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2018, Number 1

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Dermatología Cosmética, Médica y Quirúrgica 2018; 16 (1)

Melasma: Diagnostic and Management Guidelines

Arellano MI

Language: Spanish
References: 92
Page: 12-23
PDF size: 167.08 Kb.


ABSTRACT

Introduction: Melasma is a facial acquired, chronic, recurrent, and symmetric hypermelanosis in sun-exposed areas, characterized by circumscribed patches, variable in color (light to dark brown, and occasionally grey). It is a skin disorder affecting the patients’ quality of life. Its incidence in pregnancy is 14.5-56% and 11.3-46% in women taking oral contraceptives. Clinical guidelines for the treatment of melasma are needed in our country.
Material and methods: A group of experts gathered to issue a set of recommendations to treat melasma in Mexican patients. The guidelines were drafted by a group of 15 Mexican dermatologists from public hospitals and private clinical practice, where patients with this pathology are treated. They were scored by the grade system (Grading of Recommendations Assessment, Development and Evaluation) and by means of a modified Delphi questionnaire. These tools comprised items about melasma’s definition, triggering factors, pathophysiology, epidemiology, and treatment. After delivering the question naire, a meeting was held with the experts’ committee in order to assess and analyze the questionnaire’s answers and, eventually, drawing up the consensus recommendations.
Background: The melasma pathophysiology is described, based on genetics, exposure to sun and visible light, hormones, inflammatory procedures, dermal factors, pathology, and clinical manifestations.
Recomm endations: Based on diagnosis and clinimetric testing, the treatments were (topical and systemic) and superficial and medium-depth chemo-exfoliations.


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