1
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Wu Y, Sun L. Clinical value of dermoscopy in psoriasis. J Cosmet Dermatol 2024; 23:370-381. [PMID: 37710414 DOI: 10.1111/jocd.15926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/25/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Dermoscopy is a noninvasive technique that has attracted increasing attention in the field of inflammatory skin diseases (such as psoriasis) in recent years. OBJECTIVE This study aimed to provide an up-to-date overview of the role of dermoscopy in the diagnosis and extra-diagnosis of psoriasis. METHODS This study sought to review the published literature regarding use of dermoscopy in the evaluation of psoriasis. RESULTS The diagnostic value of dermoscopy in psoriasis vulgaris, nail psoriasis, and other types of psoriasis was summarized from the aspects of vascular pattern, scale pattern, and other features. Meanwhile, the application value of dermoscopy in the differential diagnosis, efficacy and severity assessment, prediction and monitoring of psoriasis was discussed. CONCLUSION Dermoscopy has good clinical value in the diagnosis and differential diagnosis of psoriasis and shows great prospects for severity assessment and efficacy prediction monitoring.
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Affiliation(s)
- Yifeng Wu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Liyun Sun
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
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2
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Batra J, Gulati S, Sarangal R, Chopra D, Puri S, Kaur R. Utility of Dermoscopy in the Diagnosis of Erythroderma: A Cross-Sectional Study. Indian Dermatol Online J 2023; 14:821-828. [PMID: 38099018 PMCID: PMC10718095 DOI: 10.4103/idoj.idoj_678_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/05/2023] [Accepted: 06/17/2023] [Indexed: 12/17/2023] Open
Abstract
Background It is difficult to diagnose the underlying cause of erythroderma on mere clinical presentation. The role of dermoscopy in diagnosing erythroderma secondary to various etiologies is evolving. Aim and Objectives This study aimed to observe the dermoscopic features of erythroderma secondary to different cutaneous disorders and compare them with clinical features and histopathology. Materials and Methods Twenty-nine consecutive patients of erythroderma were enrolled in the study. Dermoscopy was performed on every case using a Heine Delta II Dermatoscope with 10x magnification in polarized mode. A histopathological examination was conducted to confirm the diagnosis. Results Eight patients were diagnosed with psoriasis, five with endogenous eczema, four with pityriasis rubra pilaris (PRP), three with pustular psoriasis, two with drug rash secondary to antitubercular therapy, two with dermatophytic infection, one patient each of atopic dermatitis, crusted scabies, pemphigus foliaceous, drug reaction with eosinophilia and systemic symptoms, and mycosis fungoides. Characteristic dermoscopic features were observed in erythroderma due to psoriasis, PRP, pustular psoriasis, endogenous eczema, scabies, and dermatophytosis. Differentiation of other disorders based on dermoscopy alone was difficult, and clinico-histopathological correlation was crucial to reach a diagnosis. Conclusion Dermoscopic features of classical patterns of skin disorders are preserved even in the corresponding erythrodermic or unstable stage. Dermoscopic features of erythroderma secondary to psoriasis, pustular psoriasis, PRP, endogenous eczema, scabies, and dermatophytosis are clearly differentiating, whereas the dermoscopic features in other causes of erythroderma are overlapping. Thus, dermoscopy can be a good screening tool in the clinical assessment of erythroderma.
