PIGMENTATION DISORDERS Flashcards
What is vitiligo?
An autoimmune condition which results in the loss of melanocytes and consequent depigmentation of the skin
What age do vitiligo symptoms typically appear?
20-30 usual first appears
Associated conditions to vitiligo?
T1DM
Addisons disease
Autoimmune thyroid disorders
Pernicious anaemia
Alopecia areata
Features of vitiligo?
Well-demarcated patches of depigmented skin
Tends to affect the peripheries more
Trauma may precipitate new lesions - koebner phenomenon
What is the koebner phenomenon?
the appearance of new skin lesions on previously unaffected skin secondary to trauma.
Management of vitiligo?
Sunblock
Camouflage makeup
Topical corticosteroids may reverse the changes if applied early
May be a role for topical tracolimus and phototherapy
Minimise skin injuries to prevent triggering a new patch of vitiligo
What can cause generalised hyperpigmentation?
Excessive circulating melanocyte-stimulating hormone…
- addisons disease
- haemachromatosis
- metastatic melanoma: diffuse melanosis cutis
A differential is carotenoderma which is when skin looks yellow from eating too many orange coloured vegetables
What is melasma?
An acquired chronic skin disorder where there is increased pigmentation (melanin) in the skin
More common on sun-exposed areas
How does melasma present?
Brown macules or larger patches with an irregular border
Symmetrical distribution
Common sites for melasma?
Forehead
Cutaneous upper lips and cheeks
Rarely it can occur on the neck, shoulders and upper arms
Management of melasma?
Avoid known triggers e.g. COCP
Avoid sun and use sun-blocking creams
Skin lightening creams
Cosmetic camouflage
Topical Tx that aims to inhibit the formation of new melanin e.g. hyodrquinone
Last treatment - used rarely as can cause post-inflammatory hyperpigmentation
