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Subjects/Dermatology/Melasma
Melasma
easy
hand Dermatology

A 30-year-old pregnant woman presents with symmetrical, hyperpigmented macules and patches on her cheeks, forehead, and upper lip. The lesions are brownish-gray and have irregular borders. Which of the following is the most likely diagnosis?

A. A. Melasma
B. B. Post-inflammatory hyperpigmentation
C. C. Lentigo simplex
D. D. Café-au-lait macule

Explanation

This clinical presentation is classic for melasma, often triggered or exacerbated by pregnancy (chloasma). It typically presents as symmetrical, brownish-gray macules and patches on sun-exposed areas of the face, particularly the malar areas, forehead, and upper lip. Post-inflammatory hyperpigmentation usually follows an inflammatory event and may not be symmetrical or have this specific distribution. Lentigo simplex are small, discrete, dark brown macules, not typically large patches. Café-au-lait macules are usually present from birth or early childhood, are light brown, and have smooth borders.

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