00:01
Let’s take a look at other dermatologic
disorders that are important for you.
00:07
Melasma.
00:08
As soon as you hear about melasma,
the clinical pearl that you’re
thinking about is a pregnant lady,
in which upon here face, there
might be hyperpigmentation.
00:18
Why?
Well, really not
entirely understood.
00:21
But so far, what we do know
is overproduction of melanin.
00:24
So I just said that it is a pregnant
lady most likely and post partum.
00:31
There is hyperpigmentation
that might be taking place
in sun-exposed areas involvement
of hormonal stimuli perhaps.
00:40
Usually associated with pregnancy,
but in general, take a look at your
conditions or predisposing issues.
00:47
We have pregnancy, oral contraceptive
pills or hormone replacement therapy.
00:52
The common denominator in those three
situations would be estrogen exposure.
00:57
Exacerbated greatly by sun exposure,
so therefore your management
would be, for this patient,
or to recommend that the
patient stay out of UV rays
and when exposed to UV rays, make sure that
the patient has appropriate protection
in terms of maybe hats, visors,
or maybe even sunblock.
01:20
The demographics, more common in persons
of color, especially Hispanics.
01:25
Lightly brown, homogenous macule,
what does that mean to you?
Unable to feel it upon palpation
because it’s not elevation,
it is just a macule,
light brown.
01:38
No elevated component so there is
scaling that is involved, melasma.
01:45
Here’s a picture of a patient,
Hispanic lady, post partum,
and the area that you’re
looking for on the cheek here,
would be areas that
are hyperpigmented.
01:55
You’ll notice that
it is not erythema.
01:57
Is that clear?
Management: Discontinuance of provoking
agent such as oral contraceptive pill
or the source of
estrogen if identified.
02:11
Strict photoprotection as
I was mentioning earlier.
02:15
And bleaching creams such as
hydroquinone for cosmetic purposes.