Differential Diagnosis for Discoloration Brown Spots on Face
Single Most Likely Diagnosis
- Melasma: This condition is characterized by brown or gray patches on the face, particularly on the cheeks, forehead, and chin. It's often associated with hormonal changes and sun exposure, making it a common diagnosis for individuals, especially women, with a history of pregnancy or those using hormonal contraceptives.
Other Likely Diagnoses
- Solar Lentigines (Liver Spots): These are benign spots that appear due to sun exposure, typically on sun-exposed areas like the face and hands. They are more common in older adults and individuals with fair skin.
- Post-Inflammatory Hyperpigmentation (PIH): This condition occurs after inflammation or injury to the skin, leading to brown spots. It's common in individuals with acne, especially those who pick at their skin.
- Freckles (Ephelides): While typically lighter and more scattered, freckles can sometimes appear as brown spots, especially in individuals with fair skin and a history of sun exposure.
Do Not Miss Diagnoses
- Skin Cancer (Melanoma): Although less common, it's crucial to consider melanoma, especially if a brown spot is asymmetric, has irregular borders, color variation, diameter larger than 6mm, or is evolving. Early detection is key to treatment and survival.
- Addison's Disease: This rare endocrine disorder can cause hyperpigmentation, including brown spots on the face, due to increased levels of adrenocorticotropic hormone (ACTH). Other symptoms include fatigue, weight loss, and low blood pressure.
Rare Diagnoses
- Erythema Dyschromicum Perstans: A rare condition characterized by the gradual appearance of brown or grayish spots, typically on the face, without preceding inflammation. The cause is unknown, and it can be challenging to treat.
- Nevus of Ota: A congenital condition that presents as blue or brown pigmentation, usually on one side of the face, involving the area around the eye. It's due to melanocytes in the dermis and can be associated with glaucoma.
- Mastocytosis: A condition where there's an accumulation of mast cells in the skin, which can lead to brown spots or patches, among other symptoms like itching and flushing.