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Chessa MA, Patrizi A, Baraldi C, Fanti PA, Barisani A, Vaccari S. Dermoscopic-Histopathological Correlation of Eccrine Poroma: An Observational Study. Dermatol Pract Concept 2019; 9:283-291. [PMID: 31723462 DOI: 10.5826/dpc.0904a07] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2019] [Indexed: 12/19/2022] Open
Abstract
Background Eccrine poroma (EP) is a benign adnexal neoplasm that can be pigmented in 17% of cases. Four histopathological variants of EP exist. Dermoscopically, EP can mimic many other skin neoplasms. Objectives To provide a dermoscopic-histopathological correlation of EP, classifying the clinical and dermoscopic features of EPs on the basis of their histopathological subtype, in an attempt to better characterize these entities. Patients and Methods A single-center retrospective study was conducted. Clinical data were collected; patients were classified on the basis of the 4 histopathological variants of EPs. Dermoscopic images were reviewed. A dermoscopic-histopathological correlation was performed, and the results were compared with literature data. Results Twenty-six lesions were included, both pigmented and nonpigmented. Three of the 4 histopathological variants were identified. Different dermoscopic features were observed for each distinct histopathological subtype of EP. The lesions mimicked different types of other skin neoplasms, in particular: nonpigmented hidroacanthoma simplex resembled nonmelanoma skin cancer; pigmented hidroacanthoma simplex appeared like a seborrheic keratosis or a solar lentigo; EPs sensu stricto presented as pink nodules if nonpigmented and were similar to seborrheic keratosis if pigmented; dermal duct tumors appeared as pigmented nodular lesions. Conclusions Distinct dermoscopic features appeared to be recurrent in each histopathological variant. Dermoscopy can provide important clues for the diagnosis of EP; the final diagnosis is allowed by histopathology. To achieve a correct diagnosis of EP, because of its clinical and dermoscopic variability, surgical excision is recommended.
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Affiliation(s)
- Marco A Chessa
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
| | - Annalisa Patrizi
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
| | - Carlotta Baraldi
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
| | - Pier Alessandro Fanti
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
| | - Alessia Barisani
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
| | - Sabina Vaccari
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
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Errichetti E, Zalaudek I, Kittler H, Apalla Z, Argenziano G, Bakos R, Blum A, Braun RP, Ioannides D, Lacarrubba F, Lazaridou E, Longo C, Micali G, Moscarella E, Paoli J, Papageorgiou C, Russo T, Scope A, Stinco G, Thomas L, Toncic RJ, Tschandl P, Cabo H, Hallpern A, Hofmann-Wellenhof R, Malvehy J, Marghoob A, Menzies S, Pellacani G, Puig S, Rabinovitz H, Rudnicka L, Vakirlis E, Soyer P, Stolz W, Tanaka M, Lallas A. Standardization of dermoscopic terminology and basic dermoscopic parameters to evaluate in general dermatology (non-neoplastic dermatoses): an expert consensus on behalf of the International Dermoscopy Society. Br J Dermatol 2019; 182:454-467. [PMID: 31077336 DOI: 10.1111/bjd.18125] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Over the last few years, several articles on dermoscopy of non-neoplastic dermatoses have been published, yet there is poor consistency in the terminology among different studies. OBJECTIVES We aimed to standardize the dermoscopic terminology and identify basic parameters to evaluate in non-neoplastic dermatoses through an expert consensus. METHODS The modified Delphi method was followed, with two phases: (i) identification of a list of possible items based on a systematic literature review and (ii) selection of parameters by a panel of experts through a three-step iterative procedure (blinded e-mail interaction in rounds 1 and 3 and a face-to-face meeting in round 2). Initial panellists were recruited via e-mail from all over the world based on their expertise on dermoscopy of non-neoplastic dermatoses. RESULTS Twenty-four international experts took part in all rounds of the consensus and 13 further international participants were also involved in round 2. Five standardized basic parameters were identified: (i) vessels (including morphology and distribution); (ii) scales (including colour and distribution); (iii) follicular findings; (iv) 'other structures' (including colour and morphology); and (v) 'specific clues'. For each of them, possible variables were selected, with a total of 31 different subitems reaching agreement at the end of the consensus (all of the 29 proposed initially plus two more added in the course of the consensus procedure). CONCLUSIONS This expert consensus provides a set of standardized basic dermoscopic parameters to follow when evaluating inflammatory, infiltrative and infectious dermatoses. This tool, if adopted by clinicians and researchers in this field, is likely to enhance the reproducibility and comparability of existing and future research findings and uniformly expand the universal knowledge on dermoscopy in general dermatology. What's already known about this topic? Over the last few years, several papers have been published attempting to describe the dermoscopic features of non-neoplastic dermatoses, yet there is poor consistency in the terminology among different studies. What does this study add? The present expert consensus provides a set of standardized basic dermoscopic parameters to follow when evaluating inflammatory, infiltrative and infectious dermatoses. This consensus should enhance the reproducibility and comparability of existing and future research findings and uniformly expand the universal knowledge on dermoscopy in general dermatology.
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Affiliation(s)
- E Errichetti
- Institute of Dermatology, 'Santa Maria della Misericordia' University Hospital, Udine, Italy
| | - I Zalaudek
- Department of Dermatology, University of Trieste, Trieste, Italy
| | - H Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Z Apalla
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - G Argenziano
- Dermatology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - R Bakos
- Department of Dermatology, Hospital de Clınicas de Porto Alegre, Porto, Alegre, Brazil
| | - A Blum
- Public, Private and Teaching Practice of Dermatology, Konstanz, Germany
| | - R P Braun
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - D Ioannides
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - F Lacarrubba
- Dermatology Clinic, University of Catania, Catania, Italy
| | - E Lazaridou
- Second Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
| | - C Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - G Micali
- Dermatology Clinic, University of Catania, Catania, Italy
| | - E Moscarella
- Dermatology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - J Paoli
- Department of Dermatology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - C Papageorgiou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - T Russo
- Dermatology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - A Scope
- Medical Screening Institute, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - G Stinco
- Institute of Dermatology, 'Santa Maria della Misericordia' University Hospital, Udine, Italy
| | - L Thomas
- Department of Dermatology, Lyon University, Lyon, France
| | - R J Toncic
- Dermoscopy Unit, University of Zagreb, Zagreb, Croatia
| | - P Tschandl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - H Cabo
- Dermatology Institute of Medical Research, University of Buenos Aires, Buenos Aires, Argentina
| | - A Hallpern
- Memorial Sloan Kettering Cancer Center, Hauppauge, NY, U.S.A
| | | | - J Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Universitat de Barcelona IDIBAPS, Barcelona, Spain
| | - A Marghoob
- Memorial Sloan Kettering Cancer Center, Hauppauge, NY, U.S.A
| | - S Menzies
- Discipline of Dermatology, Sydney Medical School, The University of Sydney and Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - S Puig
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Universitat de Barcelona IDIBAPS, Barcelona, Spain
| | - H Rabinovitz
- Skin and Cancer Associates, Plantation, FL, U.S.A
| | - L Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - E Vakirlis
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - P Soyer
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Woolloongabba, QLD, Australia
| | - W Stolz
- Department of Dermatology and Allergology and Environmental Medicine Clinic Thalkirchen, Hospital Munich, Munich, Germany
| | - M Tanaka
- Department of Dermatology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
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Novel antipsoriatic fluidized spanlastic nanovesicles: In vitro physicochemical characterization, ex vivo cutaneous retention and exploratory clinical therapeutic efficacy. Int J Pharm 2019; 568:118556. [PMID: 31348982 DOI: 10.1016/j.ijpharm.2019.118556] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 07/15/2019] [Accepted: 07/22/2019] [Indexed: 12/20/2022]
Abstract
Tazarotene (TAZ) is a topical synthetic retinoid used in psoriasis treatment, however, it is extremely lipophilic and exhibits skin irritation. Research is in a state of continuous advancement in the field of nanocarriers fabrication, and in this regard, we investigated the formulation of novel topically oriented nanovesicles; representing a combination of spanlastics and penetration enhancer vesicles, to be termed (fluidized-SNs). TAZ-loaded fluidized SNs were physicochemically characterized, tested for ex vivo cutaneous retention, and the selected formulation was compared with the marketed product Acnitaz® regarding clinical antipsoriatic activity. The selected fluidized-SNs enriched with 1% cineole exhibited high entrapment for TAZ (76.19%), suitable size and zeta potential of 241.5 ± 5.68 nm and -36.10 ± 2.50 mV respectively, and retaining of stability after refrigeration storage for one month. As hypothesized, cineole enriched fluidized-SNs exhibited remarkable TAZ deposition amounting to a total of 81.51% in the different skin layers. Upon clinical assessment, the presented formulation displayed superior traits compared to the marketed product, in terms of dermoscopic imaging, morphometric analysis of psoriatic lesions, and statistical analysis of PASI scores. Results confirmed that the prepared novel fluidized spanlastics formulation holds great promise for the treatment of psoriasis, and its benefit should futuristically be investigated in other topical diseases.