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Affiliation(s)
- Jayati Batra
- Government Medical College, Patiala, Punjab, India
| | | | | | | | - Sulabh Puri
- Government Medical College, Patiala, Punjab, India
| | - Ravneet Kaur
- Government Medical College, Patiala, Punjab, India
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3
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Paller AS, Silverberg JI, Cork MJ, Guttman-Yassky E, Lockshin B, Irvine AD, Kim MB, Kabashima K, Chen Z, Lu Y, Bansal A, Rossi AB, Shabbir A. Efficacy and Safety of Dupilumab in Patients With Erythrodermic Atopic Dermatitis: A Post Hoc Analysis of 6 Randomized Clinical Trials. JAMA Dermatol 2023; 159:255-266. [PMID: 36723913 PMCID: PMC10018319 DOI: 10.1001/jamadermatol.2022.6192] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Importance Erythrodermic atopic dermatitis (AD) is a severe AD subtype defined by extensive skin involvement, leading to complications and sometimes hospitalization. Objective To assess dupilumab's efficacy and safety in patients with erythrodermic AD in clinical trials. Design, Setting, and Participants This post hoc analysis included patients enrolled in 6 multicenter, multinational, randomized, double-blind, placebo-controlled trials. Patients included in this analysis met erythrodermic AD criteria of 90% or greater body surface area (BSA) affected by AD and Global Individual Sign Score for erythema of 1 or higher. Data analyses for this post hoc analysis were conducted between March 5, 2019, and October 24, 2020. Interventions Dupilumab once weekly or every 2 weeks, or placebo, either as monotherapy or with concomitant topical corticosteroids (TCS). Main Outcomes and Measures Efficacy (BSA, Eczema Area and Severity Index [EASI] score, Peak Pruritus Numerical Rating Scale [PP-NRS] score), changes in serum biomarkers (thymus and activation-regulated chemokine, total immunoglobulin E, lactate dehydrogenase), and safety (incidence of adverse events) at week 16. Data were pooled within each regimen; monotherapy and concomitant TCS results are shown separately. Results Of 3075 randomized patients, 209 met criteria for erythrodermic AD at baseline, with the median age being 31 and 39 years in the monotherapy and concomitant TCS trials, respectively, similar to the overall populations (34 and 36 years, respectively); 71.3% (n = 97) and 74.0% (n = 54) of patients, respectively, were male (compared with 58.7% and 60.6% in the overall populations). In patients with erythrodermic AD, dupilumab once weekly and every 2 weeks vs placebo significantly improved percentage of BSA affected by AD (least squares mean percent change [SE]) with monotherapy (-42.0% [7.7%] and -39.9% [6.5%] vs -17.2% [11.0%]; P = .03) and concomitant TCS (-63.2% [6.7%] and -56.1% [9.1%] vs -14.5% [7.3%]; P < .001); EASI score with monotherapy (-58.5% [9.0%] and -58.3% [7.9%] vs -22.3% [12.4%]; P = .004 and P = .003, respectively) and concomitant TCS (-78.9% [7.8%] and -70.6% [10.1%] vs 19.3% [8.2%]; P < .001); and PP-NRS score in monotherapy (-45.9% [7.8%] and -33.9% [6.6%] vs -0.6% [9.4%]; P < .001) and concomitant therapy (-53.0% [8.1%] and -55.7% [10.8%] vs -26.0% [8.8%]; P = .006 and P = .01, respectively). Nominally statistically significant improvement was seen as early as week 1 (EASI and PP-NRS scores with monotherapy). Biomarker levels were significantly reduced vs placebo. The most frequent adverse events in dupilumab-treated patients were injection-site reaction, conjunctivitis, and nasopharyngitis. Conclusions and Relevance In this post hoc analysis of 6 randomized clinical trials, treatment with dupilumab resulted in rapid, sustained improvements in AD signs and symptoms with acceptable safety in patients with erythrodermic AD, similar to those in the trials' overall patient population. Trial Registration ClinicalTrials.gov Identifiers: NCT01859988, NCT02277743, NCT02277769, NCT03054428, NCT02260986, NCT02755649.
