Dermoscopic Patterns of Facial Melanoses in Adult Patients: A Cross-sectional Study

Introduction: Facial melanoses encompass a heterogeneous group of diseases characterised by altered pigmentation on the face, including melasma, lentigines, freckles, Lichen Planus Pigmentosus (LPP), actinic lichen planus, periorbital hyperpigmentation, nevus of Ota, nevus of Hori, Riehl’s melanosis and Postinflammatory Hyperpigmentation (PIH). Dermoscopy is a non invasive and reliable tool for the direct visualisation of skin pigmentation and early diagnosis due to its distinctive dermoscopic patterns. Aim: To evaluate various patterns of dermoscopy in disorders of facial melanoses. Materials and Methods: A cross-sectional study was conducted at the Konaseema Institute of Medical Sciences and Research Foundation in Amalapuram, Andhra Pradesh, India, over a period of 20 months, involving patients attending the Dermatology, Venereology, Leprosy (DVL) Outpatient Department (OPD). The study included both sexes aged over 18 years with clinical evidence of facial pigmentation. Clinical and dermoscopic examinations were performed using a contact polarised DE-3100 dermoscope attached to a smartphone. Data were analysed using Statistical Package for the Social Sciences (SPSS) version 23.0. Results: A total of 114 subjects with facial melanosis were included in the study, with the majority of patients in the age group of 31-40 years (42, 36.8%), followed by 41-50 years (33, 29%) and a female predominance (82, 71.93%). The pigment network was present in 87.7% of the cases and absent in 12.3%. The most common dermoscopic pattern observed was reticular observed in 46 (40.4%), followed by reticulo-globular in 23 (20.2%). The most common non melanocytic feature identified was arciform structures seen in 42 (36.8%), followed by crista cutis and sulcus cutis in 17 (14.9%). Vascular structures such as telangiectasia were seen in 36 (31.6%) patients, while arborising vessels were observed in 1 (0.9%) patient. Conclusion: In this study, the most commonly reported condition was melasma, followed by facial acanthosis. Different pigmentary conditions exhibit specific pigment patterns, networks and special features on dermoscopy, which aid in their diagnosis. This study emphasises the importance of pigmentoscopy in facial melanosis and its significant role in assessing prognosis, treatment response and follow-up.