Clinical and dermoscopic study of periorbital hyperpigmentation (POH) and quality of life in POH patients based on the MELASQOL scale: a case-control study

Background: Periorbital hyperpigmentation (POH), a common problem of multifactorial etiology, is obvious on the face and can affect patients’ quality of life (QoL). It is essentially a clinical diagnosis, but dermoscopy might aid in further classification of the disease. Also, it might give us a clue regarding the etiology and help in the treatment, as different types of POH respond to varying treatments. We aimed to assess clinical, dermoscopic patterns and quality of life using the Melasma Quality of Life (MELASQOL) scale in POH and to compare it with controls. Methods: Detailed histories were obtained from 100 patients with POH. The clinical and dermoscopic examination was done, and the obtained results were compared against 100 controls. The MELASQOL scale was used to assess QoL. Results: Family history (P = 0.013), lack of sleep (P = 0.003), stress (P = 0.001), and eye rubbing (P = 0.01) were the probable risk factors. Blotchy pattern (P < 0.0001), speckled pattern (P < 0.0001), and telangiectasia (P = 0.007) were the significant dermoscopic findings. Controls showed pseudoreticular (P < 0.001) and superficial dilated veins (P < 0.0001). Quality of life was affected in 30.6% of patients; it was more affected in grade 4 POH. Conclusion: Dermoscopy will aid in the classification of POH. Blotchy pattern, speckled pattern, and telangiectasia are the typical dermoscopic patterns, more so in higher grades. QoL may be affected in POH. However, MELASQOL is not adequate to assess QoL in POH.