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  Table of Contents  
THROUGH THE DERMOSCOPE
Year : 2017  |  Volume : 8  |  Issue : 6  |  Page : 525-526  

Dermoscopy of melasma


1 Consultant Dermatologist and Dermatosurgeon, SKINNOCENCE: The Skin Clinic, Gurgaon, Haryana, India
2 Department of Skin and V.D, Patna Medical College and Hospital, Patna, Bihar, India
3 Department of Dermatology Consultant Dermatologist, Apollo Hospital, Noida, Uttar Pradesh, India

Date of Web Publication14-Nov-2017

Correspondence Address:
Sidharth Sonthalia
C-2246, Sushant Lok-1, Block C, Gurgaon – 122 009, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/idoj.IDOJ_6_17

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How to cite this article:
Sonthalia S, Jha AK, Langar S. Dermoscopy of melasma. Indian Dermatol Online J 2017;8:525-6

How to cite this URL:
Sonthalia S, Jha AK, Langar S. Dermoscopy of melasma. Indian Dermatol Online J [serial online] 2017 [cited 2019 Aug 21];8:525-6. Available from: http://www.idoj.in/text.asp?2017/8/6/525/218348



A 35-year-old lady presented with brown macules of centrofacial melasma within 6 months of child birth. [Figure 1]. She was euthyroid and had never used sunscreens, depigmenting creams (topical steroids/triple combination), or hormonal pills. Polarized videodermoscopy (EScope; Nakoda, ×20) of the cheek lesion revealed a pseudoreticular pigment network, diffuse light-to-dark brown background with sparing of the periappendageal region (follicular and sweat gland openings), brown granules, and globules, including arcuate and annular structures [Figure 2]. In few fields, increased vascularity and telangiectasias were well visualized [Figure 3].
Figure 1: Light-to-dark brown macules of centrofacial melasma over the cheeks, nose, and upper lip area

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Figure 2: Dermoscopy of the melasma lesion revealing diffuse light-to-dark brown (white arrow) pseudoreticular network, multiple brown dots, granules and globules (black arrows), arcuate and annular structures (blue arrows), with sparing of the perifollicular region (green arrows), and around the openings of sweat glands (yellow arrows) (polarizing mode, ×20)

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Figure 3: Dermoscopy of another melasma lesion revealing, in addition to the features seen in Figure 2, increased vascularity and telangiectasias (black arrows) (polarizing mode, ×20)

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Despite being clinically distinct, melasma may be confused with other facial melanoses, including lichen planus pigmentosus, Riehl melanosis, nevus of Ota, nevus spilus, exogenous ochronosis (EO), and pigmentary demarcation lines. Facial biopsy is often refused by patients. Thus, dermoscopy, being noninvasive, is very useful in differentiating melasma from its clinical differentials, especially EO, and may also aid in choosing the appropriate biopsy site in suspected cases [Table 1].[1],[2]
Table 1: Dermoscopic features seen in various pigmentary disorders

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The common perception that dermoscopy of melasma has been extensively described in indexed literature seems to be presumptive. Except for the description in the study by Yalamanchili et al.,[3] other dermoscopic features of melasma have mostly been mentioned as a comparison against other facial melanosis (to rule out melasma).[1],[2] A light-to-dark brown background and brown granules and globules with perifollicular sparing have been uniformly described.[1],[2],[3],[4],[5] The basic pattern may be reticular or pseudoreticular (more common in deeper melasma).[3] The pigment color may suggest the depth of melasma,[4] although this has been contested.[5] Dermoscope is also a valuable tool in the follow-up of melasma treatment.[6] We have further experienced that, on seeing the dermoscopic pictures, the patients become more treatment compliant.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Bhattar PA, Zawar VP, Godse KV, Patil SP, Nadkarni NJ, Gautam MM. Exogenous Ochronosis. Indian J Dermatol 2015;60:537-43.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Khunger N, Kandhari R. Dermoscopic criteria for differentiating exogenous ochronosis from melasma. Indian J Dermatol Venereol Leprol 2013;79:819-21.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Yalamanchili R, Shastry V, Betkerur J. Clinico-epidemiological Study and Quality of Life Assessment in Melasma. Indian J Dermatol 2015;60:519.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Sarkar R, Arora P, Garg VK, Sonthalia S, Gokhale N. Melasma update. Indian Dermatol Online J 2014;5:426-35.  Back to cited text no. 4
  [Full text]  
5.
Barcauí CB, Pereira FBC, Tamler C, Fonseca RMR. Classification of melasma by dermoscopy: Comparative study with Wood's lamp. Surg Cosm Dermatol 2009;1:115-9.  Back to cited text no. 5
    
6.
Ibrahim ZA, Gheida SF, El Maghraby GM, Farag ZE. Evaluation of the efficacy and safety of combinations of hydroquinone, glycolic acid, and hyaluronic acid in the treatment of melasma. J Cosmet Dermatol 2015;14:113-23.  Back to cited text no. 6
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1]


This article has been cited by
1 Dermoscopy of Pigmentary Disorders in Brown Skin
Manas Chatterjee,Shekhar Neema
Dermatologic Clinics. 2018; 36(4): 473
[Pubmed] | [DOI]



 

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