Melasma
Presentation
- Symmetrical pigmentation
- Occurs mainly in women, but can be rarely seen in men
- Mainly affects the cheeks, forehead and upper lip
- Often associated with pregnancy or oral contraceptive use
- Pigmentation usually fades after pregnancy or stopping combined oral contraceptive pill, but in some cases, may be permanent
Management
- UV protection will prevent darkening of areas on exposure
- If required, laser treatment can be effective
- Camouflage products are an effective alternative
Postinflammatory hyperpigmentation
Postinflammatory hyperpigmentation
Presentation
- Macular melanin pigmentation
- Follows any inflammatory condition of the epidermis, such as eczema or psoriasis
- More common in darker skin types
- Patients usually report a rash occurring before the pigment appears
- May occur after a fixed drug eruption
Management
- No treatment particularly effective
- Pigment usually decreases with time
- Sunblock/UV avoidance will help
Poikiloderma of Civatte
Poikiloderma of Civatte
Presentation
- Combination of pigment, telangiectasia and atrophy
- Skin has a mottled red/brown appearance
- Usually occurs in middle to older age in both sexes
- Usually affects sides of the neck, sparing the chin and ears
- Thought to be a result of UV exposure and cosmetics acting as photosensitisers
- Very common and treatment not usually sought
Management
- Sunblock/UV avoidance will help
- Laser can be useful if treatment required
Naevus of Ota
Naevus of Ota
Presentation
- Grey/blue pigmentation around the eye and on the sclera
- Usually affects only one side of the face
- Type of blue naevus with melanocytes deep in the dermis
- Most common among Japanese people
- Usually present from birth or early childhood
- Remains throughout life
- Similar lesions (naevi of Ito) occur on the shoulder
Management
- Treatment not required
Dr Stollery is a GP in Leicestershire
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This is an updated version of an article that was first published in October 2014.
