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Year : 2016  |  Volume : 3  |  Issue : 2  |  Page : 83-89

Stubborn facial hypermelanosis in females: A clinicopathologic evaluation

Department of Dermatology, Sri Ramachandra University, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Aditya Kumar Bubna
Assistant Professor, Department of Dermatology, Sri Ramachandra University, Porur, Chennai - 600 116, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2349-5847.196299

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Background: Disorders of increased facial pigmentation constitute a major group of disorders in all dermatology clinics. Apart from cosmetic disfigurement, these disorders could significantly affect patient psychology. Therefore, it becomes imperative on the part of clinician to arrive at a conclusive diagnosis so that appropriate therapy could be administered. Aim: To correlate the clinical and histology findings in 70 females 30–50 years of age with persistent facial hypermelanosis. Methods: Following a written, informed consent, a 2 mm punch biopsy was performed from the lesional skin, succeeded by microscopic evaluation and clinical correlation. Results: Out of the 70 patients studied, 31 had melasma, 14 with seborrhoeic melanosis (SM) and lichenoid dermatitis each, four with acanthosis nigricans (AN) and ashy dermatoses, and the remaining three with Riehl’s melanosis. Out of these patients studied, all patients with melasma and AN demonstrated 100% clinicopathologic concordance. Koilocytes were identified in two patients with persistent facial hypermelanosis, and in 17 patients, the histology findings were undecided. Conclusion: Melasma appears to be the most common cause of facial hypermelanosis in females and has demonstrated a 100% clinicopathologic correlation. Subclinical infection with human papilloma virus (HPV) could be a cause of increased facial pigmentation which, if not carefully evaluated, could go undetected. SM still remains a disputable entity. Majority of these disorders are chronic and highly recalcitrant to all conventional therapeutic modalities.

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