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Figure 4 Elevated levels of proinflammatory cytokines (e.g., IL-1, IL-6, IL-23, IL-33, TNF, and IL-17) and reduced levels of anti-inflammatory cytokines (such as IL-10, IL-27, and TGF) are commonly termed cytokine dysregulation

Katiyar et al 6 in his study also found a significant increase in estrogen and progesterone levels in melasma subjects compared to controls

However, excessive excitatory action of glutamate may cause excitotoxic neuronal damage as a result of a sustained influx of extracellular calcium ions (Ca 2+ ) [109, 110]

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