Clinical Characteristics, Dermoscopic Features and Prognosis of Acquired Facial Pigmented Macules in Young Children: A Retrospective Analysis of 160 Cases.

Objective: To investigate the clinical manifestations, dermoscopic features, and long-term prognosis of acquired facial pigmented macules in young children, and to provide evidence for clinical diagnosis and management. Patients and Methods: A retrospective study was conducted on 160 children diagnosed with acquired facial pigmented macules at the Dermatology Outpatient Clinic of the Children's Hospital of Nanjing Medical University between January 2017 and September 2025. Clinical data, including sex, age of onset, lesion distribution, color, morphology, and dermoscopic features, were analyzed. Follow-up was performed during outpatient visits or during WeChat to assess lesion regression and prognosis. Results: The male-to-female ratio was 1.46:1, with a mean onset age of (0.66 ± 0.35) years, mostly within 6-8 months after birth. Lesions were irregular brown or brownish-red macules (4mm-3cm, mainly 4mm-1cm), predominantly located on the forehead and temporal regions. Two dermoscopic patterns were identified: a non-infiltrating pattern (pseudogrid-like brown pigmentation with linear or punctate telangiectasia), and an infiltrating pattern (pseudogrid-like brown pigmentation without vascular changes). Among 110 followed-up children, 93.64% achieved complete lesion regression at a mean age of (2.82 ± 0.69) years, mostly within 4 years old. Conclusion: Acquired facial pigmented macules in young children are benign, self-limiting disorders with characteristic clinical and dermoscopic findings. Spontaneous regression occurs in most cases and no specific treatment is required.