chloasma
Introduction
Introduction to chloasma Chloasma, also known as liver spot, is a common acquired hyperpigmented skin disease that occurs in the face and occurs in the sun and is aggravated after sun exposure. Young and middle-aged women are more common, with a chronic course of disease and no obvious symptoms. The condition has a certain seasonality, and the summer is heavy and the winter is light. The average optical density value of the pigment along the region is greater than 20% of the average optical density value of the surface of the face. basic knowledge The proportion of patients: more than 50 years old women, the incidence rate is about 20-40% Susceptible people: good for young and middle-aged women Mode of infection: non-infectious Complications: attachment inflammation uterine fibroids
Cause
Chloasma
Endocrine function changes (30%):
The cause is unclear and is often thought to be related to changes in endocrine function. Seen in women during pregnancy or oral contraceptives and other factors. Chloasma gravidarum (gestational chloasma) in women during pregnancy begins in 3 to 5 months of pregnancy, and pigmentation spots gradually disappear after delivery. Facial hyperpigmentation may be due to the combination of estrogen and progesterone, which stimulates melanocytes, and progesterone promotes the transport and diffusion of melanosomes, increasing the production of melanin to promote pigmentation.
Chronic disease (30%):
Also seen in chronic gastrointestinal diseases, liver disease, tuberculosis, cancer, malignant lymphoma and chronic alcoholism. Long-term application of this drug such as phenytoin, hibernation, contraceptives can occur chloasma.
Other factors (10%):
Strong sun exposure and application of cosmetics can also induce chloasma. Chloasma is also seen in unmarried, unpregnant normal women or men for unknown reasons.
Prevention
Chloasma prevention
Prevention of chloasma should do the following:
1. It is strictly forbidden to use freckle products containing harmful substances such as hormones, lead, mercury, etc., because cosmetics containing excessive levels of lead and mercury have too many side effects on chloasma, which causes the rebound of chloasma and the disfigurement.
2, develop good habits, quit bad habits, such as smoking, drinking, staying up late, etc., can reduce the production of chloasma to a certain extent.
3, strengthen sunscreen, all the stains are afraid of glare, especially the chloasma, so patients with chloas must be left sea sunscreen prevention work, go out with sunshade tools, sunscreen and so on.
4, anti-chloas, away from all kinds of ionizing radiation, ionizing radiation will accelerate the damage of the skin, resulting in the increase of chloasma.
5, to always maintain open-minded optimism, comfortable, cheerful, and actively cooperate with the doctor's treatment, in order to achieve good results in the treatment of chloasma.
6, eat more fresh vegetables and fruits, to ensure adequate sleep, pay attention to work and rest.
7, eat more foods rich in vitamin C, E, avoid the sun for a long time.
8. Women who take oral contraceptives should stop taking them.
9, active treatment of endocrine dysfunction, liver disease and other primary diseases, strengthen nutrition, pay attention to rest.
Complication
Chloasma complication Complications Annexitis uterine fibroids
In clinical practice, chloasma often occurs in a variety of diseases, such as: genital diseases (female uterine attachment inflammation, infertility, etc.), liver disease (when liver dysfunction, due to liver damage, estrogen accumulation in the blood, stimulation Chloasma occurs when melanin is increased, and chronic malnutrition (increased pigment due to insufficient source of sulfhydryl groups).
More serious is that chloasma is a precursor to endocrine disorders, and long-term endocrine disorders can cause breast lumps, uterine fibroids and other diseases.
Symptom
Chloasma Symptoms Common symptoms Pigment abnormalities Facial spots Pregnancy Chloasma Brown spots Skin pigmentation Deepening pregnancy spots
The skin lesions are light brown or yellowish brown spots with clear borders and irregular shape. They are symmetrically distributed around the eyelids, forehead, eyebrows, nose, cheeks, lips and mouth. There are no symptoms and general malaise.
Examine
Chloasma check
1. Liver function: Liver function has two meanings. One refers to the physiological function of the liver, namely detoxification function, metabolic function, secretion of bile, immune defense function, etc.; on the other hand, it refers to medical examination items in the hospital laboratory, including Bilirubin, albumin, globulin, transaminase, r-glutamyl transpeptidase, and the like.
2, renal function: renal function (renal function) refers to the kidney excretion of metabolic waste in the body, to maintain the body's sodium, potassium, calcium and other electrolytes stability and acid-base balance function, renal function tests including serum creatinine, blood urea nitrogen, blood and Urine 2-microglobulin, urinary albumin, urinary immunoglobulin G, urinary secretory immunoglobulin A, and the like.
3, pathological examination, histopathology: melanin increased in the basal layer of the epidermis, melanocytes did not increase, more melanocytes and free pigment particles were seen in the upper dermis, showing a small amount of lymphocytes infiltrating.
Diagnosis
Diagnosis and diagnosis of chloasma
diagnosis
According to the appearance of yellow-brown spots on the face, women have multiple symptoms and no symptoms of self-consciousness. The disease is easy to diagnose.
TCM pathogenesis and syndrome differentiation: Chinese medicine believes that kidney yin deficiency, kidney water can not be upheld, or liver qi stagnation, liver loss, stagnation heat, burns yin blood, causing facial qi and blood loss and disease, syndrome differentiation as follows:
Liver and kidney yin deficiency
Main card: facial symmetrical brown patches, weak waist and knees, chest rib pain, five upset heat, poor sleep, women often have irregular menstruation or other chronic diseases, thin white fur, thin or thin pulse string.
Dialectical: liver and kidney yin deficiency, qi and blood loss.
2. Liver qi stagnation
Main card: facial symmetry of yellow-brown patches, chest fullness, emotional irritability, multiple dreams, insomnia, pulse string slippery or fine string.
Dialectical: liver qi stagnation, qi and blood loss.
Differential diagnosis
Freckles: Born in the face, but it may also be born in the body or limbs. The shape of the skin lesions is drip-like, irregular stone-like spots, a bit like a bird's egg, so it is called freckles.
Age spots: born on the face or any part of the body, the surface is dark brown, slightly protruding on the surface of the skin, it will feel rough when touched.
Black skin disease: black skin disease is caused by poor cosmetics, especially rouge, foundation and other red pigments that irritate the skin. People who wear makeup often use cosmetics or perfumes that are not compatible with the skin. Precipitation, coupled with massage and sun exposure, can easily lead to black skin disease.
Riehl black disease occurs on the forehead, crotch, neck, and powdery scales on the spots.
Eddie is a diffuse blue-black or maroon patch, which occurs mostly in the face, areola, external genitals, etc., with systemic symptoms such as fatigue, hypotension, and weight loss.
Civatte cutaneous heterochromia is a mixture of atrophic white spots in pigmented spots and is distributed in a network.
