目的 儿童面部获得性色素沉着斑（AFHM）位于面部，影响美观，常引起患儿家长的关注和焦虑；但是临床医师对此病认识不足，漏诊和误诊并不少见。本研究旨在总结AFHM的临床及皮肤镜特征，以增进临床医师对此病的了解。方法 采用回顾性研究方法，收集2021年11月至2023年6月医院皮肤科确诊的54例AFHM患儿的临床资料，总结其临床表现，包括患者的构成、皮疹的特征以及皮肤镜下表现，并进行描述性统计分析。结果 患儿男女比例1.7∶1，发病中位年龄8（5~10）个月。在完成至少2年随访的33例患儿中，90.91%（30例）皮疹完全消退，平均消退年龄3.17±0.75岁。皮疹主要累及额部（90.74%）、颞部（70.37%）及眉部（53.70%），74.07%患儿累及2~3个部位。皮疹数目以10~20个为主（53.70%），长轴多为2~10 mm（70.37%）。92.59%的患儿皮疹呈双侧分布，61.11%秋季发病。皮肤镜下，88.89%的患儿可见棕红色假网状色素沉着斑伴毛细血管扩张。结论 AFHM是婴幼儿良性自限性皮肤病，临床表现和皮肤镜特征具有特异性。对于大多数病例，皮肤活检并非必要诊断步骤。

Objective Acquired facial hyperpigmented macules (AFHM) in children are localized to the face, affecting aesthetics and often causing concern and anxiety among parents. However, due to insufficient clinical awareness, misdiagnosis and missed diagnosis are not uncommon. This study aims to summarize the clinical and dermoscopic features of AFHM to improve clinicians' understanding of this condition. Methods A retrospective study was conducted, collecting clinical data from 54 pediatric patients diagnosed with AFHM at the Dermatology Department of Hospital between November 2021 and June 2023. The clinical manifestations, including patient demographics, rash characteristics, and dermoscopic findings, were summarized and analyzed using descriptive statistics. Results The male-to-female ratio was 1.7∶1, with a median onset age of 8 months (IQR: 5-10). Among the 33 patients who completed at least 2 years of follow-up, 90.91% (30 cases) experienced complete resolution of the lesions, with a mean resolution age of 3.17±0.75 years. The rashes predominantly affected the forehead (90.74%), temples (70.37%), and eyebrows (53.70%), with 74.07% of cases involving 2-3 sites. The number of lesions was mostly 10-20 (53.70%), with the long axis typically measuring 2-10 mm (70.37%). Bilateral distribution was observed in 92.59% of cases, and 61.11% had onset in autumn. Dermoscopy revealed brownish-red pseudo-reticular pigmented macules with telangiectasia in 88.89% of patients. Conclusion AFHM is a benign, self-limiting dermatosis in infants and young children, with distinctive clinical and dermoscopic features. For most cases, skin biopsy is not a necessary diagnostic step.