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54
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van Erp PEJ, Peppelman M, Falcone D. Noninvasive analysis and minimally invasive in vivo experimental challenges of the skin barrier. Exp Dermatol 2019; 27:867-875. [PMID: 30019358 DOI: 10.1111/exd.13743] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/27/2018] [Accepted: 07/13/2018] [Indexed: 12/19/2022]
Abstract
In this review, we aim to give a concise and selective overview of noninvasive biophysical analysis techniques for skin barrier analysis (transepidermal water loss, electrical methods, confocal Raman microspectroscopy, sebumeter, reflectance spectrophotometry, tristimulus colorimetry, diffuse reflectance spectroscopy and reflectance confocal microscopy), including advantages and limitations. Rather than giving an exhaustive description of the many techniques currently available, we show the usefulness of a representative selection of techniques in the functional and morphological evaluation of the skin barrier. Furthermore, we introduce human minimally invasive skin challenging models as a means to study the mechanisms regulating skin homoeostasis and disease and subsequently show how biophysical analysis techniques can be combined with these in vivo skin challenging models in the functional and morphological evaluation of the skin barrier in healthy human skin. We are convinced that the widespread application of biophysical analysis techniques in dermatological practice and in cosmetic sciences will prove invaluable in offering personalized and noninvasive skin treatment solutions. Furthermore, combining the human in vivo challenging models with these novel noninvasive techniques will provide valuable methodology and tools for detailed characterization of the skin barrier in health and disease.
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Affiliation(s)
- Piet E J van Erp
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Malou Peppelman
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Denise Falcone
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
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Calderón-Castrat X, Kikushima I, Ballona R. Multiple Acral Papules. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:855-856. [PMID: 31130243 DOI: 10.1016/j.ad.2018.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/27/2018] [Accepted: 05/01/2018] [Indexed: 10/26/2022] Open
Affiliation(s)
- X Calderón-Castrat
- Servicio de Dermatología Pediátrica, Instituto Nacional de Salud del Niño San Borja, Lima, Perú.
| | - I Kikushima
- Servicio de Dermatología Pediátrica, Instituto Nacional de Salud del Niño Breña, Lima, Perú
| | - R Ballona
- Servicio de Dermatología Pediátrica, Instituto Nacional de Salud del Niño Breña, Lima, Perú
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56
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García-García B, Munguía-Calzada P, Aubán-Pariente J, Argenziano G, Vázquez-López F. Dermoscopy of lichen planus: Vascular and Wickham striae variations in the skin of colour. Australas J Dermatol 2019; 60:301-304. [PMID: 30982948 DOI: 10.1111/ajd.13052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 03/13/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Begoña García-García
- Department of Dermatology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Pablo Munguía-Calzada
- Department of Dermatology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Javier Aubán-Pariente
- Department of Dermatology, Hospital Universitario Central de Asturias, Oviedo, Spain
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Widaty S, Pusponegoro EH, Rahmayunita G, Astriningrum R, Akhmad AM, Oktarina C, Miranda E, Agustin T. Applicability of Trichoscopy in Scalp Seborrheic Dermatitis. Int J Trichology 2019; 11:43-48. [PMID: 31007472 PMCID: PMC6463453 DOI: 10.4103/ijt.ijt_86_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Introduction: Seborrheic dermatitis (SD) is a chronic-recidive inflammatory skin disorder with predilection in areas rich of sebaceous gland. The most common clinical manifestations are pruritus and scales. Although SD can be diagnosed without special tools, other examinations may be needed to determine additional specific therapy. Trichoscopy is one of the noninvasive tools which can help to diagnose SD as it can provide the microstructure view of the scalp. Materials and Methods: This descriptive study was conducted to explore the trichoscopic features of SD and its characteristics. There were 96 SD patients enrolled in this study. The scalp was divided into four areas, and each area was scored based on Seborrheic Area Severity Index, comprising erythema, desquamation, number of papules, and percentage of lesion area. The most severe area was examined with a trichoscopy to observe the characteristics of hair and scalp. The association between trichoscopic findings and SD severity was analyzed with Fisher's exact test. Results: Overall, the participants were 36% males and 64% females with the mean age of 30 (13–70) years old. Based on the trichoscopic examination, the most common findings were thick hair shafts (72%), white scales (69%), arborizing thin vessels (38%), yellowish area (36%), and structureless red area (19%). These findings were not significantly different between mild and moderate SD (P > 0.05). Conclusion: Considering the merits and demerits of trichoscopic examination, it can be helpful to aid the diagnosis of SD. Further studies in Asian population with greater sample size are needed to demonstrate more significant result.
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Affiliation(s)
- Sandra Widaty
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Erdina Hd Pusponegoro
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Githa Rahmayunita
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Rinadewi Astriningrum
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Adinda Meidisa Akhmad
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Caroline Oktarina
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Eliza Miranda
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Triana Agustin
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
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58
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Al-Refu K. Dermoscopy is a new diagnostic tool in diagnosis of common hypopigmented macular disease: A descriptive study. Dermatol Reports 2018; 11:7916. [PMID: 31119026 PMCID: PMC6509478 DOI: 10.4081/dr.2018.7916] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 11/29/2018] [Indexed: 12/20/2022] Open
Abstract
One of the most frequent complaints in dermatology clinics is the eruption of hypopigmented patchy skin lesions. The aim of the study was to investigate the utility of dermoscopy in common hypopigmented macular diseases. Patients with the followings diseases were examined by dermoscopy: vitiligo, pityriasis alba, nevus depigmentosus, achromic pityriasis versicolor, idiopathic guttate hypomelanosis, and extragenital guttate lichen sclerosus. This study showed that these hypopigmented macular diseases might display specific dermoscopic features. In vitiligo, the mean dermoscopic features were the presence of a diffuse white glow with perifollicular pigment, perilesional hyperpigmentation, leukotrichia and the pigmentary network. In idiopathic guttate hypomelanosis, the characteristic features were the presence of multiple, shiny, scaly macules with welland ill-defined edges borders that coalesced into polycyclic macules. For nevus depigmentosus, the mean features were hypopigmented patches with irregular border with a faint reticular network. For pityriasis alba, the fairly ill-demarcated hypopigmented macules with fine scales were the mean feature. In lichen sclerosus, there were white structureless areas, perilesional erythematous halo, follicular plugging and white chrysalis like structures. Dermoscopy of achromic pityriasis versicolor showed a fairly demarcated white area with fine scales localized in the skin creases.