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Affiliation(s)
- Amy S Paller
- Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Jonathan I Silverberg
- The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Michael J Cork
- Sheffield Dermatology Research, University of Sheffield, Sheffield, United Kingdom
| | - Emma Guttman-Yassky
- Icahn School of Medicine at Mount Sinai Medical Center, New York, New York.,Rockefeller University, New York, New York
| | | | - Alan D Irvine
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Moon Bum Kim
- Pusan National University Hospital, Busan, South Korea
| | | | - Zhen Chen
- Regeneron Pharmaceuticals Inc, Tarrytown, New York
| | - Yufang Lu
- Regeneron Pharmaceuticals Inc, Tarrytown, New York
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4
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Pakornphadungsit K, Suchonwanit P, Thadanipon K, Visessiri Y, Rutnin S. Dermoscopic Features and Their Diagnostic Values Among Common Inflammatory and Infectious Dermatoses: A Cross-Sectional Study. Clin Cosmet Investig Dermatol 2023; 16:211-220. [PMID: 36718215 PMCID: PMC9884057 DOI: 10.2147/ccid.s397212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/14/2023] [Indexed: 01/25/2023]
Abstract
Background Dermoscopy is a non-invasive tool widely used to improve the diagnostic accuracy of general dermatological conditions. Objective To determine the dermoscopic features and their diagnostic value in distinguishing common inflammatory and infectious dermatoses. Materials and Methods A cross-sectional study was conducted on patients clinically diagnosed with common inflammatory or infectious skin diseases. Baseline characteristics and clinical and dermoscopic findings were recorded. Dermoscopic variables were analyzed using a correlation matrix. A skin biopsy was performed for each patient for a definitive diagnosis. Results Of 102 patients, 43 with dermatitis, 30 with psoriasis, 14 with lichen planus (LP), 5 with pityriasis rosea (PR), and 10 with others were included. Dull red background, patchy vessels, and scales showed significant positive correlations with dermatitis (r = 0.401, 0.488, and 0.327, respectively; p < 0.01), whereas bright red background, glomerular vessels, regular vascular distribution, and diffuse scales revealed significant positive correlations with psoriasis (r = 0.412, 0.266, 0.798, and 0.401, respectively; p < 0.01). For LP, whitish reticulate structures, purplish background, and dotted vessels mixed with linear vessels in the peripheral distribution were significantly positively correlated (r = 0.831, 0.771, 0.224, and 0.558, respectively; p < 0.05). Yellowish background and peripheral scales were predictive of PR diagnosis (r = 0.254 and 0.583, respectively; p < 0.01). Conclusion Dermoscopy can be used as an adjunctive tool to differentiate conditions among common inflammatory and infectious dermatoses in order to minimize unnecessary invasive diagnostic procedures.
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Affiliation(s)
- Kallapan Pakornphadungsit
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kunlawat Thadanipon
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Yingluck Visessiri
- Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suthinee Rutnin
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand,Correspondence: Suthinee Rutnin, Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, Thailand, 10400, Tel +66-2-2011141, Fax +66-2-201-1211 ext 4, Email
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5
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Chatterjee M, Rajput G, Hemdani R. Review article: Dermoscopy in pediatric dermatosis. APOLLO MEDICINE 2023. [DOI: 10.4103/am.am_178_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
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6
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Das A, Madke B, Jakhar D, Neema S, Kaur I, Kumar P, Pradhan S. Named signs and metaphoric terminologies in dermoscopy: A compilation. Indian J Dermatol Venereol Leprol 2022; 88:855-866. [PMID: 35146985 DOI: 10.25259/ijdvl_1047_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 06/01/2021] [Indexed: 02/03/2023]
Affiliation(s)
- Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Bhushan Madke
- Department of Dermatology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India
| | - Deepak Jakhar
- Department of Dermatology, North DMC Medical College and Hindu Rao Hospital, New Delhi, India
| | - Shekhar Neema
- Department of Dermatology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ishmeet Kaur
- Department of Dermatology, North DMC Medical College and Hindu Rao Hospital, New Delhi, India
| | - Piyush Kumar
- Department of Dermatology, Katihar Medical College, Katihar, Bihar, India
| | - Swetalina Pradhan
- Department of Dermatology, All India Institute of Medical Sciences, Patna, Bihar, India
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7
