| • | acquired, brown hypermelanosis of the face |
| • | pigmentation is secondary to increased number and activity of melanocytes, which appear highly dendritic with highly melanized melanosomes |
| • | hydroquinone – broad area treatment results in greater efficacy and the prevention of additional pigmentation (i.e. treat whole face) |
| • | minimize sun exposure between peak solar hours of 10AM to 3PM |
| • | to prevent repigmentation, it is especially important to avoid UVA exposure, which is believed to stimulate melanocytes and is present year-round outdoors as well as in tanning booths |
| • | ddx: chloasma hepatica, actinic LP |
3 types:
| 1. | epidermal: most common (70%); most amenable to treatment |
|