Detailed answer

Melasma, a common acquired facial pigmentation disorder, can sometimes present with similar pigmentation patterns as tuberous sclerosis-related hypo-/hyperpigmentation. Both conditions may appear as brown patches on the skin. However, there are distinguishing features to consider. Melasma often occurs symmetrically on the face, particularly on the forehead, cheeks, and upper lip, and is more common in women with a history of sun exposure and hormonal changes. On the other hand, tuberous sclerosis-related pigmentation tends to affect other areas of the body, such as the trunk, and is associated with other characteristic signs of tuberous sclerosis complex (TSC), such as facial angiofibromas and brain lesions. To differentiate between melasma and tuberous sclerosis-related pigmentation, a thorough evaluation by a dermatologist is crucial. They may perform a detailed clinical examination, consider the patient's medical history, and possibly order additional tests such as skin biopsies or genetic testing for TSC if necessary.