MELASMA - A CLINICAL, LIGHT MICROSCOPIC, ULTRASTRUCTURAL, AND IMMUNOFLUORESCENCE STUDY
MELASMA - A CLINICAL, LIGHT MICROSCOPIC, ULTRASTRUCTURAL, AND IMMUNOFLUORESCENCE STUDY
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DOI：
10.1016/s0190-9622(81)70071-9
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发表时间：
1981-01-01
影响因子：
13.8
通讯作者：
MIHM, MC
中科院分区：
文献类型：
--
作者：
SANCHEZ, NP;PATHAK, MA;MIHM, MC
黄褐斑是一种获得性的面部棕色黑色素过多症。虽然人们认为黄褐斑与多种病因（妊娠、遗传、种族和内分泌）有关，但其恶化的主要原因之一似乎是暴露在阳光下。临床上公认的黄褐斑有三种类型：面中央型、颧型和下颌型。Wood' s light （320- 400nm）检查有助于根据表皮和真皮中色素颗粒（黑素体）的定位来区分黄褐斑的具体类型。在Wood光检查的基础上，描述了四种类型的黄褐斑：表皮型、真皮型、混合型和第四种类型，在深色肤色的患者中，由于缺乏对比，在Wood光检查中无法识别病变，可能是由于黑人正常皮肤中黑色素体的数量增加。光、组织化学和电镜研究显示，类型特异性黑色素细胞的数量和活性增加，这些细胞似乎参与色素颗粒（黑色素小体）向表皮和真皮的形成、黑色素化和转移的增加。黑素细胞似乎经历了多种因素的组合所带来的功能改变，包括持续的阳光照射，激素因素和遗传易感性。
Melasma is an acquired brown hypermelanosis of the face. Although it is thought that melasma is associated with multiple etiologic factors (pregnancy, genetic, racial and endocrine), 1 of the primary causes of its exacerbation appears to be exposure to sunlight. Three patterns of melasma are recognized clinically: a centrofacial pattern, a malar pattern and a mandibular pattern. Examination of patients with Wood''s light (320-400 nm) is useful in classifying the specific type of melasma in correlation with the localization of pigment granules (melanosomes) in the epidermis and dermis. Four types of melasma are described on the basis of Wood''s light examination: an epidermal type, a dermal type, a mixed type, and a 4th type described in patients of dark complexion, in which the lesions, for lack of contrast, are not discernible on Wood''s light examination, perhaps due to the increased number of melanosomes in the normal skin of black individuals. Light, histochemical and EM studies revealed an increase in number and activity of type-specific melanocytes which appeared to be engaged in increased formation, melanization and transfer of pigment granules (melanosomes) to the epidermis as well as to the dermia. The melanocyte seems to undergo a functional alteration brought about by a combination of multiple factors, including persistent sun exposure, hormonal factors and genetic predisposition.