文献简介

出版社:Dermatol Ther (Heidelb)

作  者:Oluwatobi A. Ogbechie-Godec . Nada Elbuluk

编  号:

关键字:黄褐斑

年  份:2017   点击量:69

文献摘要 全文翻译

Melasma is a common acquired condition of symmetric hyperpigmentation, typically occurring on the face, with higher prevalence in females and darker skin types. Multiple etiologies, including light exposure, hormonal influences, and family history, have been implicated in the pathogenesis of this disorder. Overall prevalence ranges widely at 1–50%, since values are typically calculated within a specific ethnic population within a geographic region. Histologically, melasma can display increased epidermal and/or dermal pigmentation, enlarged melanocytes, increased melanosomes, solar elastosis, dermal blood vessels, and, occasionally, perivascular lymphohistiocytic infiltrates. Various topical, oral, and procedural therapies have been successfully used to treat melasma. Traditional topical therapies including hydroquinone, tretinoin, corticosteroids, and triple combination creams; however, other synthetic and natural topical compounds have also shown varying efficacies. Promising oral therapies for melasma include tranexamic acid, Polypodium leucotomos, and glutathione. Procedures, including chemical peels, microneedling, radiofrequency, and lasers, are also often used as primary or adjunctive treatments for melasma. Notably, combination therapies within or across treatment modalities generally result in better efficacies than monotherapies. This review serves as a comprehensive update on the current understanding of the epidemiology, pathogenesis, clinical and histologic features of melasma, as well as treatments for this common, yet therapeutically challenging, condition.

黄褐斑是一种呈对称分布的后天性色素沉着过度性皮肤病,通常好发于面部,在女性和深肤色人群中患病率较高。影响该病发病机制的因素多样(包括光照、激素影响和家族史)。总患病率范围广泛为1-50%,因为数值通常计算地理区域内的特定族裔人口。组织学上,黄褐斑可表现为表皮和/或真皮色素沉着增加、黑素细胞增大、黑素体增加、日光性弹性组织变性、真皮血管,偶尔可见血管周围淋巴组织细胞浸润。各种外用、口服和手术疗法已成功用于治疗黄褐斑。传统局部疗法,包括氢醌、维甲酸、皮质类固醇和三重药物联合使用;然而,其他合成和天然外用化合物也具有不同疗效。有望治疗黄褐斑的口服药物包括氨甲环酸、乙烯丙烯共聚物和谷胱甘肽。包括化学剥脱、微针、射频和激光在内的治疗方法也是治疗黄褐斑的主要或辅助手段。值得注意的是,联合治疗或交叉治疗通常比单药治疗效果更好。本文综述了目前黄褐斑流行病学、发病机制、临床和组织学特征以及对这种常见且治疗具有挑战的疾病的治疗方法的最新进展。