ABSTRACT
Introdução: O melasma representa a principal hipermelanose facial, sendo dermatose de considerável impacto psicossocial. Sob a lâmpada de Wood, a profundidade do pigmento melânico determina a fluorescência. Sob o exame dermatoscópico, a cor da melanina varia de acordo com sua localização nas camadas da pele. Objetivo: Avaliar a classificação do melasma através da dermatoscopia e correlacioná-la à classificação sob a lâmpada de Wood. b>Material e métodos: Análise de concordância entre os dois métodos na classificação do melasma. Quarenta pacientes foram avaliados por examinadores experientes através da lâmpada de Wood (Burton®) e dermatoscopia (videodermatoscópio BleyMed-Skincam® aumento 40x) e/ou dermatoscópio manual (3Gen Dermlite II ProHR® 10x), de forma independente. Pela dermatoscopia, considerou-se como tipo epidérmico: coloração acastanhada e rede pigmentar regular; dérmico: coloração cinza azulada e rede irregular, e misto: áreas compatíveis com ambos. Resultados: O grau de concordância entre os métodos foi considerado fraco (k < 0,2) pela análise estatística. Conclusão: Os autores consideraram a dermatoscopia mais apropriada, pois evidenciou de forma objetiva os componentes pigmentares.
Introduction: Melasma is the main cause of facial hyperchromia and has a signifi cant psychosocial impact. Wood´s lamp has been a useful device to estimate the depth of melanin determined by light-induced fl uorescence. A dermoscope enables a clear visualization of pigments distribution, and the color variation of melanin will depend on its location within the skin. Objective: Evaluate the classifi cation of melasma according to the depth of melanin by dermoscopy and to correlate the dermoscopic fi ndings with its classifi cation using Wood's lamp. Material and methods: Analysis of concordance between dermoscopy and Wood's lamp in the classifi cation of melasma. Forty patients were evaluated by expert examiners independently, using a Wood's lamp (Burton® UVA 360nm LE T5 4W BLB) and dermoscopy (Bley Med-Skincam® 40x or 3Gen Dermlite II ProHR® 10x). The melasma was considered epidermal when a regular pigment network, with a brownish homogeneous pigmentation was found; it was considered dermal when an irregular and mixed network with bluish-gray pigmentation was found; and it was considered mixed when the areas show both features. Results: The degree of concordance between the methods was considered weak (k < 0.2) by statistical analysis. Conclusions: The authors consider the dermoscopy more suitable, since it allowed the visualization of the pigmentary components in a more objective way.