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Errichetti E, Apalla Z, Geller S, Sławińska M, Kyrgidis A, Kaminska‐Winciorek G, Jurakic Toncic R, Bobos M, Rados J, Ledic Drvar D, Ceovic R, Akay BN, Piccolo V, Myskowski P, Vitiello P, Russo T, Argenziano G, Sokołowska‐Wojdyło M, Sobjanek M, Stoikovic‐Filipovic J, Longo C, Pellacani G, Stinco G, Lallas A. Dermoscopic spectrum of mycosis fungoides: a retrospective observational study by the International Dermoscopy Society. J Eur Acad Dermatol Venereol 2022; 36:1045-1053. [DOI: 10.1111/jdv.18078] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/22/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Enzo Errichetti
- Institute of Dermatology Department of Medicine University of Udine Udine Italy
| | - Zoe Apalla
- Second Department of Dermatology Aristotle University Thessaloniki Greece
| | - Shamir Geller
- Dermatology Service Department of Medicine Memorial Sloan Kettering Cancer Center New York USA
- Division of Dermatology Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University Tel Aviv Israel
| | - Martyna Sławińska
- Department of Dermatology, Venereology and Allergology Faculty of Medicine Medical University of Gdańsk Poland
| | - Athanassios Kyrgidis
- Department of Oral & Maxillofacial surgery Aristotle University Thessaloniki Greece
| | - Grażyna Kaminska‐Winciorek
- Department of Bone Marrow Transplantation and Onco‐Hematology Maria Sklodowska‐Curie National Research Institute of Oncology (MSCNRIO) Gliwice Poland
| | - Ruzica Jurakic Toncic
- University Department of Dermatology and Venereology University Hospital Centre and School of Medicine Zagreb Croatia
| | - Mattheos Bobos
- Department of Biomedical Sciences School of Health Sciences International Hellenic University Alexandrian Campus Sindos, Thessaloniki Greece
| | - Jaka Rados
- University Department of Dermatology and Venereology University Hospital Centre and School of Medicine Zagreb Croatia
| | - Daniela Ledic Drvar
- University Department of Dermatology and Venereology University Hospital Centre and School of Medicine Zagreb Croatia
| | - Romana Ceovic
- University Department of Dermatology and Venereology University Hospital Centre and School of Medicine Zagreb Croatia
| | | | | | - Patricia Myskowski
- Dermatology Service Department of Medicine Memorial Sloan Kettering Cancer Center New York USA
| | | | - Teresa Russo
- Dermatology Unit University of Campania Naples Italy
| | | | | | - Michał Sobjanek
- Department of Dermatology, Venereology and Allergology Faculty of Medicine Medical University of Gdańsk Poland
| | - Jelena Stoikovic‐Filipovic
- Clinic of Dermatology and Venereology Clinical Center of Serbia Department of Dermatology Faculty of Medicine University of Belgrade Belgrade Serbia
| | - Caterina Longo
- Department of Dermatology University of Modena and Reggio Emilia Modena Italy
- Azienda Sanitaria Locale IRCCS di Reggio Emilia Centro Oncologico ad Alta Tecnologia Diagnostica‐Dermatologia Reggio Emilia Italy
| | - Giovanni Pellacani
- Dermatology Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences University La Sapienza Rome
| | - Giuseppe Stinco
- Institute of Dermatology Department of Medicine University of Udine Udine Italy
| | - Aimilios Lallas
- First Department of Dermatology Aristotle University Thessaloniki Greece
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8
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Żychowska M, Łudzik J, Witkowski A, Lee C, Reich A. Dermoscopy of Gottron's papules and other inflammatory dermatoses involving the dorsa of the hands. J Eur Acad Dermatol Venereol 2022; 36:1080-1087. [PMID: 35274387 DOI: 10.1111/jdv.18052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/15/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Several inflammatory dermatoses, including dermatomyositis (DM), may present as erythematous papules or plaques on the dorsal aspects of the hands over the joints. Limited skin involvement in these entities may pose a diagnostic challenge. (Video)dermoscopy is being utilized more frequently to aid in differential diagnosis of inflammatory skin conditions. OBJECTIVE To describe the dermoscopic findings in Gottron's papules and compare with dermoscopic features of other dermatoses involving the dorsal aspects of the hands. METHODS Videodermoscopic images from patients presenting with erythematous papules or plaques on the dorsal surface of the hands were retrospectively analyzed for the presence of standardized dermoscopic parameters. RESULTS Dermoscopic images from patients with DM (n=12), psoriasis (n=19), chronic dermatitis (n=16), mycosis fungoides (n=7), lichen planus (n=5) and pityriasis rubra pilaris (n=3) were included. Gottron's papules were characterized by pleomorphic vessels (dotted vessels accompanied by thick or thin linear vessels with branches or linear curved vessels) in 66.7% of cases, arranged in unspecified pattern (91.7%), and accompanied by white or pink structureless areas (75.0%). Psoriatic plaques were characterized by dotted vessels arranged in a uniform pattern (94.7%). Vessels arranged in a ring pattern were nearly exclusively observed in psoriasis, while yellow structureless areas and erosions were more frequently present in chronic dermatitis. White lines, corresponding to Wickham striae, were specific for lichen planus. CONCLUSIONS Videodermoscopy might be of value in differentiating Gottron's papules from other dermatoses involving dorsa of the hands.
