Pattern of Facial Dyschromias: A Clinical and Dermoscopic Study from a Tertiary Healthcare Center in South India

Facial dyschromias (FD) are common among individuals with skin of color. At present, information on the pattern and dermoscopic features of various FD is scarce from South India.

To describe the clinical and dermoscopic features of FD in patients presenting to a tertiary healthcare center in South India.

Clinical and dermoscopic examination was performed in 274 patients presenting with FD in the outpatient department of a tertiary healthcare center in South India.

Disorders of facial hyperpigmentation (90.87%) were more commonly encountered than facial hypopigmentation (7.66%); four patients presented with both hyperpigmentation and hypopigmentation (1.46%). Females (76.27%) were more commonly affected than males (23.72%), and most of the patients belonged to the young to middle-aged groups. The common causes of facial hyperpigmentation include melasma, lichen planus pigmentosus, facial acanthosis nigricans, maturational dyschromia, and post-inflammatory hyperpigmentation. The common causes of facial hypopigmentation include tinea versicolor, seborrheic dermatitis, vitiligo, salt and pepper pigmentation, and nevus depigmentosus. Each of these conditions had distinct dermoscopic features, which aided in the diagnosis.

Histopathological examination was done in a limited number of cases, being a cross-sectional study, and no follow-up was conducted to observe the evolution of facial pigmentation.

Nearly 90% of FD are hyperpigmentary in nature. The common causes of facial hyperpigmentation include melasma, lichen planus pigmentosus, facial acanthosis nigricans, maturational dyschromia, and post-inflammatory hyperpigmentation. In contrast, tinea versicolor, seborrheic dermatitis, and vitiligo are three common causes of hypopigmentation of the face.