Background: Blaschko’s lines represent developmental pathways of ectodermal cell migration and are expressed clinically in several nevoid and linear dermatoses. In pigmented skin, Blaschkoiddermatoses frequently manifest with visible linearpigmentary alterations and patterned lesions that may cause aesthetic concern. Despite numerous case reports, systematic clinico-demographic studies evaluating their spectrum and cosmetic implications remain limited, particularly in the Indian population.

Objectives: To evaluate the clinico-demographic profile, morphological patterns, and disease spectrum of Blaschkoid dermatoses and highlight their relevance in clinical and aesthetic dermatology practice.

Methods: A hospital-based observational cross-sectional study was conducted over 12 months in the dermatology outpatient department of a tertiary care centre in Eastern India. Patients presenting with lesions distributed along Blaschko’s lines were enrolled after obtaining informed consent. Detailed demographic information, clinical characteristics, lesion distribution, pattern classification, and associated dermatoses were documented. Data were analysed using descriptive statistics

Results: A total of 68 patients were included. The most common age group was ≤10 years (47%), with a female predominance (male: female = 0.51:1).Most patients belonged to rural areas (60.3%). The mean age of onset was 9.21 years, with 38%presenting at birth or within the first year of life. Pigmentary changes were the most common presenting feature, followed by pruritus and cosmetic concern. Upper limbs were the most frequently affected sites, and right-sided involvement was slightly more common. The narrow-band pattern was the predominant subtype(83.8%). Lichen striatus (25%) was the most common diagnosis, followed by pigmentary mosaicism (14.7%) and verrucous epidermal nevus (11.8%).

Conclusion: Blaschkoid dermatoses represent a diverse group of conditions reflecting cutaneous mosaicism and embryologic development. Their frequent presentation with linear pigmentary alterations highlights their relevance at the dermatology–cosmetology interface. Recognition of these patterns is essential for accurate diagnosis, patient counselling, and appropriate management, particularly in individuals with pigmented skin, where cosmetic concerns are significant.

Madhab Datta is an Indian dermatologist based in Kolkata with over 7 years of clinical experience in skin, hair, and nail disorders. He holds an MBBS degree and an MD in Dermatology, Venereology, and Leprosy (DVL). He is known for treating a wide range of conditions, including acne, eczema, psoriasis, pigmentation disorders, and hair-related issues. He practices in clinical settings in Kolkata and is recognized for his patient-focused and skilled dermatological care.