DOI: 10.36347/sjams.2016.v04i12.048

Pages: 4439-4445

Acquired facial melanosis is a common presentation in Indian patients, causing cosmetic disfigurement with considerable psychosocial impact. This study was conducted to correlate the clinical, etiological and histopathological features of disease process. Total 25 patients presenting with acquired facial melanosis were included in the study. Detailed history, clinical examination, wood’s lamp examination and dermatoscopy were carried out and clinical diagnosis was made. A 4 mm punch biopsy from the lesion for the histopathological examination was taken. Key histopathological features on hematoxylin and eosin stain were assessed. 12 patients belonged to age group of 20-29 years. 18 patients were female. 11 (44%) patients were on oral medications and 08 (32%) patients had history of topical application of creams. (80%), 23 (92%) patients had bilateral lesions. Accentuation of lesions on Wood’s lamp examination was present in 07 (28%) patients and there was no accentuation in 18 (72%) patients. Dermatoscopy examination showed reticular pigmentation in 08 patients (32%) followed by reticular pigmentation with follicular sparing in 05 patients (20%). Clinical and Histopathological diagnosis was concordant in 23 (92%) patients while discordant in 02 (08%) patients. Melasma was the most common cause followed by PIH, Exogenous ochronosis, Riehl’s melanoses, Lichen planus pigmentosus (LPP), Acanthosis nigricans(AN) and Acquired Nevus of Ota. Although reliable diagnosis can be made clinically in cases of acquired facial melanosis, histopathology is a useful tool and must be carried out where diagnosis is in doubt clinically for proper management and better prognosis.