Clinico-dermoscopic study and comparative evaluation with Wood’s Lamp as a diagnostic tool in patients with melasma

Background: Melasma is a common acquired facial hypermelanosis. While mostly diagnosable clinically, Wood’s lamp and dermoscopy can aid in differentiating melasma types based on pigment distribution. Aims: To study the clinico-dermoscopic distribution of melasma and compare it with Wood’s lamp finding. Methods: A total of 140 patients with melasma attending the Dermatology OPD of a tertiary care hospital over a duration of 12 months were included in this cross-sectional analytical study. Patients were subjected to clinical examination, Wood’s lamp examination, and dermatoscopic examination. Noted findings were recorded and analyzed for descriptive values and associations. Results: Among 140 patients, 123 were females and 17 were males, with a mean age of 33.49 ± 7.65 years. Clinically, 78 (55.7%) had centrofacial distribution, 55 (39.3%) had malar distribution, and 7 (5%) had a mandibular distribution of lesions. Wood’s lamp examination showed epidermal type in 64 (47.71%), mixed type in 60 (42.9%), and dermal type in 16 (11.4%). Dermoscopic examinations revealed an epidermal pattern in 79 (56.42%), a dermal pattern in 6 (4.2%), and a mixed type in 55 (39.28%). The most common dermoscopic finding was an exaggerated pseudoreticular network, followed by reticuloglobular pattern, arciform structures, and patternless hyperpigmentations, respectively. The association between color on clinical examination and melasma type by dermoscopy was significant (Cramer’s V = 0.535, P-value = 0.000). The degree of agreement between Wood’s lamp examination and dermoscopic examination was significant with a moderate agreement, (κ = 0.548 P < 0.0005). Conclusion: Although dermoscopy can be used more effectively, both Wood’s lamp and dermoscopy can aid in the diagnosis and determination of pigment distribution in melasma, promising effective intervention, and prognosis assertion.