Sharply demarcated, blotchy, brown, macules found in a symmetric distribution over the cheeks and forehead and sometimes on the neck or upper lip. Frequently occurs during pregnancy, at menopause, and in patients taking oral contraceptives. Same type may be seen in patients with chronic liver disease. Usual course - variable; chronic; relapsing.

• oral contraceptives plus ultraviolet light
• pregnancy plus ultraviolet light
• endocrine dysfunction
• cosmetics
• Mesantoin
• diphenylhydantoin