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59
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Jayasree P, Malakar S, Raja H, Gopinathan Nair N. Dermoscopic features in nodular chromoblastomycosis. Int J Dermatol 2018; 58:e107-e109. [PMID: 30565211 DOI: 10.1111/ijd.14344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/08/2018] [Accepted: 11/23/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Puravoor Jayasree
- Department of Dermatology, Medical Trust Hospital, Cochin, Kerala, India
| | | | - Haritha Raja
- Department of Pathology, Medical Trust Hospital, Cochin, Kerala, India
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Sgouros D, Apalla Z, Ioannides D, Katoulis A, Rigopoulos D, Sotiriou E, Stratigos A, Vakirlis E, Lallas A. Dermoscopy of Common Inflammatory Disorders. Dermatol Clin 2018; 36:359-368. [PMID: 30201145 DOI: 10.1016/j.det.2018.05.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In addition to its "traditional" application for the early diagnosis of melanoma and nonmelanoma skin cancers, dermoscopy gains appreciation in fields beyond dermato-oncology. Nowadays, dermoscopy has been established as a reliable adjunctive tool to the everyday clinical practice of general dermatology. Morphology and distribution of vascular structures, background colors, follicular abnormalities, and the presence of scales are important features that should be evaluated. Clinical examination remains the undoubted mainstay of diagnosis in inflammatory and infectious diseases.
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Affiliation(s)
- Dimitrios Sgouros
- 2nd Department of Dermatology - Venereology, National Kapodistrian University of Athens, ATTIKON University Hospital, 1 Rimini Street, Chaidari, Athens 12462, Greece
| | - Zoe Apalla
- 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece
| | - Dimitrios Ioannides
- 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece
| | - Alexander Katoulis
- 2nd Department of Dermatology - Venereology, National Kapodistrian University of Athens, ATTIKON University Hospital, 1 Rimini Street, Chaidari, Athens 12462, Greece
| | - Dimitrios Rigopoulos
- 1st Department of Dermatology - Venereology, National Kapodistrian University of Athens, A. Syggros Hospital, 5 I.Dragoumi Street, Athens 16121, Greece
| | - Elena Sotiriou
- 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece
| | - Alexander Stratigos
- 1st Department of Dermatology - Venereology, National Kapodistrian University of Athens, A. Syggros Hospital, 5 I.Dragoumi Street, Athens 16121, Greece
| | - Efstratios Vakirlis
- 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece
| | - Aimilios Lallas
- 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece.
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61
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Naspolini AP, Rocha Barone C, Prieto Herman Reinehr C, Bakos RM. Periumbilical purpura: dermatoscopic findings in disseminated strongyloidiasis. Int J Dermatol 2018; 57:e30-e31. [PMID: 29740812 DOI: 10.1111/ijd.14033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/09/2018] [Accepted: 04/10/2018] [Indexed: 01/11/2023]
Affiliation(s)
- Ana P Naspolini
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Carolina Rocha Barone
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Renato M Bakos
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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62
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Dermoscopy of chondrodermatitis nodularis helicis. Arch Dermatol Res 2018; 310:551-560. [DOI: 10.1007/s00403-018-1844-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 06/10/2018] [Accepted: 06/14/2018] [Indexed: 11/26/2022]
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Abstract
Tinea manuum is a dermatophytosis which is often mistaken for other keratodermas, especially palmar psoriasis and chronic hand eczema. We report the use of dermoscopy as a diagnostic aid in a case of tinea manuum. The dermoscopic clue turned out to be the presence of whitish scaling located mainly in the furrows. This aspect has never been seen in other keratodermas and therefore can be considered as a useful finding to assist in the recognition of tinea manuum.
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Affiliation(s)
- Enzo Errichetti
- Department of Experimental and Clinical Medicine, Institute of
Dermatology, University of Udine, Udine, Italy
| | - Giuseppe Stinco
- Department of Experimental and Clinical Medicine, Institute of
Dermatology, University of Udine, Udine, Italy
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64
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The Rejuvenating Effect and Tolerability of an Auto-Cross-Linked Hyaluronic Acid on Décolletage: A Pilot Prospective Study. Aesthetic Plast Surg 2018; 42:520-529. [PMID: 29218478 DOI: 10.1007/s00266-017-1022-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 10/29/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND A novel auto-cross-linked hyaluronic acid formulation (HA-ACP) has been proposed as a treatment for skin rejuvenation. This prospective pilot study aims to assess its tolerability and performance in the treatment of skin aging of the décolletage. METHODS Fifteen women (mean age 49.0 ± 8.0 (range 30-65)) who complained about the appearance of their décolletage were prospectively enrolled and treated with three sets of HA-ACP (IAL-SYSTEM ACP®) intradermal injections, administered three weeks apart. Control visits followed at 80 and 120 days from enrollment. The rejuvenating effect was assessed using the Beagley-Gibson and Fabi-Bolton scores. The investigators and the subjects also subjectively assessed skin appearance using a 1-10 scale. The rejuvenating effect and its persistence were assessed comparing the scores collected at the different experimental times by means of Wilcoxon rank tests. Adverse events and their duration were recorded and compared to those reported in the literature. RESULTS The HA-ACP formulation provided a significant improvement according to the Beagley-Gibson score (p < 0.005) at all time points. At the 120-day follow-up, the Fabi-Bolton score was significantly improved with respect to baseline (p < 0.05). The rejuvenating effect persisted unaltered between the 80-day and the 120-day visits. At the 120-day visit, the subjects' and investigators' subjective scores were between 8 and 10 in most cases. No unexpected adverse effects were observed. All adverse effects were well tolerated and disappeared over a short period. CONCLUSIONS The HA-ACP treatment under investigation is safe, well tolerated, and provides effective and long-lasting décolletage rejuvenation. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Errichetti E, Stinco G. Clinical and dermoscopic response predictors in psoriatic patients undergoing narrowband ultraviolet B phototherapy: results from a prospective study. Int J Dermatol 2018; 57:681-686. [DOI: 10.1111/ijd.13983] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 01/21/2018] [Accepted: 03/05/2018] [Indexed: 02/01/2023]
Affiliation(s)
- Enzo Errichetti
- Department of Experimental and Clinical Medicine; Institute of Dermatology; University of Udine; Udine Italy
| | - Giuseppe Stinco
- Department of Experimental and Clinical Medicine; Institute of Dermatology; University of Udine; Udine Italy
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66
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Castro CGD, Vázquez-López F, García-García B, López SR, Oliva NP. Trigeminal trophic syndrome simulating rodent ulcer basal cell carcinoma: a new clinico-dermoscopic approach. An Bras Dermatol 2017; 92:148-150. [PMID: 29267476 PMCID: PMC5726707 DOI: 10.1590/abd1806-4841.20175762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 07/07/2016] [Indexed: 11/22/2022] Open
Abstract
Trigeminal trophic syndrome is an uncommon cause of facial ulcers, that affects
the sensitive area of the trigeminal nerve. We present the case of an
84-year-old patient with ulcerated facial trigeminal trophic syndrome, and
report the development of a clinico-dermoscopic approach for his clinical
examination. The value of this model for the diagnosis of facial ulcers
suspected to be a rodent ulcer basal cell carcinoma is suggested.
