NEUROENDOKRINOLOGI MELASMA
DOI:
https://doi.org/10.33820/mdvi.v46i2.64Abstract
Melasma adalah kelainan hipermelanosis didapat, ditandai dengan makula hiperpigmentasi yang terdistribusi secara simetris pada bagian tubuh yang terpajan sinar matahari, terutama wajah. Patogenesis kondisi ini belum diketahui secara pasti. Berbagai faktor telah diketahui berkaitan dengan terjadinya melasma, yang tidak berdiri sendiri.Sistem neuroendokrinologi pada kulit berperan secara lokal dan sistemik melalui jaras humoral dan neurologis untuk menginduksi perubahan vaskular, imunitas, atau pigmen. Sistem ini juga berfungsi menjaga dan memelihara integritas struktur dan fungsi kulit, dan penting dalam homeostasis kulit. Perubahan pada sistem neuroendokrinologi kulit dapat berpengaruh dalam berbagai jenis kelainan kulit, salah satunya melasma. Keterlibatan neurologis pada melasma terutama berhubungan dengan peningkatan ekspresi nerve growth factor receptor (NGFR) dan neural endopeptidase (NEP) serta hipertrofi serabut saraf dermis. Terkait dengan faktor endokrin sejumlah penelitian menunjukkan hasil yang konsisten mengenai keterlibatan hormon estrogen, progesteron dan hipofisa. Mekanisme patogenesis melasma bersifat heterogen. Pemahaman patogenesis khususnya aspek neuroendokrinologi dapat memberikan terobosan untuk menyelesaikan kesulitan terapi melasma.
Kata kunci: hormone, neuroendokrin, melasma, patogenesis
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References
2. Miot LD, Miot HA, Silva MG, Marques ME. Physio-pathology of melasma. An Bras Dermatol. 2009;84:623-5.
3. Handel AC, Miot LDB, Miot HA. Melasma: A clinical and epidemiological review. An Bras Dermatol. 2014;89:771-82.
4. Scholzen T, Armstrong CA, Bunnett W, Luger TA, Olerud JC, Ansel JC. Neuropeptides in the skin: Interactions between the neuroendocrine and the skin immune systems. Exp Dermatol. 1998;7:81-96.
5. Rozengurt E. Convergent signaling in the action of integrins, neuropeptides, growth factors and oncogenes. Cancer Surv 1995;24:81-96.
6. Abdel-Malek Z, Suzuki I, Tada A, Im S, Akcali C. The melanocortin-1 receptor and human pigmentation. Ann N Y Acad Sci 1999;885:117-33.
7. Zvulunov A, Esterly NB. Neurocutaneous syndromes associated with pigmentary lesions. J Am Acad Dermatol 1995;32:915-35.
8. Bak H, Lee HJ, Chang SE, Choi JH, Kim MN, Kim BJ. Increased expression of nerve growth factor receptor and neural endopeptidase in the lesional skin of melasma. Dermatol Surg. 2009;35:1244-50.
9. Sheth VM, Pandya AG. Melasma: A comprehensive update: part I. J Am Acad Dermatol. 2011;45:1-19.
10. Kroumpouzos G, Cohen LM. Dermatoses of pregnancy. J Am Acad Dermatol. 2001;45:1-19.
11. Jee SH, Lee SY, Chiu HC, Chang CC Chen TJ. Effects of estrogen and estrogen receptor in normal human melanocytes. Biochem Biophys Res Commun. 1994;199:1407-12.
12. Madea K, Naganuma M, Fukuda M, Matsunaga J, Tomita Y. Effect of pituitary and ovarian hormones on human melanocytes in vitro. Pigment Cell Res. 1996;9:204-12.
13. Lieberman R, Moy L. Estrogen receptor expression in melasma: Result from facial skin of affected patients. J Drugs Dermatol. 2008;7:463-5.
14. Im S, Lee ES, Kim W, On W, Kim J. Donor specific response of estrogen and progesterone on cultured human melanocytes. J Korean Med Sci. 2002;17:58-64.
15. Ortonne JP, Arellano I, Bernevurg M, Cestari T, Chan H, Grimes P, dkk. A global survey of the role of ultraviolet radiation and hormonal influences in the development of melasma. J Eur Acad Dermatol Venereol. 2009;23:1254-62.
16. Guinot C, Cheffai S, Latreille J, Dhaoui MA, Youssef S, Jaber K, dkk. Aggravating factors for melasma: A prospective study in 197 Tunisian patients. J Eur Acad Dermatol Venereol. 2010;24:1060-9.
17. Lyford WH. Melasma: background, pathophysiology, etiology [Online]. 2017 [dikutip 2018 Jan 10]. Sumber: https://emedicine.medscape.com/article/1068640-overview#a7.
18. Im S, Kim J, On WY, Kang WH. Increased expression of alpha-melanocyte stimulating hormone in the lesional skin of melasma. Br J Dermatol. 2007;146:165-7.
19. Adalatkhah H, Sadeghi-Bazargani H, Amini-Sani N, Zeynizadeh S. Melasma and its association with different types of nevi in women: A case-control study. BMC Dermatol. 2008;8:3.
20. Hernandez-Barrera R, Torres-Alvares B, Castanedo-Cazares JP, Oros-Ovalle C, Moncada B. Solar elastosis and presence of mast cells as key features in the pathogenesis of melasma. Clin Exp Dermatol. 2008;33:305-8.
21. Kang HY, Hwang JS, Lee JY, Ahn JH, Kim JY, Lee ES, dkk. The dermal stem cell factor and c-kit are over-expressed in melasma. Br J Dermatol. 2006;154:1094-9.
22. Lutfi RJ, Fridmanis M, Misiunas AL, Pafume O, Gonzales EA. Association of melasma with thyroid autoimmunity and other thyroidal abnormalities and their relationship to the origin of the melasma. J Clin Endocrinol Metab. 1985:61:28-31.
23. Yazdanfar A, Hashemi B. Association of melasma with thyroid autoimmunity: A case-control study. Iran J Dermatol. 2010;13:51-3.
