Clinical and Dermoscopic Evaluation of Periorbital Melanosis and Its Psychological Impact and Effect on Quality of Life: A Descriptive Study.

INTRODUCTION

Periorbital melanosis (POM) is a poorly defined condition that is becoming an increasing aesthetic concern. With its multifactorial origin, it necessitates a thorough assessment of targeted multimodal treatments. The psychological impact and underlying pathogenesis have been underexplored, as evidenced by the gap between the roughly 100 indexed articles and the 150 million search engine results on treatments for dark circles. This descriptive study aims to explore the clinical and dermoscopic evaluation of POM and its impact on quality of life.

METHODS

This descriptive prospective, tertiary hospital-based study included 250 patients with POM attending the Dermatology Outpatient Department. After obtaining informed consent, patients were subjected to clinical assessment, hematological investigations, and Wood's lamp (by Dermaindia, Chennai, India) examination. The dermatoscopic examination was done using a Dino-Lite video dermatoscope AF4515ZT+WF-20 (AnMo Electronics Corporation, Taipei, Taiwan). Quality of life was measured using the Melasma Quality of Life (MELASQoL) scale, and the psychological impact was assessed using the Perceived Stress Scale (PSS) and Body Dysmorphic Disorder Questionnaire-Dermatology Version (BDDQ-DV).

RESULTS

Among 250 patients, 179 (71.6%) were female and 71 (28.4%) were male, with a mean age of 30.53±9.29 years and a disease duration of 6.82±5.04 years. Constitutional POM was the most common type observed in 219 (87.6%) patients. Dermoscopy showed blotches in 166 (66.4%), telangiectasia in 211 (84.4%), and exaggerated skin markings in 17 (6.8%), and no atrophic changes were observed. Mean MELASQoL and PSS scores were 25.63±10.52 and 16.64±3.27, respectively; four (1.6%) patients had body dysmorphic disorder.

CONCLUSION

POM has a complex etiology with multiple underlying mechanisms. Thorough clinical assessment enables accurate diagnosis and a targeted treatment approach. Thus, unnecessary medications and procedures can be avoided by first understanding the underlying pathophysiology. Further studies are warranted in the Indian population with POM, as the skin type, demography, and socioeconomic status are diverse. Various proposed classifications are available but do not cater to the Indian skin type; hence, further research is due.