Although the etiology remains unknown, many factors have been implied as causative agents:
■ Genetic predisposition
■ Oral contraceptives
■ Ovaric disfunctions (elevated levels of LH, FSH and estradiol)
■ Thyroid disfunctions
■ Antiseizure drugs (phenytoin)
■ Cosmetics containing perfumes
Among these factors, sun exposure remains the most important, although all of them significantly increase the activity of tyrosinase in producing melanin.
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