Uso do microagulhamento no tratamento de indivíduos com melasma: um estudo de revisão

Detalhes bibliográficos
Autor(a) principal: Silva, Daniela Ribeiro da Silva
Data de Publicação: 2022
Tipo de documento: Trabalho de conclusão de curso
Idioma: por
Título da fonte: Repositório do Centro Universitário Braz Cubas
Texto Completo: https://repositorio.cruzeirodosul.edu.br/handle/123456789/3968
Resumo: Melasma is an acquired hyperpigmentation disorder that is often resistant to some therapies, with microneedling being a very common technique for the treatment of this condition. In this sense, the objective of the present study is to analyze the effects of microneedling in individuals with Melasma. This study is characterized as a narrative literature review, based on studies indexed in MEDLINE, SciELO and Google Scholar databases. The keywords “melasma”, “hyperpigmentation”, “microneedling”, “treatment”, “physiotherapy”, as well as their respective synonyms in English were used. The combination of keywords was performed using the Boolean operators AND and OR. Also, secondary data sources were consulted. Clinical studies that evaluated the efficacy and safety of the use of microneedling in the treatment of Melasma were included in the present review. Given the need for the scope of the study, there was no delimitation regarding the language of publication or the year of publication. Exclusion criteria were the imputation of important data for the analysis of the study, in addition to the presence of low methodological quality. Most of the included studies evaluated the usefulness of microneedling in combination with other therapies and observed positive effects. Based on the evidence analyzed, it is possible to state that microneedling can play an important role in the treatment of Melasma, having the additional effect of facilitating the delivery of topical therapies to the epidermis and dermis, presenting a very low risk of post-inflammatory hyperpigmentation.
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spelling Uso do microagulhamento no tratamento de indivíduos com melasma: um estudo de revisãoHiperpigmentaçãoMicroagulhamentoTratamentoCNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONALMelasma is an acquired hyperpigmentation disorder that is often resistant to some therapies, with microneedling being a very common technique for the treatment of this condition. In this sense, the objective of the present study is to analyze the effects of microneedling in individuals with Melasma. This study is characterized as a narrative literature review, based on studies indexed in MEDLINE, SciELO and Google Scholar databases. The keywords “melasma”, “hyperpigmentation”, “microneedling”, “treatment”, “physiotherapy”, as well as their respective synonyms in English were used. The combination of keywords was performed using the Boolean operators AND and OR. Also, secondary data sources were consulted. Clinical studies that evaluated the efficacy and safety of the use of microneedling in the treatment of Melasma were included in the present review. Given the need for the scope of the study, there was no delimitation regarding the language of publication or the year of publication. Exclusion criteria were the imputation of important data for the analysis of the study, in addition to the presence of low methodological quality. Most of the included studies evaluated the usefulness of microneedling in combination with other therapies and observed positive effects. Based on the evidence analyzed, it is possible to state that microneedling can play an important role in the treatment of Melasma, having the additional effect of facilitating the delivery of topical therapies to the epidermis and dermis, presenting a very low risk of post-inflammatory hyperpigmentation.O Melasma é um distúrbio adquirido de hiperpigmentação que muitas vezes é resistente a algumas terapias, sendo omicroagulhamento uma técnica bastante comum para o tratamento dessa condição. Nesse sentido, o objetivo do presente estudo é analisar os efeitos do microagulhamento em indivíduos com Melasma. Este estudo é caracterizado como uma revisão de literatura do tipo narrativa, a partir de estudos indexados nas bases de dados MEDLINE, SciELO e Google Scholar. Foram utilizadas as palavras-chave “melasma”, “hiperpigmentação”, “microagulhamento”, “tratamento”, “fisioterapia”, bem como