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Affiliation(s)
- M Żychowska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszów, Poland
| | - J Łudzik
- Department of Telemedicine and Bioinformatics, Jagiellonian University Medical College, Krakow, Poland.,Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - A Witkowski
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - C Lee
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - A Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszów, Poland
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9
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Golińska J, Sar-Pomian M, Sławińska M, Sobjanek M, Sokołowska-Wojdyło M, Rudnicka L. Trichoscopy may enhance differential diagnosis of erythroderma. Clin Exp Dermatol 2021; 47:394-398. [PMID: 34388270 DOI: 10.1111/ced.14887] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/15/2021] [Accepted: 08/12/2021] [Indexed: 11/29/2022]
Abstract
There is a paucity of data concerning the usability of trichoscopy in erythrodermic patients. The objective of the study was to compare trichoscopic features in erythroderma of various etiologies. Forty-nine patients with the determined cause of erythroderma (including atopic dermatitis, mycosis fungoides, allergic contact eczema, psoriasis, Sézary syndrome, drug reactions, pityriasis rubra pilaris, dermatomyositis, actinic reticuloid, crusted scabies and pemphigus foliaceus) were included in the study. Dotted vessels were present in patients with atopic dermatitis, pityriasis rubra pilaris, mycosis fungoides, Sézary syndrome and psoriasis and absent in dermatomyositis, crusted scabies, and pemphigus foliaceus (chi-square test, p=0.016). Spermatozoon-like vessels were observed only in mycosis fungoides and Sézary syndrome (p=0.001). Whitish-pinkish structureless areas were described in all patients with mycosis fungoides, pemphigus foliaceus, actinic reticuloid, and crusted scabies (p=0.028). The type of vessels and the presence of whitish-pinkish structureless areas under trichoscopy may indicate the cause of erythroderma.
