A Young Woman with Facial Hyperpigmented Macules

A 27-year-old woman presented with hyperpigmented patches on the forehead and bilateral cheeks. The onset was one year earlier. Initially, she had erythematous macules then turned spontaneously into hyperpigmented patches. She was diagnosed with allergic contact dermatitites, treated with topical corticosteroid but there was no improvement. She has no specific personal medical history as well as no family history of autoimmune disorders. She is an accountant and a carefully history interrogation revealed no exposure to any new substance or new condition recently. She reported no arthralgia, no fever, no hair loss, no tiredness, no photosensitivity. Physical examination found some hyperpigmented macules and some of them had an atrophic center. On examination with a dermoscope, we observed follicular plugging, telangiectasia, and hyperkeratosis. No fluorescence was observed on Wood's lamp examination of this area. There’s no mucosal lesion.