Hyperpigmentation conditions are widespread, especially among individuals with skin of color. According to studies, over 65% of Black or African American patients have experienced at least one instance of hyperpigmentation due to skin damage or irritation. Melasma and post-inflammatory hyperpigmentation are the most common forms of hyperpigmentation in patients with skin of color, while other conditions, such as lichen planus and erythema dyschromicum perstans can be more severe and cause substantial morbidity in this patient cohort. Therefore, it is essential to have an accurate and prompt diagnosis to manage these conditions precisely. 

Pagan et al presented an updated review of the latest information on dermoscopy, reflectance confocal and conventional light microscopy in diagnosing hyperpigmentation disorders in skin of color. The authors also highlighted the pros and cons of these techniques, focusing on their accuracy and potential to evaluate favorable treatment outcomes. The review contained recent investigations that compared these diagnostic techniques across various hyperpigmentation disorders and practical discoveries that can be employed in everyday practice.

The authors acknowledged that cost, clinician training and device availability are critical factors when selecting the ideal diagnostic tool and provided varied approaches to improve accuracy. Recent technological advances have made diagnosing and treating hyperpigmentation skin conditions easier. Noninvasive and better reliable techniques, like dermoscopy and reflectance confocal microscopy, are promising adjuncts to guide laser and light therapies and scan treatment responses in dermatology clinics and clinical trials.

Healthcare providers must be insightful about the latest diagnostic techniques available to them to provide better care to patients and improve outcomes for those with hyperpigmentation disorders.

Source: Pagan AD, Mitchell K, Yousif J, Henry M. Diagnostic tools for hyperpigmentation disorders in skin of color: an updated review. Dermatol Rev. 2022. https://doi.org/10.1002/der2.146