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Affiliation(s)
- Celia Gómez de Castro
- Department of Dermatology. Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Begoña García-García
- Department of Dermatology. Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Sheila Requena López
- Department of Dermatology. Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Narciso Pérez Oliva
- Department of Dermatology. Hospital Universitario Central de Asturias, Oviedo, Spain
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67
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Legnani S, Zini E, Roccabianca P, Funiciello B, Zanna G. Dermoscopic analysis of the skin of healthy warmblood horses: a descriptive study of 34 cases in Italy. Vet Dermatol 2017; 29:165-e61. [DOI: 10.1111/vde.12508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2017] [Indexed: 12/24/2022]
Affiliation(s)
- Sara Legnani
- Istituto Veterinario di Novara; Strada Provinciale 9 28060 Granozzo con Monticello NO Italy
| | - Eric Zini
- Istituto Veterinario di Novara; Strada Provinciale 9 28060 Granozzo con Monticello NO Italy
- Clinic for Small Animal Internal Medicine; Vetsuisse Faculty; University of Zurich; Winterthurerstrasse 260 8057 Zurich Switzerland
- Department of Animal Medicine Production and Health; Università degli Studi di Padova; Viale dell'Università 16 35020 Legnaro PD Italy
| | - Paola Roccabianca
- DIMEVET-Faculty of Veterinary Medicine; Via Celoria 10 20133 Milano Italy
| | | | - Giordana Zanna
- Istituto Veterinario di Novara; Strada Provinciale 9 28060 Granozzo con Monticello NO Italy
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68
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Ankad BS, Sakhare PS. Dermoscopy of borderline tuberculoid leprosy. Int J Dermatol 2017; 57:74-76. [PMID: 28833001 DOI: 10.1111/ijd.13731] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 07/14/2017] [Accepted: 07/22/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Leprosy is a chronic granulomatous condition caused by Mycobacterium leprae, and borderline tuberculoid (BT) leprosy is the most common type of leprosy and presents with large, well- to ill-defined hypopigmented patches. It is known for atypical presentations. Dermoscopy of granulomatous conditions is well documented. However, there is no description of dermoscopy of BT leprosy in the literature. Authors evaluated the dermoscopic patterns of BT leprosy. CASE REPORT Patients with BT leprosy were studied for dermoscopic patterns. A total of 12 patients (8 male, 4 female) with a median age of 25 years were present. Mean duration of disease was 6 months. The most frequent pattern was white areas (100%) followed by decreased density of hairs. Yellow globules were observed in 8 (66.66%) patients. Decreased white dots (represent sweat duct openings) and branching vessels were noted in 6 (50%) and 4 (33.33%) patients, respectively. CONCLUSION This is the first report of dermoscopy of BT leprosy in the literature, and new dermoscopic observations were made by the authors. Dermoscopy of BT leprosy shows characteristic patterns, thus it adds valuable information for the diagnosis of BT leprosy.
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Affiliation(s)
- Balachandra S Ankad
- Department of Dermatology, S. Nijalingappa Medical College, Bagalkot, Karnataka, India
| | - Punit S Sakhare
- Department of Dermatology, S. Nijalingappa Medical College, Bagalkot, Karnataka, India
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69
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Saceda-Corralo D, Tosti A. Trichoscopic Features of Linear Morphea on the Scalp. Skin Appendage Disord 2017; 4:31-33. [PMID: 29457011 DOI: 10.1159/000478022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 06/02/2017] [Indexed: 01/15/2023] Open
Abstract
Linear scleroderma en coup de sabre (LSCS) is the most common form of morphea on the scalp and its trichoscopic features have not been described yet. We report 2 adult women with LSCS with distinct dermoscopic findings. They both had an atrophic well-defined linear patch of alopecia on the frontotemporal scalp. Dermoscopy showed loss of follicular openings on a whitish skin surface; scattered black dots, broken hairs, and pili torti; and short thick linear and branching tortuous vessels on the periphery of the lesion. Pathology confirmed the diagnosis of LSCS in the 2 cases. This description of dermoscopic features in LSCS on the scalp may help in the early diagnosis of the disease.
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Affiliation(s)
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, FL, USA
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70
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Chae JB, Ohn J, Mun JH. Dermoscopic features of digital mucous cysts: A study of 23 cases. J Dermatol 2017; 44:1309-1312. [DOI: 10.1111/1346-8138.13892] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 03/23/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Je Byeong Chae
- Department of Dermatology; Seoul National University College of Medicine; Seoul Korea
| | - Jungyoon Ohn
- Department of Dermatology; Seoul National University College of Medicine; Seoul Korea
| | - Je-Ho Mun
- Department of Dermatology; Seoul National University College of Medicine; Seoul Korea
- Institute of Human-Environment Interface Biology; Seoul National University; Seoul Korea
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71
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Patel P, Khanna S, McLellan B, Krishnamurthy K. The need for improved dermoscopy training in residency: a survey of US dermatology residents and program directors. Dermatol Pract Concept 2017; 7:17-22. [PMID: 28515987 PMCID: PMC5424656 DOI: 10.5826/dpc.0702a03] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 02/24/2017] [Indexed: 01/11/2023] Open
Abstract
Background Inadequate dermoscopy training represents a major barrier to proper dermoscopy use. Objective To better understand the status of dermoscopy training in US residency programs. Methods A survey was sent to 417 dermatology residents and 118 program directors of dermatology residency programs. Results Comparing different training times for the same training type, residents with 1–10 hours of dedicated training had similar confidence using dermoscopy in general (p = 1.000) and satisfaction with training (p = .3224) than residents with >10 hours of dedicated training. Comparing similar training times for different training types, residents with 1–10 hours of dedicated training had significantly increased confidence using dermoscopy in general (p = .0105) and satisfaction with training (p = .0066) than residents with 1–10 hours of only bedside training. Lastly, residents with 1–10 hours of dedicated training and >10 hours of dedicated training had significantly increased confidence using dermoscopy in general (p = .0002, p = .2471) and satisfaction with training (p <.0001, p < .0001) than residents with no dermoscopy training at all. Conclusions Dermoscopy training in residency should include formal dermoscopy training that is overseen by the program director and is possibly supplemented by outside dermoscopy training.
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Affiliation(s)
- Parth Patel
- Department of Medicine, Division of Dermatology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sarika Khanna
- Department of Medicine, Division of Dermatology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Beth McLellan
- Department of Medicine, Division of Dermatology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Karthik Krishnamurthy
- Department of Medicine, Division of Dermatology, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Dermatology, Nova Southeastern University, Fort Lauderdale, FL, USA
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Barcaui EDO, Carvalho ACP, Lopes FPPL, Piñeiro-Maceira J, Barcaui CB. High frequency ultrasound with color Doppler in dermatology. An Bras Dermatol 2017; 91:262-73. [PMID: 27438191 PMCID: PMC4938268 DOI: 10.1590/abd1806-4841.20164446] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 05/11/2015] [Indexed: 11/23/2022] Open
Abstract
Ultrasonography is a method of imaging that classically is used in dermatology to
study changes in the hypoderma, as nodules and infectious and inflammatory
processes. The introduction of high frequency and resolution equipments enabled
the observation of superficial structures, allowing differentiation between skin
layers and providing details for the analysis of the skin and its appendages.
This paper aims to review the basic principles of high frequency ultrasound and
its applications in different areas of dermatology.
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73
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Differentiation of pityriasis rubra pilaris from plaque psoriasis by dermoscopy. Arch Dermatol Res 2017; 309:311-314. [DOI: 10.1007/s00403-017-1727-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/03/2017] [Accepted: 02/22/2017] [Indexed: 11/27/2022]
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74
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Kwon S, Yoon Y, Kim B, Jang WH, Oh B, Chung KY, Kim KH. Dermoscopy guided dark-field multi-functional optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2017; 8:1372-1381. [PMID: 28663834 PMCID: PMC5480549 DOI: 10.1364/boe.8.001372] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 01/31/2017] [Accepted: 01/31/2017] [Indexed: 05/21/2023]
Abstract
Dermoscopy is a skin surface microscopic technique allowing specular reflection free observation of the skin, and has been used to examine pigmented skin lesions. However, dermoscopy has limitations in providing depth information due to lack of 3D resolution. In order to overcome the limitations, we developed dermoscopy guided multi-functional optical coherence tomography (MF-OCT) providing both high-contrast superficial information and depth-resolved structural, birefringent, and vascular information of the skin simultaneously. Dermoscopy and MF-OCT were combined by using a dichroic mirror, and dark-field configuration was adapted for MF-OCT to reduce specular reflection. After characterization, dermoscopy guided MF-OCT was applied to several human skin lesions such as the scar, port-wine stain (PWS) as well as the normal skin for demonstration. Various features of the scar and PWS were elucidated by both dermoscopy and MF-OCT. Dermoscopy guided MF-OCT may be useful for evaluation and treatment monitoring of skin lesions in clinical applications.