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Affiliation(s)
- J Golińska
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008, Warsaw, Poland
| | - M Sar-Pomian
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008, Warsaw, Poland
| | - M Sławińska
- Department of Dermatology, Venereology and Allergology of the Medical University of Gdańsk, Smoluchowskiego 17, 80-214, 80-210, Gdańsk, Poland
| | - M Sobjanek
- Department of Dermatology, Venereology and Allergology of the Medical University of Gdańsk, Smoluchowskiego 17, 80-214, 80-210, Gdańsk, Poland
| | - M Sokołowska-Wojdyło
- Department of Dermatology, Venereology and Allergology of the Medical University of Gdańsk, Smoluchowskiego 17, 80-214, 80-210, Gdańsk, Poland
| | - L Rudnicka
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008, Warsaw, Poland
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10
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Clinical and trichoscopic features in 18 cases of Folliculotropic Mycosis Fungoides with scalp involvement. Sci Rep 2021; 11:10555. [PMID: 34006952 PMCID: PMC8131629 DOI: 10.1038/s41598-021-90168-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/04/2021] [Indexed: 11/17/2022] Open
Abstract
Folliculotropic Mycosis Fungoides (FMF) is a rare variant of Mycosis Fungoides involving the scalp leading to alopecia. The clinical and trichoscopic features in 18 patients were analyzed and compared with the reports in the literature. Gender, age, disease stage, site of onset were taken into consideration. Clinical and trichoscopic analyses were performed on each patient. From a clinical point of view, Folliculotropic Mycosis Fungoides lesions involving the scalp presented as generalized alopecia (27.8%) or patchy-plaque alopecia (72.2%). Trichoscopic analysis revealed six most frequent features: single hair (83.3%), dotted dilated vessels (77.8%), broken-dystrophic hairs (66.7%), vellus hairs (61.1%), spermatozoa-like pattern vessels (55.6%), and yellow dots (55.6%). Additional identified trichoscopic patterns were dilation of follicular openings, scales-crusts, purpuric dots, short hair with split-end, pigtail hairs, perifollicular hyperkeratosis, milky-white globules, black dots, white dots/lines and absence of follicular dots. These trichoscopic features were further correlated to clinical presentations and stage of the disease. The rarity of the disease is a limitation. The relatively high number of patients allowed to identify several clinical and trichoscopic patterns that could be featured as specific or highly suspicious for FMF in order to consider trichoscopy as a complementary diagnostic approach and improve the differential diagnoses between FMF and other scalp disorders.
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11
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Sławińska M, Sokołowska-Wojdyło M, Olszewska B, Nowicki RJ, Sobjanek M, Zalaudek I. Dermoscopic and trichoscopic features of primary cutaneous lymphomas - systematic review. J Eur Acad Dermatol Venereol 2021; 35:1470-1484. [PMID: 33710688 DOI: 10.1111/jdv.17219] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 02/25/2021] [Indexed: 01/24/2023]
Abstract
Dermoscopy and trichoscopy are non-invasive methods used as auxiliary tools in diagnostics of different dermatoses. To date, no systematic review concerning the utility of dermoscopy and trichoscopy in the diagnostics of primary cutaneous lymphomas has been published. The aim of this study was to summarize the current state of knowledge on this topic based on systematic search of PubMed database and related references published before 8th of August 2020. Besides dermoscopic features, type of dermoscope, polarization mode, magnification, number of cases and histopathological correlation were analysed. A total of 34 records were included into the final analysis, evaluating 141 patients diagnosed with primary cutaneous T-cell lymphomas and 70 patients with primary cutaneous B-cell lymphomas. Most of the analysed records evaluated dermoscopic features (n = 206); trichoscopy was analysed in only 5 cases. Structures most commonly observed in classical mycosis fungoides (n = 108) were fine short linear vessels/linear vessels, spermatozoa-like vessels and orange-yellow patchy areas. In folliculotropic mycosis fungoides (n = 12), most frequently observed were comedonal lesions/comedo openings/central keratotic plugs and white halo around hair follicles/perifollicular accentuation. Primary cutaneous marginal zone B-cell lymphoma (n = 42) and primary cutaneous follicle centre lymphoma (n = 20) most commonly presented with salmon-coloured background and fine short/linear irregular/serpentine vessels. For other PCL, with less than 10 cases reported in the analysed records, details have been provided in the article. Most observations analysed in this systematic review rely on findings from case reports/case series (with the level of evidence V) and lack a control group. A few studies provided information concerning technical aspects of dermoscopic/trichoscopic examination. The role of dermoscopy/trichoscopy in diagnostics of cutaneous lymphomas requires further studies, especially in entities where dermoscopic features have been described in only single or a few cases. However, it seems that this practical, accessory tool in future may provide additional clues during clinical assessment.
