Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
Indian J Dermatol Venereol Leprol. 2011 Sep-Oct;77(5):552-63; quiz 564. doi: 10.4103/0378-6323.84046.
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.
面部色素沉着（FM）是印度患者常见的表现，会导致容貌受损，对心理造成严重影响。FM 的一些明确病因包括黄褐斑、瑞尔黑变病、扁平苔藓色素沉着、持久性红斑、红斑病和 Civatte 皮肤异色病。但在临床实体之间，这些特征有相当大的重叠。大多数病因的发病机制尚不清楚，但一些因素如黄褐斑中的紫外线辐射、EDP 中的化学物质暴露、瑞尔黑变病中的过敏原暴露都与发病有关。诊断通常基于临床特征。FM 的治疗包括消除加重因素、积极的光保护，以及使用局部药物或物理治疗模式进行某种形式的主动色素减退。局部药物包括氢醌（HQ），这是最常用的药物，通常与维甲酸、皮质类固醇、壬二酸、曲酸和乙醇酸联合使用。化学换肤是物理治疗的重要手段，其他形式还包括激光和磨皮术。