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Affiliation(s)
- Soonjae Kwon
- Department of Mechanical Engineering, Pohang University of Science and Technology, San 31, Hyoja-dong, Nam-gu, Pohang, Gyeongbuk 790-784, South Korea
- These authors contributed equally to this work
| | - Yeoreum Yoon
- Department of Mechanical Engineering, Pohang University of Science and Technology, San 31, Hyoja-dong, Nam-gu, Pohang, Gyeongbuk 790-784, South Korea
- These authors contributed equally to this work
| | - Bumju Kim
- Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, San 31, Hyoja-dong, Nam-gu, Pohang, Gyeongbuk 790-784, South Korea
| | - Won Hyuk Jang
- Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, San 31, Hyoja-dong, Nam-gu, Pohang, Gyeongbuk 790-784, South Korea
| | - Byungho Oh
- Department of Dermatology, Keimyung University, College of Medicine, 56, Dalseong-ro, Jung-gu, Daegu, 41931, South Korea
| | - Kee Yang Chung
- Departments of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | - Ki Hean Kim
- Department of Mechanical Engineering, Pohang University of Science and Technology, San 31, Hyoja-dong, Nam-gu, Pohang, Gyeongbuk 790-784, South Korea
- Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, San 31, Hyoja-dong, Nam-gu, Pohang, Gyeongbuk 790-784, South Korea
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Abstract
Livedoid vasculopathy (atrophie blanche) is a form of thrombotic vasculopathy. It is characterized by small ulcers that become crusted, and heal after several months to produce white atrophic scars. The most commonly affected sites are the lower legs, in particular the dorsum of the feet and ankles. To date, the dermoscopic features of livedoid vasculopathy have not been clearly described in the literature. In this observational study, we sought to evaluate the dermoscopic patterns of livedoid vasculopathy and determine whether the dermoscopic features are associated with certain histopathological characteristics. We evaluated 9 patients with livedoid vasculopathy by dermoscopy. Skin biopsy specimens were stained with hematoxylin and eosin for histopathologic examination, and dermoscopic features were correlated with histopathological characteristics. In the majority of patients with livedoid vasculopathy, examination with dermoscopy revealed central crusted ulcers or ivory white areas associated with peripheral pigmentation in a reticular pattern. In addition, increased vascular structures including linear and glomerular vessels were found. On histopathological examination, the central ivory white areas correlated with dermal fibrosis, the reticular pigmentation corresponded to epidermal basal layer hyperpigmentation or melanin within melanophages in the dermal papillae, and the vascular structures correlated with dilatation and proliferation of capillaries in the upper dermis. In summary, the most common dermoscopic features of livedoid vasculopathy identified in this study were central crusted ulcers or ivory white scar-like areas associated with peripheral reticular pigmentation and increased vascular structures. The characterization of dermoscopic criteria for livedoid vasculopathy may improve the accuracy in the clinical diagnosis and follow-up of this disease.
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Affiliation(s)
- Stephen Chu-Sung Hu
- Department of Dermatology, College of Medicine, Kaohsiung Medical University
- Department of Dermatology, Kaohsiung Medical University Hospital
| | - Gwo-Shing Chen
- Department of Dermatology, College of Medicine, Kaohsiung Medical University
- Department of Dermatology, Kaohsiung Medical University Hospital
| | - Chi-Ling Lin
- Department of Dermatology, Kaohsiung Medical University Hospital
- Department of Dermatology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung
| | - Yang-Chun Cheng
- Department of Dermatology, Kaohsiung Medical University Hospital
| | - Yung-Song Lin
- Department of Otolaryngology, Chi Mei Medical Center
- Center of General education, Southern Taiwan University of Technology, Tainan City
- Department of Otolaryngology, School of Medicine, Taipei Medical University, Taipei, Taiwan
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76
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Lallas A, Apalla Z, Lazaridou E, Sotiriou E, Vakirlis E, Ioannides D. Scabies escaping detection until dermoscopy was applied. Dermatol Pract Concept 2017; 7:49-50. [PMID: 28243495 PMCID: PMC5315041 DOI: 10.5826/dpc.0701a09] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 11/26/2016] [Indexed: 01/04/2023] Open
Abstract
Dermoscopy is already considered a fairly established method for diagnosing scabies. This is because dermoscopy enables the visualization both of the burrow and the mite itself, forming the so-called “jet with a contrail” structure. In the present report we present an extraordinary case of a patient with scabies lesions on the face and neck, which was misdiagnosed during sequential visits and underwent unnecessary surgical diagnostic procedures. Finally, the diagnostic problem was solved when dermoscopy was applied.
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Affiliation(s)
- Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Zoe Apalla
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | - Elena Sotiriou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
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Affiliation(s)
- P Bahadoran
- Department of Dermatology, Clinical Research Center, Archet Hospital, Nice, France
| | - J Malvehy
- Dermatology Department, Melanoma Unit, Hospital Clinic and IDIBAPS, Barcelona, Spain
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Errichetti E, Stinco G. Dermoscopy in General Dermatology: A Practical Overview. Dermatol Ther (Heidelb) 2016; 6:471-507. [PMID: 27613297 PMCID: PMC5120630 DOI: 10.1007/s13555-016-0141-6] [Citation(s) in RCA: 186] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Indexed: 12/15/2022] Open
Abstract
Over the last few years, dermoscopy has been shown to be a useful tool in assisting the noninvasive diagnosis of various general dermatological disorders. In this article, we sought to provide an up-to-date practical overview on the use of dermoscopy in general dermatology by analysing the dermoscopic differential diagnosis of relatively common dermatological disorders grouped according to their clinical presentation, i.e. dermatoses presenting with erythematous-desquamative patches/plaques (plaque psoriasis, eczematous dermatitis, pityriasis rosea, mycosis fungoides and subacute cutaneous lupus erythematosus), papulosquamous/papulokeratotic dermatoses (lichen planus, pityriasis rosea, papulosquamous sarcoidosis, guttate psoriasis, pityriasis lichenoides chronica, classical pityriasis rubra pilaris, porokeratosis, lymphomatoid papulosis, papulosquamous chronic GVHD, parakeratosis variegata, Grover disease, Darier disease and BRAF-inhibitor-induced acantholytic dyskeratosis), facial inflammatory skin diseases (rosacea, seborrheic dermatitis, discoid lupus erythematosus, sarcoidosis, cutaneous leishmaniasis, lupus vulgaris, granuloma faciale and demodicidosis), acquired keratodermas (chronic hand eczema, palmar psoriasis, keratoderma due to mycosis fungoides, keratoderma resulting from pityriasis rubra pilaris, tinea manuum, palmar lichen planus and aquagenic palmar keratoderma), sclero-atrophic dermatoses (necrobiosis lipoidica, morphea and cutaneous lichen sclerosus), hypopigmented macular diseases (extragenital guttate lichen sclerosus, achromic pityriasis versicolor, guttate vitiligo, idiopathic guttate hypomelanosis, progressive macular hypomelanosis and postinflammatory hypopigmentations), hyperpigmented maculopapular diseases (pityriasis versicolor, lichen planus pigmentosus, Gougerot-Carteaud syndrome, Dowling-Degos disease, erythema ab igne, macular amyloidosis, lichen amyloidosus, friction melanosis, terra firma-forme dermatosis, urticaria pigmentosa and telangiectasia macularis eruptiva perstans), itchy papulonodular dermatoses (hypertrophic lichen planus, prurigo nodularis, nodular scabies and acquired perforating dermatosis), erythrodermas (due to psoriasis, atopic dermatitis, mycosis fungoides, pityriasis rubra pilaris and scabies), noninfectious balanitis (Zoon's plasma cell balanitis, psoriatic balanitis, seborrheic dermatitis and non-specific balanitis) and erythroplasia of Queyrat, inflammatory cicatricial alopecias (scalp discoid lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia and folliculitis decalvans), nonscarring alopecias (alopecia areata, trichotillomania, androgenetic alopecia and telogen effluvium) and scaling disorders of the scalp (tinea capitis, scalp psoriasis, seborrheic dermatitis and pityriasis amiantacea).