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Affiliation(s)
- M Sławińska
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - M Sokołowska-Wojdyło
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - B Olszewska
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - R J Nowicki
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - M Sobjanek
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - I Zalaudek
- Department of Dermatology, University of Trieste, Trieste, Italy
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12
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Bhat YJ, Jha AK. Dermatoscopy of Inflammatory Diseases in Skin of Color. Indian Dermatol Online J 2021; 12:45-57. [PMID: 33768022 PMCID: PMC7982019 DOI: 10.4103/idoj.idoj_613_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/02/2020] [Accepted: 12/20/2020] [Indexed: 11/04/2022] Open
Abstract
Dermatoscopy is a relevant in vivo diagnostic tool for inflammatory diseases of the skin that aids not only in diagnosis, but also in monitoring the response to treatment. The inflammatory diseases show dermoscopic patterns involving the vessels, scales, follicles, background hue, and special clues. This review aims to provide an overview on the use of dermoscopy in inflammatory dermatoses based on the available literature and the deviation from it in the skin of color (SOC) as there is paucity of literature in dermoscopy of inflammatory disorders in SOC. The dermatoscopic patterns in most of the inflammatory diseases in SOC are similar to that of white skin, with pigmentary changes being the prominent dermoscopic findings while vascular patterns and erythema being less evident.
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Affiliation(s)
- Yasmeen J Bhat
- Department of Dermatology, Venereology and Leprosy, Government Medical College, Srinagar, University of Kashmir, Jammu and Kashmir, India
| | - Abhijeet K Jha
- Department of Skin and VD, Patna Medical College, Patna, Bihar, India
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13
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Errichetti E, Stinco G. Dermoscopy of senile gluteal dermatosis: an observational study. Int J Dermatol 2020; 59:e460-e462. [DOI: 10.1111/ijd.15057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/04/2020] [Accepted: 06/16/2020] [Indexed: 11/29/2022]
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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Sławińska M, Sokołowska-Wojdyło M, Sobjanek M, Golińska J, Nowicki RJ, Rudnicka L. The significance of dermoscopy and trichoscopy in differentiation of erythroderma due to various dermatological disorders. J Eur Acad Dermatol Venereol 2020; 35:230-240. [PMID: 33073390 DOI: 10.1111/jdv.16998] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/02/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND The diagnosis of a patient with erythroderma may be difficult and sometimes pose a challenge for both dermatologist and pathologist. The role of dermoscopy in this area seems to be poorly investigated. There are only a few reports, with limited number of patients, describing dermoscopic features in erythroderma of various origins. To the best of our knowledge, none of the previous studies had included trichoscopic examination. OBJECTIVES Analysis of dermoscopic and trichoscopic patterns in series of patients with erythroderma. METHODS We retrospectively analysed 28 adult patients who presented with erythroderma between May 2016 and August 2020. Demographic data, disease course and duration, previous treatment, as well as dermoscopic and trichoscopic features were analysed. RESULTS There were 9 patients (32.1%) with the diagnosis of mycosis fungoides, 8 patients (28.5%) with atopic dermatitis, 3 patients (10.5%) with Sézary syndrome and 3 patients (10.5%) with pityriasis rubra pilaris. The others were diagnosed with allergic eczema (n = 1; 3.6%), dermatomyositis sine myositis (n = 1; 3.6%), psoriasis (n = 1; 3.6%), actinic reticuloid (n = 1; 3.6%) and crusted scabies (n = 1; 3.6%). Characteristic dermoscopic/trichoscopic patterns have been observed in erythroderma due to crusted scabies, psoriasis, dermatomyositis sine myositis, Sézary syndrome and pityriasis rubra pilaris. Differentiation of mycosis fungoides and long-standing atopic dermatitis based on dermoscopy is difficult, as the overlap of vessel morphology, background colour and scale colour exists. Similarly, differentiation between AD and AE based on dermoscopy/trichoscopy seems to be impossible, and clinical background is crucial. CONCLUSION Dermoscopy and trichoscopy seem to provide additional clues in the assessment of erythrodermic patient. Depending on the underlying cause, trichoscopy or dermoscopy may be more useful.
