Light Brown Raised Skin Patch: Differential Diagnosis (Melasma, PIH, SK, Skin Cancer)
A light-brown, slightly raised patch has several possible etiologies:
Benign Pigmented Lesions
- Melasma: Symmetric facial patches; hormonal (pregnancy, OCP), UV-triggered; epidermal/dermal/mixed
- Post-inflammatory hyperpigmentation (PIH): Follows acne, eczema, trauma, procedures; more in darker skin
- Solar lentigines (age/liver spots): Flat, discrete, UV-induced; face, hands, arms
- Seborrheic keratosis (SK): "Stuck-on," waxy, verrucous, variably pigmented; trunk, face; increases with age
Potentially Malignant
- Melanoma: Asymmetric, irregular border, color variation, diameter >6 mm, evolving (ABCDE)
- Pigmented basal cell carcinoma: Pearly, telangiectatic, may be pigmented
When to See a Dermatologist
- Any new/changing lesion >6 mm
- ABCDE features
- Bleeding, ulceration, rapid growth
- Personal/family history of skin cancer
- Immunosuppression
Dermoscopy enables non-invasive diagnosis. Biopsy if uncertain.
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