seus respectivos sinônimos em inglês. A combinação das palavras-chave foi feita com auxílio dos operadores boleanos ANDe OR. Ainda, foram consultadas fontes secundárias de dados.Foram incluídos na presente revisão estudos clínicos que avaliassem a eficácia e segurança do uso do microagulhamento no tratamento doMelasma. Diante da necessidade de abrangência do estudo, não houve qualquer delimitação quanto ao idioma de publicação ou ao ano de publicação. Foram considerados como critérios de exclusão a imputação de dados importantes para a análise do estudo,além da presença de baixa qualidade metodológica.A maioria dos estudos incluídos avaliou a utilidade do microagulhamento emcombinação com outras terapias e observou efeitos positivos. Com basenas evidências analisadas é possível afirmar que o microagulhamento pode desempenhar um papel importante no tratamento do Melasma, tendo comoefeitoadicionala facilitação da entrega de terapias tópicas à epiderme e derme,apresentando risco muito baixo de hiperpigmentação pós-inflamatória.Centro Universitário de João PessoaBrasilUNIPÊPinheiro, Yago Tavareshttp://lattes.cnpq.br/3811482061077693Silva, Daniela Ribeiro da Silva2022-07-18T17:13:32Z2022-07-202022-07-202022-07-18T17:13:32Z2022-05-28info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/bachelorThesisapplication/pdfSILVA, Daniela Ribeiro da Silva. Uso do microagulhamento no tratamento de indivíduos com melasma: um estudo de revisão. 18 P. 2022. Trabalho de conclusão de curso (Pós-Graduação Fisioterapia Dermatofuncional) - Centro Universitário de João Pessoa – UNIPÊ, João Pessoa, 2022.https://repositorio.cruzeirodosul.edu.br/handle/123456789/3968porARKSEY, H.; O’MALLEY, L. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, v. 8, n. 1, p. 19–32, fev. 2005.ARTZI, O. et al.The pathogenesis of melasma and implications for treatment. Journal of Cosmetic Dermatology, v. 20, n. 11, p. 3432–3445, 19 nov. 2021. Disponível em: <https://onlinelibrary.wiley.com/doi/10.1111/jocd.14382>.BOLOGNIA, J.; MURRAY, M.; PAWELEK, J. UVB-induced melanogenesis may be mediated through the MSH-receptor system. The Journal of investigative dermatology, v. 92, n. 5, p. 651–6, maio 1989. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/2497190>.BUDAMAKUNTLA, L. et al.A Randomised, Open-label, Comparative Study of Tranexamic Acid Microinjections and Tranexamic Acid with Microneedling in Patients with Melasma. Journal of cutaneous and aesthetic surgery, v. 6, n. 3, p. 139–43, jul. 2013. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/24163529>.CASSIANO, D. P. et al.Early clinical and histological changes induced by microneedling in facial melasma: A pilot study. Indian journal of dermatology, venereology and leprology, v. 85, n. 6, p. 638–641, 2019. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/31607716>.COHEN, B. E.; ELBULUK, N. Microneedling in skin of color: Areview of uses and efficacy. Journal of the American Academy of Dermatology, v. 74, n. 2, p. 348–55, fev. 2016. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/26549251>.FABBROCINI, G. et al.Skin needling to enhance depigmenting serum penetration in the treatment of melasma. Plastic surgery international, v. 2011, n. 1, p. 158241, 2011. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/22567235>.GRIMES, P. E.; YAMADA, N.; BHAWAN, J. Light microscopic, immunohistochemical, and ultrastructural alterations in patients with melasma. The American Journal of dermatopathology, v. 27, n. 2, p. 96–101, abr. 2005. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/15798432>.HANDEL, A. C.; MIOT, L. D. B.; MIOT, H. A. Melasma: a clinical and epidemiological review. Anais brasileiros de dermatologia, v. 89, n. 5, p. 771–82, 2014. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/25184917>.IM, S. et al.Increased expression of alpha-melanocyte-stimulating hormone in the lesional skin of melasma. The British journal of dermatology, v. 146, n. 1, p. 165–7, jan. 2002. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/11852920>.IMOKAWA, G. et al.Biological characterization of human fibroblast-derived mitogenic factors for human melanocytes. The Biochemical journal, v. 330, n. 3, p. 1235–9, 15 mar. 1998. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/9494091>.ISMAIL, E. S. A. et al.Efficacy of microneedling with topical vitamin C in the treatment of melasma. Journal of cosmetic dermatology, v. 3, n. 1, p. 56–67, 15 17fev. 2019. