Dermoscopy as a useful tool for evaluating melasma and assessing the response to 1064-nm Q-switched Nd:YAG laser.

BACKGROUND: Melasma is a hard-to-manage disorder with considerable relapsing behavior. Dermoscopy emerged to help in comprehensive evaluation of pigmentary disordes and melasma. OBJECTIVE: To evaluate the potential role of dermoscopy in assessing melasma and monitoring the efficacy of 1064-nm low-fluence Q-switched neodymium:yttrium-aluminum-garnet (QS Nd:YAG) laser. METHODS: 31 patients with facial melasma were included. A total of 5 laser sessions were done with 2-week intervals. Patients were evaluated at baseline and 2 weeks after the last session (at the 10th week) by; digital photography, modified melasma area and severity index (mMASI), colorimetry, as well as dermoscopic score for pigment and vascular elements. Adverse effects were reported. RESULTS: Post laser sessions, mMASI scores as well as the colorimetric melanin and erythema indices had showed significant improvement. The 'dermoscopic score of pigmentary and vascular elements' displayed significant change and confirmed the improvement. Side effects were tolerable. CONCLUSION: Modified-MASI, colorimetry and dermoscopy had ascertained the efficacy of low-fluence 1064-nm QS Nd:YAG laser in melasma, however, dermoscopy is superior to other assessments as it can help in the diagnosis of melasma besides the follow-up assessment and can precisely detect the detailed changes in response to treatment. This article is protected by copyright. All rights reserved.