Chloasma

Dermatologic—chloasma (pigmentation of the skin) or melasma (discoloration of the skin), which may continue when use of the drug is discontinued... 

Melasma is an acquired hyperpigmentation disorder characterized by moth-eaten tan or brownish macules and patches that occur on the sun-exposed areas of the skin (Fig. 14.1) [1]. Melasma is most commonly observed in women, but also in 10% of men. It affects all racial groups but is more prevalent in skin types IV-Vl. When melasma is associated with pregnancy it is called chloasma or mask of pregnancy . 

Additional side effects have been noted in some women. Women with contact lenses may have visual changes and more disturbances with lenses. If normal saline eye drops do not help, referral to an ophthalmologist is recommended. Melasma and chloasma can occur secondary to estrogen stimulation of melanocyte production. Women with darker pigmentation are more susceptible. The melasma may not be... 

Chloasma Melasma characterized by irregularly shaped brown patches on the face and other areas of the skin, often seen during pregnancy or associated with use of oral contraceptives. 

Alopecia Bulla Chloasma Deficiency of hair Large blister or vesicle fdled with serous fluid Cutaneous discoloration occurring in yellow-brown patches and spots... 

Unlike seborrhoeic dermatitis, chloasma, acne vulgaris and herpes simplex labialis, furuncles (boils) are not worsened by skin exposure. 

Adverse effects include acne, urticaria, fluid retention, weight changes, GI disturbances, change in libido, breast discomfort, premenstrual symptoms, irregular menstrual cycles, chloasma, depression, pyrexia, insomnia, somnolence, alopecia, hirsutism and rarely jaundice. Injection may be painful. 

The most common side effects are nausea, vomiting, headache, dizziness, fatigue, weight gain and breast fullness. The other side effects which appear after sometime of therapy are acne, increased body hair, pigmentation of cheeks, nose and forehead (chloasma). 

Smith AG, Shuster S, Thody AJ, Peberdy M. Chloasma, oral contraceptives, and plasma immunoreactive beta-mel-anocyte-stimulating hormone. J Invest Dermatol 1977 68(4) 169-70. 

Pigmentation e.g. oral contraceptives (chloasma in photosensitive distribution), phenothiazines, heavy metals, amiodarone, chloroquine (pigmentations of nails and palate, depigmentation of the hair), minocycline. 

Other reported adverse effects of spironolactone include urticaria, alopecia, and chloasma (SEDA-14,185). 

Purpura, edema, leg cramps, gynecomastia, porphyria cutanea tarda, and chloasma may be associated with the chronic use of diethylstilbestrol. Various cancers in premenopausal women have been shown to occur. Other chronic toxic effects include thrombocytopenia, gynecomastia, and fluid retention. 

Hughes BR, Dermatology Times June, 10 (chloasma-like) (1988) Hughes BR+, fir j Dermatol I 18, 687 (chloasma-like)... 

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