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/30770637>.KANG, H. Y. et al.The dermal stem cell factor and c-kit are overexpressed in melasma. The British journal of dermatology, v. 154, n. 6, p. 1094–9, jun. 2006. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/16704639>.KWON, S.-H. et al.Heterogeneous Pathology of Melasma and Its Clinical Implications. International journal of molecular sciences, v. 17, n. 6, p. 1–9, 26 maio 2016. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/27240341>.KWON, S.-H. et al.Melasma: Updates and perspectives. Experimental dermatology, v. 28, n. 6, p. 704–708, 2019. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/30422338>.KWON, S. Clues to the Pathogenesis of Melasma from its Histologic Findings. Journal of Pigmentary Disorders, v. 01, n. 05, p. 1–10, 2014. Disponível em: <http://omicsgroup.org/journals/clues-to-the-pathogenesis-of-melasma-from-its-histologic-findings-2376-0427.1000141.php?aid=33146>.LEE, B.W.; SCHWARTZ, R. A.; JANNIGER, C. K. Melasma. Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia, v. 152, n. 1, p. 36–45, 2017. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/27589484>.LEE, D. et al.Defective barrier function in melasma skin. Journal of the European Academy of Dermatology and Venereology : JEADV, v. 26, n. 12, p. 1533–7, dez. 2012. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/22077137>.LIMA, E. V. A. et al.Assessment of the effects of skin microneedling as adjuvant therapy for facial melasma: a pilot study. BMC dermatology, v. 17, n. 1, p. 14, 2017. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/29183309>.OGBECHIE-GODEC, O. A.; ELBULUK, N. Melasma: an Up-to-Date Comprehensive Review. Dermatology and therapy, v. 7, n. 3, p. 305–318, set. 2017. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/28726212>.PASSERON, T.; PICARDO, M. Melasma, a photoaging disorder. Pigment cell & melanoma research, v. 31, n. 4, p. 461–465, 2018. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/29285880>.RAJANALA, S.; MAYMONE, M. B. DE C.; VASHI, N. A. Melasma pathogenesis: a review of the latest research, pathological findings, and investigational therapies. Dermatology online journal, v. 25, n. 10, p. 35–47, 15 out. 2019. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/31735001>.SANCHEZ, N. P. et al.Melasma: a clinical, light microscopic, ultrastructural, and immunofluorescence study. Journal of the American Academy of Dermatology, v. 4, n. 6, p. 698–710, jun. 1981. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/6787100>.SARKAR, R et al.Melasma in men: a clinical, aetiological and histological study. Journal of the European Academy of Dermatology and Venereology, v. 24, n. 7, p. 768–772, 15 dez. 2009. Disponível em: 18<https://onlinelibrary.wiley.com/doi/10.1111/j.1468-3083.2009.03524.x>.SARKAR, RASHMI; BANSAL, A.; AILAWADI, P. Future therapies in melasma: What lies ahead? Indian journal of dermatology, venereology and leprology, v. 86, n. 1, p. 8–17, 2020. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/31793496>.SHETH, V. M.; PANDYA, A. G. Melasma: a comprehensive update: part I. Journal of the American Academy of Dermatology, v. 65, n. 4, p. 689–697, out. 2011. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/21920241>.TARAZ, M.; NIKNAM, S.; EHSANI, A. H. Tranexamic acid in treatment of melasma: A comprehensive review of clinical studies. Dermatologic therapy, v. 30, n. 3, p. 1–12, maio 2017. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/28133910>.VIDEIRA, I. F. DOS S.; MOURA, D. F. L.; MAGINA, S. Mechanisms regulating melanogenesis. Anais brasileiros de dermatologia, v. 88, n. 1, p. 76–83, 2013. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/23539007>.WU, D. C. et al.A Systematic Review of Picosecond Laser in Dermatology: Evidence and Recommendations. Lasers in surgery and medicine, v. 53, n. 1, p. 9–49, 2021. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/32282094>.XU, Y. et al.Efficacy of functional microarray of microneedles combined with topical tranexamic acid for melasma: A randomized, self-controlled, split-face study. Medicine, v. 96, n. 19, p. e6897, maio 2017. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/28489798>.ZHOU, L. L.; BAIBERGENOVA, A. Melasma: systematic review of the systemic treatments. International journal of dermatology, v. 56, n. 9, p. 902–908, set. 2017. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/28239840>info:eu-repo/semantics/openAccessreponame:Repositório do Centro Universitário Braz Cubasinstname:Centro Universitário Braz Cubas (CUB)instacron:CUB2022-08-11T18:08:58Zoai:repositorio.cruzeirodosul.edu.br:123456789/3968Repositório InstitucionalPUBhttps://repositorio.brazcubas.edu.br/oai/requestbibli@brazcubas.edu.bropendoar:2022-08-11T18:08:58Repositório do Centro Universitário Braz Cubas - Centro Universitário Braz Cubas (CUB)false
