Learning Objective
Identify common causes of hyperpigmentation and describe their clinical features.
Melasma
Presentation:
Irregular, blotchy hyperpigmented patches on the face.
Associations:
- Sun exposure
- Oral contraceptive use
- Pregnancy (“mask of pregnancy”)
Course: May regress after pregnancy or with removal of the trigger.
Addison Disease
Presentation:
Generalized hyperpigmentation, often most prominent in sun-exposed areas, palmar creases, and mucous membranes.
Pathophysiology:
Increased melanin production in the basal layer due to chronically elevated ACTH.
Clinical relevance: Can signal primary adrenal insufficiency.
Activity
Clinical Notes
- Hyperpigmentation may be localized (melasma) or generalized (Addison’s disease).
- Evaluation should consider hormonal, genetic, and environmental factors.
- Sun protection and hormonal management are important for the prevention and treatment of melasma.
