before use in the face of hydroquinone should be first tested for a week on a small spot behind the ear or on the forearm, as it can cause skin irritation or allergic reactions. Azelaic acid cream 15 to 20%, can be used instead of, or with hydroquinone and / or tretinoin be employed. Hydroquinone, tretinoin and azelaic acid are bleach. In patients with severe melasma, unresponsive to topical bleaching agent, a chemical peeling with glycolic acid or 30 to 50% is possible trichloroacetic acid. Laser treatments were used, but so far no as standard therapy has been established yet. Two promising technologies of the Q-switched Nd: YAG (1064 nm) laser and nonablative fractional resurfacing in conjunction with triple topical therapy. During and after therapy strict protection from the sun Notice must be. Lentigines lentigines (singular: lentigo) are flat, dark yellow to brown, oval _Hautflecken. They often occur due to chronic exposure to the sun (solar lentigines, sometimes called liver spots) and occur most often on the face and back of the hand. They usually appear first in middle age and increase with age. Although the progression of lentigines is not proven to be a melanoma, lentigines are an independent risk factor for melanoma. If lentigines are a cosmetic concern, they are treated with cryotherapy or laser; Hydroquinone is not effective. Lentigo simplex © Springer Science + Business Media var model = {thumbnailUrl: ‘/-/media/manual/professional/images/445-lentigo-simplex-slide-3-springer-high_de.jpg?la=de&thn=0&mw=350’ , imageUrl: ‘/-/media/manual/professional/images/445-lentigo-simplex-slide-3-springer-high_de.jpg?la=de&thn=0’, title: ‘lentigo simplex’ description: ‘ u003Ca id = “v37894938 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eDiese figure shows lentigo simplex

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