dc.title.none.fl_str_mv Uso do microagulhamento no tratamento de indivíduos com melasma: um estudo de revisão
title Uso do microagulhamento no tratamento de indivíduos com melasma: um estudo de revisão
spellingShingle Uso do microagulhamento no tratamento de indivíduos com melasma: um estudo de revisão
Silva, Daniela Ribeiro da Silva
Hiperpigmentação
Microagulhamento
Tratamento
CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL
title_short Uso do microagulhamento no tratamento de indivíduos com melasma: um estudo de revisão
title_full Uso do microagulhamento no tratamento de indivíduos com melasma: um estudo de revisão
title_fullStr Uso do microagulhamento no tratamento de indivíduos com melasma: um estudo de revisão
title_full_unstemmed Uso do microagulhamento no tratamento de indivíduos com melasma: um estudo de revisão
title_sort Uso do microagulhamento no tratamento de indivíduos com melasma: um estudo de revisão
author Silva, Daniela Ribeiro da Silva
author_facet Silva, Daniela Ribeiro da Silva
author_role author
dc.contributor.none.fl_str_mv Pinheiro, Yago Tavares
http://lattes.cnpq.br/3811482061077693
dc.contributor.author.fl_str_mv Silva, Daniela Ribeiro da Silva
dc.subject.por.fl_str_mv Hiperpigmentação
Microagulhamento
Tratamento
CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL
topic Hiperpigmentação
Microagulhamento
Tratamento
CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL
description Melasma is an acquired hyperpigmentation disorder that is often resistant to some therapies, with microneedling being a very common technique for the treatment of this condition. In this sense, the objective of the present study is to analyze the effects of microneedling in individuals with Melasma. This study is characterized as a narrative literature review, based on studies indexed in MEDLINE, SciELO and Google Scholar databases. The keywords “melasma”, “hyperpigmentation”, “microneedling”, “treatment”, “physiotherapy”, as well as their respective synonyms in English were used. The combination of keywords was performed using the Boolean operators AND and OR. Also, secondary data sources were consulted. Clinical studies that evaluated the efficacy and safety of the use of microneedling in the treatment of Melasma were included in the present review. Given the need for the scope of the study, there was no delimitation regarding the language of publication or the year of publication. Exclusion criteria were the imputation of important data for the analysis of the study, in addition to the presence of low methodological quality. Most of the included studies evaluated the usefulness of microneedling in combination with other therapies and observed positive effects. Based on the evidence analyzed, it is possible to state that microneedling can play an important role in the treatment of Melasma, having the additional effect of facilitating the delivery of topical therapies to the epidermis and dermis, presenting a very low risk of post-inflammatory hyperpigmentation.
publishDate 2022
dc.date.none.fl_str_mv 2022-07-18T17:13:32Z
2022-07-20
2022-07-20
2022-07-18T17:13:32Z
2022-05-28
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/bachelorThesis
format bachelorThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv SILVA, Daniela Ribeiro da Silva. Uso do microagulhamento no tratamento de indivíduos com melasma: um estudo de revisão. 18 P. 2022. Trabalho de conclusão de curso (Pós-Graduação Fisioterapia Dermatofuncional) - Centro Universitário de João Pessoa – UNIPÊ, João Pessoa, 2022.
https://repositorio.cruzeirodosul.edu.br/handle/123456789/3968
identifier_str_mv SILVA, Daniela Ribeiro da Silva. Uso do microagulhamento no tratamento de indivíduos com melasma: um estudo de revisão. 18 P. 2022. Trabalho de conclusão de curso (Pós-Graduação Fisioterapia Dermatofuncional) - Centro Universitário de João Pessoa – UNIPÊ, João Pessoa, 2022.
