Dermoscopic features of molluscum contagiosum based on white structures and their correlation with histopathological findings

Dermoscopy of Bacterial, Viral, and Fungal Skin Infections: A Systematic Review of the Literature

Over the last three decades, the use of dermoscopy has been extended to inflammatory and infectious dermatoses. Regarding the latter, while the first applications concerned skin parasitoses, there has been a significant increase in the publication trend regarding nonparasitic dermatoses over recent years, yet data on this topic are sparse and often lack a standardized analytical approach. This systematic literature review summarizes published data on dermoscopy of bacterial, viral, and fungal dermatoses (dermoscopic findings, used setting, pathological correlation, and level of evidence of studies) and provides a homogeneous terminology of reported dermoscopic features according to a standardized methodology. A total of 152 papers addressing 43 different dermatoses and describing 184 different dermoscopic findings were included in the analysis. The majority of them displayed a level of evidence of V (107 single case reports and 40 case series), with only 5 studies showing a level of evidence of IV (case-control studies). Moreover, our analysis also underlined a high variability in the terminology used in published articles (even for the same dermatosis). Therefore, despite significant potential, future studies designed according to a systematic and standardized approach are required for a better characterization of dermoscopy of nonparasitic skin infections.

New Developing Treatments for Molluscum Contagiosum

A large variety of treatments for molluscum contagiosum (MC) are available, but none are Food and Drug Administration (FDA) approved and there is no consensus on the optimal approach, mainly owing to a lack of high-level data. Physical modalities are widely used, but require repeated outpatient visits for administration, are painful and difficult to perform in children, and are associated with the possibility of residual scarring and post-inflammatory hypo- or hyperpigmentation. Two experimental topical drugs, a new standardized preparation of topical cantharidin, called VP-102, and a topical nitric oxide (NO)-releasing product containing berdazimer, called SB206, represent promising products that have been designed to overcome the limitations of current treatments. They have recently shown good results in terms of safety and efficacy in large cohorts of patients in phase III studies and have the potential to be the first FDA-approved therapies for the treatment of MC.

Clinical and dermoscopic overlap of genital molluscum contagiosum with condyloma acuminate

A 24-year-old male presented with asymptomatic penile papules for 1 month. Dermatology examination showed pink, soft papules on the ventral side of the penis, with a clear boundary and rough surface, and papillary hyperplasia could be seen. Dermoscopy revealed multiple finger-like projections without vessels in the center of the lesion under polarized light, and linear and crown-like vessels could be seen at the edge of the lesion. Histopathological examination revealed endophytic infundibular hyperplasia with keratinocytes containing Henderson–Patterson bodies. A diagnosis of molluscum contagiosum was made. Molluscum contagiosum can present with several atypical presentations including giant, cystic, ulcerated, or condyloma acuminatum-like, especially in immunosuppressed patients. Here, we report a case of atypical genital molluscum contagiosum with novel dermoscopic findings in an otherwise-healthy adult.

Frequency of Publication of Dermoscopic Images in Inter-observer Studies: A Systematic Review

Research interest in dermoscopy is increasing, but the complete dermoscopic image sets used in inter-observer studies of skin tumours are not often shared in research publications. The aim of this systematic review was to analyse what proportion of images depicting skin tumours are published in studies investigating inter-observer variations in the assessment of dermoscopic features and/or patterns. Embase, MEDLINE and Scopus databases were screened for eligible studies published from inception to 2 July 2020. For included studies the proportion of lesion images presented in the papers and/or supplements was extracted. A total of 61 studies (53 original studies and 8 shorter reports (i.e. research letters or concise reports)). published in the period 1997 to 2020 were included. These studies combined included 14,124 skin tumours, of which 373 (3%) images were published. This systematic review highlights that the vast majority of images included in dermoscopy research are not published. Data sharing should be a requirement for future studies, and must be enabled and standardized by the dermatology research community and editorial offices.

Cutaneous manifestations and dermoscopic findings are important clues to the diagnosis of Talaromyces marneffei in HIV patients with immune reconstitution inflammatory syndrome: A case report and literature review

Talaromyces (formerly Penicillium) marneffei is a dimorphic fungus that causes talaromycosis (formerly penicilliosis). The condition is predominantly found in patients with HIV. Important diagnostic clues are a history of living or travelling in endemic areas, and central umbilicated skin lesions. Dermoscopy is particularly useful for providing rapid bedside information, with a round, whitish, amorphous structure being the most common finding. Immune reconstitution inflammatory syndrome (IRIS) may occur. Driven by the initiation of antiretroviral therapy, IRIS is an exaggerated response of T cells to pathogens. Although mycobacterial and cryptococcal opportunistic infections are common with IRIS, a linkage between T. marneffei and IRIS has rarely been reported. Here, we report on a literature review of patients with HIV who developed IRIS associated with talaromycosis. Dermatologists should be aware of the cutaneous and dermoscopic findings of talaromycosis as they provide important clues that enable its early diagnosis and treatment.

Dermoscopy of skin infestations and infections (entomodermoscopy) - Part II: viral, fungal and other infections

In addition to the infestations and bacterial infections reported in part I, the study of entomodermoscopy also involves descriptions of dermoscopic findings of a growing number of viral and fungal infections, among others. In this article, the main clinical situations in viral infections where dermoscopy can be useful will be described, that is in the evaluation of viral warts, molluscum contagiosum, and even in recent scenarios such as the COVID-19 pandemic. As for fungal infections, dermoscopy is particularly important, not only in the evaluation of the skin surface, but also of skin annexes, such as hairs and nails. The differential diagnosis with skin tumors, especially melanomas, can be facilitated by dermoscopy, especially in the evaluation of cases of verruca plantaris, onychomycosis and tinea nigra.

A practical review of dermoscopy for pediatric dermatology part II: Vascular tumors, infections, and inflammatory dermatoses

In addition to the evaluation of melanocytic growths (Part I), dermoscopy is helpful in the identification and management of vascular tumors, skin infections, and inflammatory conditions. In this practical review, we present the classic dermoscopic findings of the following: vascular tumors, infectious conditions (molluscum contagiosum, scabies, verruca vulgaris), inflammatory conditions (psoriasis, atopic dermatitis), juvenile xanthogranuloma, and nevus sebaceus.

Update on Dermoscopy and Infectious Skin Diseases

Nowadays, dermoscopy is a global worldwide diffuse diagnostic tool supporting clinicians in their daily hard task of correct orientation among dermatological diseases. Born to be an instrument for early diagnosis of skin cancer, the dermatoscope is now considered the dermatologist's stethoscope, as it can be routinely used to support diagnosis in general dermatology, so spreading its utility in cutaneous inflammatory and infectious diseases, as adjuvant and not substitute to histology and potassium hydroxide examination. As concerns the latter, plenty of papers have been published since the first description of dermoscopic findings of scabies. The aim of this review is to give the clinician a practical approach to dermoscopic parameters of cutaneous infectious diseases with a focus on the latest updates in this topic.

Subungual Molluscum Contagiosum: A Rare Presentation

Molluscum contagiosum (MC) is a self-limiting viral infectious cutaneous disease usually characterized by pinkish skin color and round umbilicated papules varying in size and shape. MC can affect any region, but the lower abdomen, thighs, genitals, and perianal area are the sites most commonly involved. Atypical localizations of the lesions may be difficult to diagnose. We report a case of subungual MC with dermoscopic features in a young male.