Melasma is an acquired epidermal pigmentation disorder with lesions located in the epidermis and superficial dermis, manifesting as symmetrically distributed hyperpigmented spots. Dermoscopic examination reveals light yellowish brown patches of varying color shades and sizes, which are irregularly shaped, reticular or honeycomb. Chloasma lesions may show pathological changes of capillary dilatation and inflammatory cell infiltration, which are manifested as capillary network and light red patches under dermoscopy. Melasma dermatopathology is characterized by increased melanin content in the epidermis and increased number and density of melanocytes. Chloasma is usually easy to diagnose if the morphology and distribution of lesions are typical; if the morphology and distribution of lesions are atypical, such as small lesion area and atypical site of onset, it is difficult to diagnose accurately. Therefore, it is recommended to consult hospitals to avoid delay in treatment.