A clinico-epidemiological study of facial melanosis

Abstract

Background: Facial melanosis is a group of heterogenous entities, sharing a common clinical feature of altered pigmentation of the face and thus easily visible cosmetic disfigurement and significant psychosocial consequences. The importance of these disorders is growing, as they form the major percentage of dermatology consultations. Aims: To assess the patients of facial pigmentary disorders for demographic, etiological and clinical profile. Methods: This prospective hospital-based clinical study, conducted in a tertiary center over 1-year, involved 208 patients with facial pigmentary disorders, assessed using detailed history taking and clinical examination for demographic, etiological and clinical data. Relevant investigations including the skin biopsy and patch testing were also done wherever required. Results: The maximum number of patients belonged to 21-40 years age group (56.73%). Females predominated the study, with a female to male ratio of 1.92: 1. Among patients of facial hypermelanosis, melasma was the most common comprising of 73 patients, followed by postinflammatory hyperpigmentation (35), periorbital hyperpigmentation (14), ephelides (10) and lichen planus pigmentosus (9). Riehl's melanosis (8), drug-induced hyperpigmentation (6), naevoid hyperpigmentation (1), acanthosis nigricans (1) and Addison's disease (1) were other hypermelanosis conditions. Pityriasis alba (22) was the most common cause of facial hypomelanosis followed by vitiligo (19), postinflammatory hypopigmentation (8) and leprosy (1). Almost all cases of facial hyperpigmentation gave history of exacerbation following sun exposure. Conclusion: A variety of pigmentary disorders, both hyper and hypopigmentation, with variable clinical presentations and etiological factors, and associated with significant distress affect the face.