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Disorders of skin color

Disorders of skin color. Dr. Kejian Zhu Sir Run Run Shaw Hospital. http:www.srrsh.com. diseases of hypo(de)pigmentation diseases of hyperpigmentation. diseases of depigmentation. vitiligo. outline. hypopigmentated patches (leukoderma) melanocytes are reduced or lost

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Disorders of skin color

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  1. Disorders of skin color Dr. Kejian Zhu Sir Run Run Shaw Hospital http:www.srrsh.com

  2. diseases of hypo(de)pigmentationdiseases of hyperpigmentation

  3. diseases of depigmentation vitiligo

  4. outline • hypopigmentated patches (leukoderma) • melanocytes are reduced or lost • Pathogenesis is not clear • Autoimmunity against melanocytes or melanin is thought to be associated with the occurrence • Topical steroids and PUVA are useful treatments

  5. classification • Vulgaris: Focal: localized Generalized: multiple, usually symmetrical, less than 50% of body area Universal: widespread, more than 50% of body area Acral: hand and foot • Segmental: leukoderma paralleled to cutaneous nerves

  6. Clinical features • 1-2% of the population • Men and women at the age about 20 • 1-2% familial cases • Complete leukoderma, sharply circumscribed • Slight increase in pigmentation at the periphery of the eruptions • Irregular in shape and size • Often coalesce • Gray hair around the leukoderma, white hair in the leukoderma • asymptomatic

  7. symmetrical involvement universal focal gray and white hair

  8. treatment • Topical and oral PUVA therapies and topical steroids are the first-line treatments • Leukoderma on the face and fingers can be concealed by special cosmetics • Narrowband UVB exposure • Surgical interventions • TCM

  9. diseases of hyperpigmentation chloasma

  10. Clinical features • Also named as melasma • Occur in women in their 30s or older, rare in men • Sharply demarcated light to dark brown patches on the face • Irregular in size and shape • Aggravated by UVR in summer and subsides in winter • Pregnancy may trigger the onset • asymptomatic

  11. dark brown macular pigmentation Butterfly-like macule

  12. pathogenesis • Not clear • Abnormalities in sex hormones (estrogen ) and adrenocortical hormones • Autoimmune hyperthyroidism • Drugs: chlopromazine, phenytonium, spironolactone, et al.

  13. treatment • Discontinue the causal factors, such as artificial sex hormones • Protection from UVR • Topical hydroquinone (2-5%) and tretinoin • Oral or intravenous vitamin C • Q-switched Nd:YAG laser • TCM

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