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Epidermal melasma showed network with a brownish homogenous pigmentation on dermoscopy while mixed melasma showed showed few areas of enhancement by woods light and irregular pigment network superimposed by dark brown or bluish-black granules, globules and blotches on dermoscopy

One proposed mechanism of action is that stimulation of 5-HT 2C receptors in pro-opiomelanocortin (POMC) neurons within the arcuate nucleus of the hypothalamus leads to increased release of -MSH (Garfield and Heisler, 2009)

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