Clinicoepidemiological and Dermoscopic Patterns of Hypopigmented Disorders: A Cross-Sectional Observational Study

Introduction Hypopigmented disorders comprise a heterogeneous group of dermatoses characterized by hypopigmented macules, patches, plaques, papules, and scaling lesions. These disorders often follow a chronic course and significantly affect patients' quality of life. Clinical differentiation may be challenging because of overlapping clinical presentations and atypical morphology. Dermoscopy serves as a non-invasive diagnostic tool that enhances visualization of submacroscopic morphological features and improves diagnostic accuracy. Materials and methods This cross-sectional observational study included 150 patients with hypopigmented disorders attending the dermatology outpatient department over a period of 18 months. The study population comprised 84 (56%) females and 66 (44%) males, with a mean age of 30.2 ± 2.57 years. Patients fulfilling the inclusion and exclusion criteria were enrolled after obtaining informed consent and institutional ethics committee's approval. Detailed history taking and clinical examination were performed using a predesigned proforma. Dermoscopic evaluation was conducted using polarized and non-polarized modes at 10× magnification. Clinical and dermoscopic findings were documented photographically and analyzed. Results Among 150 patients, pityriasis versicolor was the most common disorder, observed in 36 (24%) patients, followed by vitiligo in 33 (22%) patients and pityriasis alba in 30 (20%) patients. Reduced pigment network was the most consistent dermoscopic finding and was observed in all 150 (100%) cases. Scaling was predominantly observed in pityriasis versicolor in 25 (69.4%) patients and pityriasis alba in 18 (60%) patients. Vascular structures were commonly observed in lichen sclerosus in nine (90%) patients, while leukotrichia was characteristic of vitiligo and was seen in 13 (39.4%) patients. Additional findings such as pseudopod-like extensions, perifollicular pigmentation, comet-tail appearance, and double-edged scales assisted in differentiating specific disorders. Dermoscopic findings showed a strong correlation with clinical diagnosis. Conclusion Dermoscopy is a reliable and non-invasive adjunctive tool in the evaluation of hypopigmented disorders. In addition to a reduced pigment network, characteristic findings such as scaling patterns, vascular morphology, follicular changes, and border alterations improve diagnostic precision and help distinguish clinically similar conditions. Incorporation of dermoscopy into routine dermatological practice enhances diagnostic confidence and may reduce the need for invasive procedures.