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Affiliation(s)
- Enzo Errichetti
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy.
| | - Giuseppe Stinco
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
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79
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Abstract
Microcomedonal lesions can be aesthetically and psychologically displeasing. The burden of comedones increases when considering their frequency and demand for time-consuming attention. The objective of the current study was to describe a novel technique to facilitate open microcomedone extraction. The instrumentation used includes smartphone photography with dermatoscopy. The dermatoscope is an effective tool for diagnosing a broad range of dermatologic conditions. The polarized dermatoscope can facilitate execution of cutaneous procedures whenever magnification and optimal illumination are necessary. Its connection to a smartphone with a unique adapter enabled single-handed examination of microcomedones. Under magnification with this unit, the involved lesions are photographed to clearly demonstrate the condition and achieve informed consent. The complete procedure can be recorded on video for documentation. In this case, four separate lesions of the left auricle of a young man were treated using direct pressure extraction. The procedure undertaken was rapid, convenient, and completed without any adverse sequelae. This procedure is recommended for similar cases using the dermatoscope, which does not require additional specific training and is readily available at no extra cost. This technique could be used in various dermatologic conditions.
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Affiliation(s)
- Sody Abby Naimer
- Department of Family Medicine, Siaal Research Center for Family Medicine and Primary Care, Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Eilon Moreh Clinic, Clalit Health Services, Shomron District, Lev Shomron, Israel
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80
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Lallas A, Argenziano G, Zalaudek I, Apalla Z, Ardigo M, Chellini P, Cordeiro N, Guimaraes M, Kyrgidis A, Lazaridou E, Longo C, Moscarella E, Papadimitriou I, Pellacani G, Sotiriou E, Vakirlis E, Ioannides D. Dermoscopic hemorrhagic dots: an early predictor of response of psoriasis to biologic agents. Dermatol Pract Concept 2016; 6:7-12. [PMID: 27867739 PMCID: PMC5108638 DOI: 10.5826/dpc.0604a02] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 07/18/2016] [Indexed: 01/10/2023] Open
Abstract
Background Biologic agents are routinely used in the treatment of severe psoriasis. The evaluation of treatment response is mainly based on the physician’s global clinical assessment. Objective To investigate whether dermoscopy might enhance the assessment of response of psoriasis to treatment with biologic agents. Methods Patients with severe psoriasis scheduled to receive a biologic agent were enrolled in the study. A target lesion from each patient was clinically and dermoscopically documented at baseline and after one, two and six months. The clinical response was evaluated by the recruiting clinicians at all visits, while dermoscopic images were evaluated by two independent investigators, blinded to the clinical information. Chi Square test was used for cross-tabulation comparisons, while odds ratios, 95% confidence intervals and p values were calculated using univariate logistic regression. Results Overall, there was a significant correlation between clinical response and vessel distribution at all time points: a regular vessel distribution correlated with no response, a clustered distribution with partial response, and the dermoscopic absence of vessels with complete response. The presence of dermoscopic hemorrhagic dots was a potent predictor of favorable clinical response at the subsequent visit at all time points. Among lesions initially clinically responding and later recurring, 87.5% displayed dermoscopic dotted vessels despite the macroscopic remission. Conclusion Dermoscopy might be a useful additional tool for evaluating the response of psoriatic patients to biologic agents. Hemorrhagic dots represent an early predictor of clinical response, while the persistence or reappearance of dotted vessels might predict clinical persistence or recurrence, respectively.
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Affiliation(s)
- Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | - Iris Zalaudek
- Non-melanoma Skin Cancer Unit, Department of Dermatology, Medical University, Graz, Austria
| | - Zoe Apalla
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Marco Ardigo
- Clinical Dermatology Department, IFO-San Gallicano Dermatological Institute, Rome, Italy
| | - Patricia Chellini
- Instituto de Dermatologia Professor Rubem David Azulay-Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Natalia Cordeiro
- Instituto de Dermatologia Professor Rubem David Azulay-Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariana Guimaraes
- Instituto de Dermatologia Professor Rubem David Azulay-Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Caterina Longo
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Elvira Moscarella
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | | | | | - Elena Sotiriou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
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81
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Ramadan S, Hossam D, Saleh MA. Dermoscopy could be useful in differentiating sarcoidosis from necrobiotic granulomas even after treatment with systemic steroids. Dermatol Pract Concept 2016; 6:17-22. [PMID: 27648379 PMCID: PMC5006548 DOI: 10.5826/dpc.0603a05] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 05/24/2016] [Indexed: 11/27/2022] Open
Abstract
Background: Diagnosing cutaneous sarcoidosis and necrobiotic granulomas is challenging. Objective: Assessing the value of dermoscopy in differentiating cutaneous sarcoidosis from necrobiotic granulomas and evaluating whether their dermoscopic features will be altered after treatment. Methods: Nineteen cutaneous sarcoidosis and 11 necrobiotic granuloma patients (2 necrobiosis lipoidica, 4 granuloma annulare and 5 rheumatoid nodule) were included in this study. The diagnosis was confirmed by skin biopsy. The lesions were examined using non-contact polarized dermoscope (Dermlite 2 HR-Pro; 3Gen, San Juan Capistrano, CA). Results: Ten out of 19 cutaneous sarcoidosis patients and 7/11 necrobiotic cases group were receiving treatments (topical, intralesional or systemic steroids ± chloroquine) but still have cutaneous lesions. Treatment duration in the sarcoidosis group ranged from 2 months to 10 years (median 3 years) and in the necrobiotic cases group ranged from 3 months to 16 years (median 2 years). Pink homogenous background, translucent orange areas, white scar-like depigmentation and fine white scales were significantly associated with the cutaneous sarcoidosis compared to necrobiotic cases group. On the other hand mixed pink, white and yellowish background was significantly associated with the necrobiotic cases group. No significant difference in the dermoscopic findings was detected between treated and non-treated patients. Conclusion: Some dermoscopic findings are shared between the cutaneous sarcoidosis group and the necrobiotic cases group, yet dermoscopy could be a useful aid in differentiating them even after treatment.
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Affiliation(s)
| | - Dalia Hossam
- Dermatology Department Cairo University, Cairo, Egypt
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82
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Chappuis P, Duru G, Marchal O, Girier P, Dalle S, Thomas L. Dermoscopy, a useful tool for general practitioners in melanoma screening: a nationwide survey. Br J Dermatol 2016; 175:744-50. [PMID: 26914613 DOI: 10.1111/bjd.14495] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dermoscopy improves diagnostic accuracy in melanoma, as shown by several meta-analyses. Although it is used by general practitioners (GPs) in Australia, Canada and Italy, no published data on this topic are available in France. OBJECTIVES To review the opinions and use of dermoscopy by GPs in France and to understand their practice of skin examination. METHODS We designed a descriptive and cross-sectional survey and conducted it between 26 November and 26 December 2014. An anonymous, multiple-choice questionnaire about the demographic characteristics, skin examination modalities and use and training in dermoscopy was sent to 4057 GPs in four large regions of France. Pearson, χ(2) , Student, Welch and Fisher tests were used for cross-tabulation statistical analysis. RESULTS Only 8% of respondents had access to a dermoscope; most were male practitioners and aged > 50 years. Dermoscopy increased self-confidence in analysing pigmented lesions (P = 0·004), and dermoscopy users referred fewer patients to dermatologists. The number of biopsies was reduced in the dermoscopy users group (P = 0·004). In total, 425 questionnaires were returned and analysed. Dermoscopy users took more time to evaluate a single pigmented lesion (P = 0·015). Only 16·9% of physicians declared having received some training on dermoscopy, yet this number reached 47% for those owning a dermoscope. Their training was mostly short and recent. Overall 29·2% of the respondents said the main advantage was to reduce the number of referrals to the dermatologists (P = 0·004), while its main disadvantage was the necessity of training (54·6%). Our responders declared they could spend seven working days on a dermoscopy training course. CONCLUSIONS Our study demonstrates positive opinions regarding dermoscopy, despite a minority of French GPs using this technique in the areas surveyed. The need for formal training appears to be the main limitation to wider use. Appropriate and specifically designed training programmes should be offered.
