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Facial melanoses: Indian perspective
Khanna, Neena & Rasool, Seemab
Abstract
Facial melanoses (FM) are a common presentation in Indian patients, causing cosmetic
disfigurement with considerable psychological impact. Some of the well defined causes of FM
include melasma, Riehl's melanosis, Lichen planus pigmentosus, erythema dyschromicum
perstans (EDP), erythrosis, and poikiloderma of Civatte. But there is considerable overlap in
features amongst the clinical entities. Etiology in most of the causes is unknown, but some
factors such as UV radiation in melasma, exposure to chemicals in EDP, exposure to allergens
in Riehl’s melanosis are implicated. Diagnosis is generally based on clinical features. The
treatment of FM includes removal of aggravating factors, vigorous photoprotection, and some
form of active pigment reduction either with topical agents or physical modes of treatment.
Topical agents include hydroquinone (HQ), which is the most commonly used agent, often
in combination with retinoic acid, corticosteroids, azelaic acid, kojic acid, and glycolic acid.
Chemical peels are important modalities of physical therapy, other forms include lasers and
dermabrasion.
Keywords
Corticosteroids, erythema dyschromicum perstans, facial melanosis, hydroquinone, lichen planus pigmentosus, melasma, Riehl's melanosis, retinoids
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