Dermoscopic features of Melasma

Abstract

Melasma, is a chronic acquired disorder of hypermelanosis of skin which is exposed to ultraviolet radiation. The clinical presentation is most often in the form of hyperpigmented patches over the face in three common patterns: Centrofacial, malar and mandibular. It is commonly seen in pigmented skin phenotypes (Fitzpatrick skin types III-V). The disease has an impact on the quality of life of patients. Dermoscopy is an in vivo noninvasive technique used to examine pigmented and amelanotic skin lesions. The technique is performed using a hand-held self-illuminating device called dermatoscope that visualizes features present under the skin surface. : To study dermoscopic (dermatoscopic) features of melasma and to distinguish between epidermal and dermal melasma based on dermoscopic features.: This study was conducted in an OPD in a clinic on 40 patients of melasma. Dermoscopy was done and their dermatoscopic features were recorded, melasma was classified as epidermal or dermal depending on dermatoscopic features. : Dermatoscopic features of melasma seen were – Accentuation of pseudoreticular pigment network, light to dark brown in colour sparing of the periappendageal region (follicular and sweat gland openings), brown granules, blue- gray perifollicular accentuation honeycomb like reticular pattern and arcuate pigmented lines. 18 patients (45%) showed epidermal type 9 patients (22.5%) revealed dermal type of melasma, 13 patients showed mixed features (epidermal and dermal). Melasma with steroid abuse showed marked erythema and telangiectasia. Dermatoscope is a valuable aid to diagnose, classify and to monitor treatment of melasma.