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Dermoscopic Profile of Melasma: A Cross-Sectional Observational Study From a Tertiary Care Center in North India
Amrit Pant1, Ram Chander1, Sania Khan1
1Dermatology, Santosh University, Ghaziabad, IND.
Background Melasma is an acquired, chronic pigmentary disorder affecting sun-exposed areas of the face, predominantly in women of reproductive age. Dermoscopy has emerged as a non-invasive, in vivo imaging tool that can delineate the characteristic features of melasma, assess pigment depth, and facilitate differentiation from other facial melanoses. However, systematic dermoscopic data from Indian populations remain limited. This study aimed to describe the dermoscopic profile of melasma and study dermoscopic findings with clinical parameters, Wood's lamp-based pigment depth, disease severity (modified Melasma Area and Severity Index (mMASI)), and quality of life (Hindi version of the Melasma Quality of Life Scale (Hi-MelasQoL)). Methodology This hospital-based, observational, cross-sectional study enrolled 119 patients with clinically diagnosed melasma attending the dermatology outpatient department of a tertiary care institution. All patients underwent detailed clinical profiling, Wood's lamp examination for depth assessment, dermoscopy using the DermLite DL5 dermatoscope, mMASI scoring, and quality of life evaluation using the validated Hi-MelasQoL. Results The study cohort had a mean age of 34.31 ± 7.65 years with a female-to-male ratio of 4.1:1. The most prevalent dermoscopic features were globules (N = 116, 97.5%), pseudoreticular enhancement (N = 114, 95.8%), perifollicular sparing (N = 66, 55.5%), telangiectasias (N = 61, 51.3%), arcuate pattern (N = 50, 42.0%), and dots/granules (N = 27, 22.7%). The mean mMASI was 4.25 ± 1.99, and the mean Hi-MelasQoL was 29.93 ± 10.22. A strong positive correlation was found between mMASI and Hi-MelasQoL (Spearman's rho = 0.74, p < 0.001). Conclusions Pseudoreticular enhancement and globules are the dominant dermoscopic hallmarks of melasma in the Indian population, confirming findings from prior studies. The frequent co-occurrence of telangiectasias underscores the vascular component of melasma pathogenesis and has direct therapeutic implications. Dermoscopy is a valuable tool for diagnostic confirmation, depth assessment, and treatment guidance in melasma.
Background Melasma is an acquired, chronic pigmentary disorder affecting sun-exposed areas of the face, predominantly in women of reproductive age. Dermoscopy has emerged as a non-invasive, in vivo imaging tool that can delineate the characteristic features of melasma, assess pigment depth, and facilitate differentiation from other facial melanoses. However, systematic dermoscopic data from Indian populations remain limited. This study aimed to describe the dermoscopic profile of melasma and study dermoscopic findings with clinical parameters, Wood's lamp-based pigment depth, disease severity (modified Melasma Area and Severity Index (mMASI)), and quality of life (Hindi version of the Melasma Quality of Life Scale (Hi-MelasQoL)). Methodology This hospital-based, observational, cross-sectional study enrolled 119 patients with clinically diagnosed melasma attending the dermatology outpatient department of a tertiary care institution. All patients underwent detailed clinical profiling, Wood's lamp examination for depth assessment, dermoscopy using the DermLite DL5 dermatoscope, mMASI scoring, and quality of life evaluation using the validated Hi-MelasQoL. Results The study cohort had a mean age of 34.31 ± 7.65 years with a female-to-male ratio of 4.1:1. The most prevalent dermoscopic features were globules (N = 116, 97.5%), pseudoreticular enhancement (N = 114, 95.8%), perifollicular sparing (N = 66, 55.5%), telangiectasias (N = 61, 51.3%), arcuate pattern (N = 50, 42.0%), and dots/granules (N = 27, 22.7%). The mean mMASI was 4.25 ± 1.99, and the mean Hi-MelasQoL was 29.93 ± 10.22. A strong positive correlation was found between mMASI and Hi-MelasQoL (Spearman's rho = 0.74, p < 0.001). Conclusions Pseudoreticular enhancement and globules are the dominant dermoscopic hallmarks of melasma in the Indian population, confirming findings from prior studies. The frequent co-occurrence of telangiectasias underscores the vascular component of melasma pathogenesis and has direct therapeutic implications. Dermoscopy is a valuable tool for diagnostic confirmation, depth assessment, and treatment guidance in melasma.
