Recenzija, Prikaz slučaja
Chloasma – The Mask of Pregnancy
Ivan Bolanča
Željana Bolanča
Krunoslav Kuna
Ante Vuković
Neven Tučkar
Radoslav Herman
Goran Grubišić
Sažetak
Chloasma is a required hypermelanosis of sun-exposed areas occurred during pregnancy and it can affect 50–70% of
pregnant women. It presents as symmetric hyperpigmented macules, which can confluent or punctuate. The most common
locations are the cheeks, the upper lip, the chin and the forehead. The exact mechanism by which pregnancy affects
the process of melanogenesis is unknown. Estrogen, progesterone, and melanocyte-stimulating hormone (MSH) levels
are normally increased during the third trimester of pregnancy. However, nulliparous patients with chloasma have no
increased levels of estrogen or MSH. In addition, the occurrence of melasma with estrogen- and progesterone-containing
oral contraceptive pills has been reported. The observation that postmenopausal woman who are given progesterone develop
melasma, while those who are given only estrogen do not, implicates progesterone as playing a critical role in the
development of melasma. UV-B, UV-A, and visible light are all capable of stimulating melanogenesis. The condition is
self-limited; however spontaneous resolution is time-consuming and may take months to resolve normal pigmentation.
Therefore, it is worthwhile to prevent the onset of chloasma, by strict photoprotection. Prudent measures to avoid sun exposure
include hats and other forms of shade combined with the application of a broad-spectrum sunscreen at least daily.
Sunscreens containing physical blockers, such as titanium dioxide and zinc oxide, are preferred over chemical blockers
because of their broader protection. Chloasma can be difficult to treat. Quick fixes with destructive modalities (eg, cryotherapy,
medium-depth chemical peels, lasers) yield unpredictable results and are associated with a number of potential
adverse effects. The mainstay of treatment remains topical depigmenting agents. Hydroquinone (HQ) is most commonly
used.
Ključne riječi
chloasma; melasma; chemical peelings; hydroquinone; tretinoin; sunscreens; prevention
Hrčak ID:
34638
URI
Datum izdavanja:
1.10.2008.
Posjeta: 3.316 *