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Affiliation(s)
- P Chappuis
- Department of General Medicine, Claude Bernard Lyon 1 University, 43 Boulevard 11 Novembre, 1918 BP 761, 69622, Villeurbanne Cedex, France
| | - G Duru
- Department of Mathematics, Claude Bernard Lyon 1 University, 43 Boulevard 11 Novembre, 1918 BP 761, 69622, Villeurbanne Cedex, France
| | - O Marchal
- Lyon University, Institute Camille Jordan, UMR 5208, Université Jean Monnet, Lyon, France
| | - P Girier
- Department of General Medicine, Claude Bernard Lyon 1 University, 43 Boulevard 11 Novembre, 1918 BP 761, 69622, Villeurbanne Cedex, France
| | - S Dalle
- Dermatology Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 69495, Pierre Bénite Cedex, France.,INSERM U1052, CNRS UMR5286, Lyon Cancer Research Center, Lyon, France
| | - L Thomas
- Dermatology Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 69495, Pierre Bénite Cedex, France. .,INSERM U1052, CNRS UMR5286, Lyon Cancer Research Center, Lyon, France.
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83
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Dermoscopic Follow-Up of the Skin towards Acute Graft-versus-Host-Disease in Patients after Allogeneic Hematopoietic Stem Cell Transplantation. BIOMED RESEARCH INTERNATIONAL 2016; 2016:4535717. [PMID: 27446950 PMCID: PMC4944033 DOI: 10.1155/2016/4535717] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/31/2016] [Accepted: 04/28/2016] [Indexed: 01/01/2023]
Abstract
Background. Acute graft-versus-host disease (aGVHD) involving skin is one of the most frequent complications of allogeneic hematopoietic stem cell transplantation (alloHSCT), usually diagnosed based on clinical manifestations. So far, skin biopsy with histopathological evaluation is the only method to confirm the diagnosis. Objective. In this prospective study we monitored alloHSCT recipients by dermoscopy in order to assess its utility as an alternative noninvasive tool to early diagnose acute GVHD. Methods. Thirteen consecutive patients who received alloHSCT were examined clinically and dermoscopically towards aGVHD [days 28 (±7), 56 (±7), and 100 (±7)], as well as in each patient who developed cutaneous aGVHD diagnosed according to clinical criteria (Glucksberg scale). Results. Six patients (46%) developed symptoms of cutaneous acute GVHD (grade 1, n = 3; grade 2, n = 3). Dermoscopic evaluation revealed pinkish or reddish background and well-visible, multiple thin telangiectasias. Conclusion. To our knowledge, this is the first report on the use of dermoscopy to evaluate skin involvement in the course of acute GVHD suggesting its role as a diagnostic tool in follow-up of GVHD, which can be also used before clinical symptoms occur.
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84
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Youn S. A prelude to a functional noninvasive in vivodiagnostic tool for skin diseases. Br J Dermatol 2016; 174:961. [DOI: 10.1111/bjd.14561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S.W. Youn
- Department of Dermatology; Seoul National University Bundang Hospital; Seoul National University College of Medicine; 82 Gumi-ro 173 Beon-gil Seongnam 13620 Gyeonggi-do South Korea
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85
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Bollea-Garlatti L, Molinari L, Galimberti G, Galimberti R. Melanoma With Meyerson's Phenomenon: Clinical and Dermoscopic Features. ACTAS DERMO-SIFILIOGRAFICAS 2016. [DOI: 10.1016/j.adengl.2016.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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86
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Bollea-Garlatti L, Molinari L, Galimberti G, Galimberti R. Melanoma con fenómeno de Meyerson: características clínicas y dermatoscópicas. ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:255-7. [DOI: 10.1016/j.ad.2015.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Revised: 06/15/2015] [Accepted: 06/27/2015] [Indexed: 10/22/2022] Open
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87
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Abstract
The use of dermoscopy has offered a new morphological dimension of skin lesions and has provided an effective diagnostic tool to differentiate melanoma from other benign or malignant skin tumors but also to support the clinical diagnosis in general dermatology. The aim of this article is to provide an overview of the most recent and important advances in the rising world of dermoscopy.
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Affiliation(s)
- Teresa Russo
- Dermatology Unit, Second University of Naples, Naples, Italy
| | | | - Aimilios Lallas
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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88
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Affiliation(s)
- Feroze Kaliyadan
- Department of Dermatology, College of Medicine, King Faisal University, Al Hasa, Kingdom of Saudi Arabia E-mail:
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89
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Bollea Garlatti LA, Torre AC, Bollea Garlatti ML, Galimberti RL, Argenziano G. Dermoscopy aids the diagnosis of crusted scabies in an erythrodermic patient. J Am Acad Dermatol 2015; 73:e93-5. [PMID: 26282822 DOI: 10.1016/j.jaad.2015.04.061] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 04/29/2015] [Accepted: 04/30/2015] [Indexed: 10/23/2022]
Affiliation(s)
| | - Ana Clara Torre
- Department of Dermatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | | | - Giuseppe Argenziano
- Skin Cancer Unit, Arcispedale Santa Maria Nuova Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy
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90
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Errichetti E, Stinco G. Dermoscopy in differential diagnosis of palmar psoriasis and chronic hand eczema. J Dermatol 2015; 43:423-5. [PMID: 26460228 DOI: 10.1111/1346-8138.13142] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 08/17/2015] [Indexed: 11/29/2022]
Abstract
Clinical differentiation between palmar psoriasis and chronic hand eczema may sometimes be a diagnostic challenge; in such cases histopathological analysis helps to differentiate the two conditions. In the present study, palmar psoriasis and chronic hand eczema were investigated using dermoscopy and the significance of specific dermoscopic features was assessed in order to improve their non-invasive differentiation. Ten patients with biopsy-proven palmar psoriasis and 11 patients with biopsy-proven chronic hand eczema were included in the study. We found that the presence of diffuse white scales was significant in palmar psoriasis whereas the presence of yellowish scales, brownish-orange dots/globules and yellowish-orange crusts was significant in chronic hand eczema.
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Affiliation(s)
- Enzo Errichetti
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
| | - Giuseppe Stinco
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
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91
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Jemec GBE. Through the looking-glass, and what the dermatologist found there. Br J Dermatol 2015; 173:321-3. [PMID: 26346077 DOI: 10.1111/bjd.13935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- G B E Jemec
- Department of Dermatology, Health Sciences Faculty, Roskilde Hospital, University of Copenhagen, Copenhagen, Denmark.
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92
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Lamberti A, Filippou G, Adinolfi A, Fimiani M, Rubegni P. Infantile perianal pyramidal protrusion: a case report with dermoscopy and ultrasound findings. Dermatol Pract Concept 2015; 5:125-8. [PMID: 26114069 PMCID: PMC4462916 DOI: 10.5826/dpc.0502a25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 12/28/2014] [Indexed: 01/02/2023] Open
Abstract
Infantile perianal pyramidal protrusion, it is a rare benign cutaneous condition described in relatively recent times. It is considered to be under-reported in the pediatric literature because it is often mistaken for other conditions. The unawareness of this lesion may be responsible for an excessive concern both in physician and in parents, which leads to overly aggressive and unnecessary treatments. Thus its recognition has many implications regarding proper management and treatment. We report a typical presentation of IPPP in which the diagnosis was based on the use of non-invasive diagnostic tools and in particular of dermoscopy and ultrasonography.
