Melasma and Endocrine Disorders

Melasma was described as a chronic skin disorder characterized by symmetrical hypermelanosis, primarily affecting the face and sometimes the neck and forearms. It was prevalent during pregnancy and in women taking exogenous hormones, and occasionally in males with primary hypogonadism or on estrogen therapy for prostate cancer. The condition appeared linked to female sex hormones, though not consistently with high estrogen or progesterone levels, suggesting other factors like genetics, UV exposure, cosmetics, and medications played roles. Despite melanocortins' role in melanogenesis, melasma was not associated with pituitary or adrenal diseases, nor with thyroid disorders or vitamin D production issues. Clinicians were advised to differentiate melasma from general hyperpigmentation related to pregnancy or elevated ACTH levels in pituitary and adrenal diseases.