Diffuse facial melanosis – An overview of etiology and dermoscopic findings

Abstract

Facial pigmentary disorder is a common condition in dark-skinned individual which causes significant psychological morbidity to the patients. Some of the well-defined causes of facial melanoses include melasma, Riehl’s melanosis, lichen planus pigmentosus, erythema dyschromicum perstans, and poikiloderma of Civatte. However, most of these conditions share many clinical and histopathological features in common. Sunlight exposure is one of the most common etiological factors, but application of irritant and photochemical substances also plays a role. Treatment of facial pigmentation is difficult and involves mainly the usage of various skin lightening agents acting at different levels of melanogenesis such as hydroquinone, chemical peels, and lasers. There is no universally effective specific therapy – existing agents have varying degrees of efficacy and relapses are frequent. Dermoscopy has been used mostly in the evaluation of pigmented lesions which have shown superiority over clinical examination and is of immense help to the clinicians for the appreciation of subtle features which are invisible to the naked eye.