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Affiliation(s)
- Arianna Lamberti
- Department of Medicine, Surgery and Neurosciences, Dermatology Section, University of Siena, Italy
| | - Georgios Filippou
- Department of Medicine, Surgery and Neurosciences, Rheumatology Section, University of Siena, Italy
| | - Antonella Adinolfi
- Department of Medicine, Surgery and Neurosciences, Rheumatology Section, University of Siena, Italy
| | - Michele Fimiani
- Department of Medicine, Surgery and Neurosciences, Dermatology Section, University of Siena, Italy
| | - Pietro Rubegni
- Department of Medicine, Surgery and Neurosciences, Dermatology Section, University of Siena, Italy
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93
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Errichetti E, Piccirillo A, Stinco G. Dermoscopy of prurigo nodularis. J Dermatol 2015; 42:632-4. [PMID: 25808786 DOI: 10.1111/1346-8138.12844] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 02/05/2015] [Indexed: 12/01/2022]
Abstract
The diagnosis of prurigo nodularis is mainly clinical, based on its distinctive features. However, in some cases it may be difficult to differentiate it from other nodular dermatoses only on the clinical basis, thus requiring histopathological examination to reach a definitive diagnosis. The aim of this study was to describe for the first time the dermoscopic features of prurigo nodularis and the useful contribution of dermoscopy in the differential diagnosis of such dermatoses. Fourteen patients with histopathologically proven prurigo nodularis were included in the study. The results of our study suggest that the detection of a "white starburst pattern" surrounding brown-reddish/brown-yellowish crust(s), erosion(s) and/or hyperkeratosis/scales is a useful clue to support the clinical diagnosis of prurigo nodularis, distinguishing it from the other main differential diagnoses.
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Affiliation(s)
- Enzo Errichetti
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
| | - Angelo Piccirillo
- Department of Dermatology and Venereology, San Carlo Hospital, Potenza, Italy
| | - Giuseppe Stinco
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
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94
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Kim WJ, Lee WK, Song M, Kim HS, Ko HC, Kim BS, Kim MB. Clinical clues for differential diagnosis between verruca plana and verruca plana-like seborrheic keratosis. J Dermatol 2015; 42:373-7. [PMID: 25571765 DOI: 10.1111/1346-8138.12760] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 11/24/2014] [Indexed: 11/30/2022]
Abstract
Sometimes the clinical differentiation between verruca plana (VP) and VP-like seborrheic keratosis (SK) could be challenged. However, there have been no studies on this issue to date. The aim of this study was to elucidate clinical and dermoscopic differences between these two diseases, and also to suggest a diagnostic algorithm of VP and VP-like SK without skin biopsy. The patients who had lesions clinically considered as VP or VP-like SK were the target of our study. We took clinical and dermoscopic photos with informed consent and conducted a questionnaire. All patients had their diagnoses confirmed by biopsy. Thirty-three patients were enrolled in our study. Seventeen patients were finally diagnosed with VP (51.5%) and 16 patients with VP-like SK (48.5%). In clinical findings, VP-like SK showed significantly more scattered distribution than VP (P = 0.039), which exhibited more clustered or grouped distribution (P = 0.039). In dermoscopic findings, brain-like appearance was more commonly observed in VP-like SK (P = 0.003) whereas VP showed more red dots or globular vessels (P = 0.017) and even-colored light brown to yellow patch (P < 0.001). Sex, onset age, the size of each lesion, location, color and shape showed no significant differences between them (P > 0.05). Based on our results, we suggest a diagnostic algorithm using Koebner's phenomenon, dermoscopic findings, distribution of each lesion and biopsy for multiple VP-like lesions in adults, and we think it will be a very useful diagnostic tool in daily clinical dermatological practice.
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Affiliation(s)
- Won-Jeong Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
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95
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Zanna G, Auriemma E, Arrighi S, Attanasi A, Zini E, Scarampella F. Dermoscopic evaluation of skin in healthy cats. Vet Dermatol 2014; 26:14-7, e3-4. [DOI: 10.1111/vde.12179] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Giordana Zanna
- Studio Dermatologico Veterinario; Via G. Sismondi 62 20133 Milan Italy
| | - Edoardo Auriemma
- Istituto Veterinario di Novara; Strada Provinciale 9 28060 Granozzo con Monticello (NO) Italy
| | - Silvana Arrighi
- Department of Health, Animal Science and Food Safety; Laboratory of Anatomy and Confocal Microscopy; Università degli Studi di Milano; Via Trentacoste 2 20134 Milan Italy
| | - Anna Attanasi
- Istituto Veterinario di Novara; Strada Provinciale 9 28060 Granozzo con Monticello (NO) Italy
| | - Eric Zini
- Istituto Veterinario di Novara; Strada Provinciale 9 28060 Granozzo con Monticello (NO) Italy
- Clinic for Small Animal Internal Medicine; Vetsuisse Faculty; University of Zurich; Winterthurerstrasse 260 8057 Zurich Switzerland
- Department of Animal Medicine, Production and Health; University of Padova; Viale dell'Università 16 35020 Legnaro (PD) Italy
| | - Fabia Scarampella
- Studio Dermatologico Veterinario; Via G. Sismondi 62 20133 Milan Italy
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96
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Dermoscopic features of clinically inflammatory dermatoses and their correlation with histopathologic reaction patterns. Arch Dermatol Res 2014; 307:23-30. [PMID: 25297393 DOI: 10.1007/s00403-014-1513-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 09/21/2014] [Accepted: 09/29/2014] [Indexed: 10/24/2022]
Abstract
Dermoscopy can be used in diagnosis of some chronic inflammatory dermatoses. In this study, the single most recent, fully developed lesion in 74 patients with clinically inflammatory dermatoses was examined dermoscopically and correlated histopathologically with psoriasiform, lichenoid, or spongiotic reaction patterns. Vascular component (morphology and arrangement) was the most prominent feature in the studied patterns mostly in the shape of dots (45 specimens, 60.8%), globules (30 specimens, 40.5%), and lines (45 specimens, 60.8%). Psoriasiform pattern showed vascular dots (20 specimens, 76.92%), and/or red globules (15 specimen, 57.69%), regularly distributed (17 specimens, 65.38%), on intense red background (15 specimens, 57.69%), and diffuse (13 specimens, 50%) white scales (18 specimen, 69.23%), with probability of these features together 100%. Lichenoid pattern showed red lines (23 cases, 65.71%), on dull or light red background (14 cases, 40% for each), with discolored areas (15 cases, 42.86%), brown reticular pigmentation (21 cases, 60%), and white scales (13 cases, 37.14%). Spongiotic pattern was characterized by follicular component and diffuse or peripheral scale distribution, with probability of both features together 100%. The main histopathologic features of inflammatory dermatoses, which influenced their dermoscopic patterns, are depth and size of vessels, presence and shape of epidermal hyperplasia, presence of spongiosis, and degree of dermal inflammation and oedema. These features influenced vascular morphology and distribution, corneal component, and background color. Among the studied reaction patterns, psoriasiform pattern showed the most consistent correlation with dermoscopic features. Dermoscopic picture of lichenoid reaction was the most contradictory. Spongiotic reaction showed absent specific vascular component.
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97
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Anker JP, Kaminska-Winciorek G, Lallas A, Nicoletti S, Januszewski K, Mazzei ME, Wydmanski J, Borges AL, Zalaudek I. The dermoscopic variability of Degos disease at different stages of progression. Dermatol Pract Concept 2014; 4:59-61. [PMID: 25126461 PMCID: PMC4132001 DOI: 10.5826/dpc.0403a11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Accepted: 05/05/2014] [Indexed: 11/12/2022] Open
Affiliation(s)
- Javiera Pérez Anker
- Unidad de Lesiones Pigmentadas Pigmentadas, Cátedra de Dermatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | | | - Aimillios Lallas
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Sofia Nicoletti
- Unidad de Lesiones Pigmentadas Pigmentadas, Cátedra de Dermatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - Krzysztof Januszewski
- Department of Pathology, Silesian Medical Center, Silesian Medical University, Katowice, Poland
| | - Maria Eugenia Mazzei
- Unidad de Dermatopatología, Cátedra de Dermatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - Jerzy Wydmanski
- Department of Conventional and Intraoperative Radiotherapy Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Alejandra Larre Borges
- Unidad de Lesiones Pigmentadas Pigmentadas, Cátedra de Dermatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - Iris Zalaudek
- Department of Dermatology, Medical University of Graz, Graz, Austria
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