Journal of Asia Pacific Aesthetic Sciences

Abstract: Dermoscopy reveals diagnostic details not discernible to the naked eye. This non-invasive tool is particularly useful in the evaluation of hypomelanotic dermatoses, where subtle pigmentary changes often pose diagnostic challenges. Assessing vascular, pigmentary, and structural features aids in differentiating various hypomelanotic macular conditions. This study aimed to characterize the dermoscopic features of common hypomelanotic skin conditions in a tertiary hospital and to evaluate the diagnostic utility of dermoscopy in reducing reliance on skin biopsies. An observational descriptive study was conducted over three months, involving patients with newly developed hypomelanotic patches and macules. All patients underwent clinical evaluation and dermoscopic examination using a handheld DermLite DL3N. Dermoscopic assessment included evaluation of pigmentation changes, lesion edge definition, scaling, perifollicular and perilesional pigmentation, hair color changes, vascular morphology, and distinctive dermoscopic patterns. The mean age of the patients was 28.82 ± 13.01 years. Of the cohort, 26 (54.2%) were male and 22 (45.8%) were female. Diagnoses included pityriasis versicolor (n=27, 56.3%), vitiligo (n=11, 22.9%), pityriasis alba (n=9, 18.8%), and nevus depigmentosus (n=1, 2.1%). This study highlights dermoscopy as a valuable diagnostic tool for hypomelanotic macular diseases, particularly in resource-limited rural settings with restricted access to histopathology. While not definitive for all hypomelanotic conditions, its integration with clinical evaluation may improves diagnostic accuracy and provides a practical alternative to invasive procedures, supporting its role in standard dermatologic practice.

Keywords: Dermoscopy, Hypopigmented, Vitiligo, Pityriasis versicolor, Pityriasis alba, Nevus depigmentosus