Melasma of pregnancy

Introduction Increased levels of various hormones cause pigmentation. Pregnancy chloasma is caused by pregnancy. The majority of pregnant women have deeper nipple, areola, midline and genital skin. The degree of depth varies from person to person, and the original black sputum color will also deepen. This pigmentation is caused by a large amount of progesterone, estrogen and melanocytic hormone secreted by the pituitary gland during pregnancy, resulting in enhanced function of melanocytes in the skin, which is a physiological change during pregnancy.

Cause

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. Pregnant women with chloasma gestational chloasma during pregnancy begin at 3 to 5 months of gestation and 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. 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. In addition, intense sun exposure and application of cosmetics can also induce chloasma. Chloasma is also seen in unmarried, unpregnant normal women or men for unknown reasons. If the diet is chronically deficient in glutathione, the tyrosinase activity in the skin can be increased, and tyrosine forms dopaquinone under the action of tyrosinase, thereby forming dopacin and causing pigmentation. Butterfly spot.

Chinese medicine believes that chloasma is caused by dysfunction of liver function, which causes facial qi and blood loss and produces liver qi stagnation. Liver qi stagnation, liver stagnation for a long time and fumigation of the face and the formation of plaque; Second, the kidney essence is damaged and the kidney yin is damaged for a long time, the kidney yin is insufficient and the face is not nourished, the face is not honored; the third is qi stagnation and blood stasis Not glory skin; Fourth, the liver and spleen are not dysfunctional with blood and can not be honored.

an examination

Related inspection

Obstetric B super blood routine obstetric examination

Laboratory inspection:

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Histopathology: melanin increased in the basal layer of the epidermis, melanocytes did not increase, and more melanocytes and free pigment particles were seen in the upper dermis, showing a small amount of lymphocytes infiltrating.

Differential diagnosis

Differential diagnosis of gestational chloasma:

1. Riel melanosis: occurs in the forehead, ankle, neck and ears, but also can affect the trunk and limbs, grayish brown, dark brown or blue-gray damage, sometimes slightly reticulated, unclear, pigment There are often powdery scales on the spots, which may be accompanied by mild redness and itching of the skin.

2. Addison's disease: pigmentation is a systemic diffuse distribution, from bronze to dark brown patches, in addition to the face can also be found in the areola, external genitals, etc., systemic symptoms such as weight loss, fatigue, blood pressure, etc. .

3. Civatte skin heterochromia: lesions are symmetrically distributed on the face, neck and upper chest, reddish-brown reticular pigmentation with telangiectasia and atrophy.

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