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2020, Número 4

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Dermatología Cosmética, Médica y Quirúrgica 2020; 18 (4)


Actualidades en el tratamiento de melasma

Dagdug VAG, Guevara HC, Arellano MI

Idioma: Español
Referencias bibliográficas: 60
Paginas: 307-317
Archivo PDF: 163.95 Kb.


RESUMEN

El melasma es un trastorno de la hiperpigmentación que afecta principalmente a mujeres, en su patogénesis se han identificado factores como la exposición crónica a la radiación ultravioleta, luz visible, estimulación hormonal y factores genéticos. Se caracteriza por manchas reticuladas, irregulares, de color marrón, en áreas de la piel expuestas al sol.
Histológicamente se observa aumento de melanina en la epidermis y/o en la dermis, además de hallazgos de fotoenvejecimiento como elastosis solar, disrupción de la membrana basal, aumento de la vascularización e incremento en el número de mastocitos.
Las metas en el manejo del melasma son: reducir la intensidad del pigmento, disminuir el área de mancha, prevenir la recurrencia y mejorar la calidad de vida del paciente. El tratamiento de primera línea incluye la utilización de agentes despigmentantes tópicos, hasta ahora considerados el estándar de oro, ya sea solos o en combinación para crear sinergia; así como evitar factores agravantes como la exposición intensa a la radiación UVA, UVB, infrarroja y luz visible, el uso de anticonceptivos hormonales y fármacos fotosensibilizantes.


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