PMC10457460_01
(A) Hyperpigmented macules at the level of the V1 and V2 nerves on the forehead and right cheek. (B) Hyperpigmented macules on the forehead. (C) Hyperpigmented macules on the right cheek.
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A 35-year-old Indonesian woman of Sundanese ethnicity presented with brownish hyperpigmented macules at the level of the V1 and V2 nerves on the forehead and right cheek (Figure 1).
Histopathological features of a punch biopsy of the hyperpigmented macule on the right cheek showed an increase in melanin pigmentation in the basal layer of the epidermis (red circle).
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Histopathological examination showed increased melanin pigmentation in the basal layer of the epidermis and inflammatory cell lymphocytes in the papillary dermis fibrocollagenous connective tissue (Figure 2), which confirmed the diagnosis of PUL in the forehead and right cheek.  
Comparison of hyperpigmented macules on the forehead and right cheek. (A) Before treatment. (B) After one session of treatment. (C) After two sessions of treatment.
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The hyperpigmented macules reduced and faded after one session of treatment (Figures 3A and B), and the spectrophotometry L* values became 57.04, 59.38, and 60.1 on the right forehead, upper right cheek, and lower right cheek, respectively (Figure 4). Significant improvement was observed after the two treatment sessions (Figure 3C).
The L* values of spectrophotometry.
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The hyperpigmented macules reduced and faded after one session of treatment (Figures 3A and B), and the spectrophotometry L* values became 57.04, 59.38, and 60.1 on the right forehead, upper right cheek, and lower right cheek, respectively (Figure 4). Spectrophotometry L* values were increased to 57.77, 59.56, and 61.45 on the right forehead, upper right cheek, and lower right cheek, respectively (Figure 4).