Abstract
Melasma is easy to diagnose but a difficult and challenging to manage clinical condition. It is not usual and necessary to take a biopsy to prove that it is melasma. On the basis of circumscribed hyperpigmented macules or patches affecting the face, neck, and arms, almost symmetrically, the following are the most common differential diagnoses to consider:
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Postinflammatory hyperpigmentation
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Exogenous ochronosis
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Acquired bilateral nevus of ota-like macules (Hori’s nevus)
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Solar lentigines
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Drug-induced pigmentation, e.g., due to minocycline or nonsteroidal anti-inflammatory drugs
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Actinic lichen planus
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Erythema dyschromicum perstans (ashy dermatosis)
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Riehl’s melanosis
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Ephelides (freckles)
A good meticulous history, physical examination, and skin biopsy when in doubt should lead us to the correct diagnosis and management of melasma.
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Handog, E.B., Enriquez-Macarayo, M.J. (2017). Differential Diagnosis of Melasma in Brown Skin. In: Handog, E., Enriquez-Macarayo, M. (eds) Melasma and Vitiligo in Brown Skin. Springer, New Delhi. https://doi.org/10.1007/978-81-322-3664-1_9
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