url https://repositorio.cruzeirodosul.edu.br/handle/123456789/3968
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv ARKSEY, H.; O’MALLEY, L. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, v. 8, n. 1, p. 19–32, fev. 2005.ARTZI, O. et al.The pathogenesis of melasma and implications for treatment. Journal of Cosmetic Dermatology, v. 20, n. 11, p. 3432–3445, 19 nov. 2021. Disponível em: <https://onlinelibrary.wiley.com/doi/10.1111/jocd.14382>.BOLOGNIA, J.; MURRAY, M.; PAWELEK, J. UVB-induced melanogenesis may be mediated through the MSH-receptor system. The Journal of investigative dermatology, v. 92, n. 5, p. 651–6, maio 1989. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/2497190>.BUDAMAKUNTLA, L. et al.A Randomised, Open-label, Comparative Study of Tranexamic Acid Microinjections and Tranexamic Acid with Microneedling in Patients with Melasma. Journal of cutaneous and aesthetic surgery, v. 6, n. 3, p. 139–43, jul. 2013. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/24163529>.CASSIANO, D. P. et al.Early clinical and histological changes induced by microneedling in facial melasma: A pilot study. Indian journal of dermatology, venereology and leprology, v. 85, n. 6, p. 638–641, 2019. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/31607716>.COHEN, B. E.; ELBULUK, N. Microneedling in skin of color: Areview of uses and efficacy. Journal of the American Academy of Dermatology, v. 74, n. 2, p. 348–55, fev. 2016. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/26549251>.FABBROCINI, G. et al.Skin needling to enhance depigmenting serum penetration in the treatment of melasma. Plastic surgery international, v. 2011, n. 1, p. 158241, 2011. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/22567235>.GRIMES, P. E.; YAMADA, N.; BHAWAN, J. Light microscopic, immunohistochemical, and ultrastructural alterations in patients with melasma. The American Journal of dermatopathology, v. 27, n. 2, p. 96–101, abr. 2005. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/15798432>.HANDEL, A. C.; MIOT, L. D. B.; MIOT, H. A. Melasma: a clinical and epidemiological review. Anais brasileiros de dermatologia, v. 89, n. 5, p. 771–82, 2014. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/25184917>.IM, S. et al.Increased expression of alpha-melanocyte-stimulating hormone in the lesional skin of melasma. The British journal of dermatology, v. 146, n. 1, p. 165–7, jan. 2002. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/11852920>.IMOKAWA, G. et al.Biological characterization of human fibroblast-derived mitogenic factors for human melanocytes. The Biochemical journal, v. 330, n. 3, p. 1235–9, 15 mar. 1998. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/9494091>.ISMAIL, E. S. A. et al.Efficacy of microneedling with topical vitamin C in the treatment of melasma. Journal of cosmetic dermatology, v. 3, n. 1, p. 56–67, 15 17fev. 2019. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/30770637>.KANG, H. Y. et al.The dermal stem cell factor and c-kit are overexpressed in melasma. The British journal of dermatology, v. 154, n. 6, p. 1094–9, jun. 2006. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/16704639>.KWON, S.-H. et al.Heterogeneous Pathology of Melasma and Its Clinical Implications. International journal of molecular sciences, v. 17, n. 6, p. 1–9, 26 maio 2016. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/27240341>.KWON, S.-H. et al.Melasma: Updates and perspectives. Experimental dermatology, v. 28, n. 6, p. 704–708, 2019. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/30422338>.KWON, S. Clues to the Pathogenesis of Melasma from its Histologic Findings. Journal of Pigmentary Disorders, v. 01, n. 05, p. 1–10, 2014. Disponível em: <http://omicsgroup.org/journals/clues-to-the-pathogenesis-of-melasma-from-its-histologic-findings-2376-0427.1000141.php?aid=33146>.LEE, B.W.; SCHWARTZ, R. A.; JANNIGER, C. K. Melasma. Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia, v. 152, n. 1, p. 36–45, 2017. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/27589484>.LEE, D. et al.Defective barrier function in melasma skin. Journal of the European Academy of Dermatology and Venereology : JEADV, v. 26, n. 12, p. 1533–7, dez. 2012. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/22077137>.LIMA, E. V. A. et al.Assessment of the effects of skin microneedling as adjuvant therapy for facial melasma: a pilot study. BMC dermatology, v. 17, n. 1, p. 14, 2017. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/29183309>.OGBECHIE-GODEC, O. A.; ELBULUK, N. Melasma: an Up-to-Date Comprehensive Review. Dermatology and therapy, v. 7, n. 3, p. 305–318, set. 2017. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/28726212>.PASSERON, T.; PICARDO, M. Melasma, a photoaging disorder. Pigment cell & melanoma research, v. 31, n. 4, p. 461–465, 2018. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/29285880>.RAJANALA, S.; MAYMONE, M. B. DE C.; VASHI, N. A. Melasma pathogenesis: a review of the latest research, pathological findings, and investigational therapies. Dermatology online journal, v. 25, n. 10, p. 35–47, 15 out. 2019. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/31735001>.SANCHEZ, N. P. et al.Melasma: a clinical, light microscopic, ultrastructural, and immunofluorescence study. Journal of the American Academy of Dermatology, v. 4, n. 6, p. 698–710, jun. 1981. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/6787100>.SARKAR, R et al.Melasma in men: a clinical, aetiological and histological study. Journal of the European Academy of Dermatology and Venereology, v. 24, n. 7, p. 768–772, 15 dez. 2009. Disponível em: 18<https://onlinelibrary.wiley.com/doi/10.1111/j.1468-3083.2009.03524.x>.SARKAR, RASHMI; BANSAL, A.; AILAWADI, P. Future therapies in melasma: What lies ahead? 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UNIPÊ
publisher.none.fl_str_mv Centro Universitário de João Pessoa
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