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Affiliation(s)
- M Sławińska
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - M Sokołowska-Wojdyło
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - M Sobjanek
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - J Golińska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - R J Nowicki
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - L Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
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15
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Errichetti E, Lallas A, Apalla Z, Stinco G. Dermoscopy of chronic superficial scaly dermatitis (small-plaque parapsoriasis): a controlled comparative morphological study. Int J Dermatol 2020; 60:e94-e96. [PMID: 33040330 DOI: 10.1111/ijd.15214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/26/2020] [Accepted: 09/02/2020] [Indexed: 12/26/2022]
Affiliation(s)
- Enzo Errichetti
- Department of Medical Areas, Institute of Dermatology, University of Udine, Udine, Italy
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Zoe Apalla
- Second Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Giuseppe Stinco
- Department of Medical Areas, Institute of Dermatology, University of Udine, Udine, Italy
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16
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Ye C, Yi J, Lai W, Zheng Y. Skin barrier damaging and repairing process: A new application field of dermoscopy. J Cosmet Dermatol 2020; 20:897-905. [PMID: 32892490 DOI: 10.1111/jocd.13643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/18/2020] [Accepted: 07/21/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although more and more noninvasive detection technologies have been used in assessing skin barrier integrity and functions, more accurate, intuitive, and convenient detective methods still needed to be explored and developed. AIMS To investigate the characteristic image changes under the dermoscopy and to explore the relationship with skin physiological indexes in skin barrier damaging and repairing process. PATIENTS/METHODS 25 healthy subjects with normal skin in forearm were included and divided into different groups according to the operated strips numbers (30, 35, and 40 times). Before tape stripping, and immediately, 3, 7, 14, and 21 days after tape stripping, dermoscopic examination and skin transepidermal water loss (TEWL), surface hydration, and L*a*b* value were simultaneously tested in the same region. RESULTS Immediately after different times tape stripping, the amount of cuticle cells residues and the microvascular images were different. In skin barrier repairing process, the scab forming time observed under dermoscopy was day 14, day 7, and day 3 on 30 times, 35 times, and 40 times stripped skin, respectively. A small amount of cuticle cells and blurry vessels could be identified in hydration value <40 group, while there was no cuticle cell residue, and the branching vessels were obvious in hydration value >40 group. CONCLUSIONS Unique manifestations could be observed under dermoscopy in different time points of skin barrier with various degree of injury and in skin barrier repairing process. By combining dermoscopy and skin indexes assessing technologies, the skin barrier integrity and function could be observed and evaluated more accurately and precisely.
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Affiliation(s)
- CongXiu Ye
- Department of Dermato-Venereology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - JinLing Yi
- Department of Dermato-Venereology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wei Lai
- Department of Dermato-Venereology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yue Zheng
- Department of Dermato-Venereology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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17
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Errichetti E, Zelin E, Pinzani C, Kyrgidis A, Lallas A, Stinco G. Dermoscopic and Clinical Response Predictor Factors in Nonsegmental Vitiligo Treated with Narrowband Ultraviolet B Phototherapy: A Prospective Observational Study. Dermatol Ther (Heidelb) 2020; 10:1089-1098. [PMID: 32749663 PMCID: PMC7477062 DOI: 10.1007/s13555-020-00431-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Indexed: 01/14/2023] Open
Abstract
Introduction Few data on possible local factors that can influence the achievement of response in nonsegmental vitiligo (NSV) treated with narrowband ultraviolet B (Nb-UVB) phototherapy are available. Our objective is to evaluate possible correlations between therapeutic outcomes and dermoscopic and local (lesional) clinical findings of vitiligous lesions undergoing Nb-UVB phototherapy to find positive and/or negative response predictor factors to such treatment. Methods For each target patch, we calculated the extension area using a computer-aided method and assessed dermoscopic and local (lesional) clinical findings at baseline. After 30 phototherapy sessions (twice weekly), surface area of the lesions was reevaluated to assess clinical improvement, correlating the therapeutic outcome with initial clinical and dermoscopic features. Results A total of 70 lesions were finally included in the study. At the end of therapy, 18 patches (25.7%) achieved improvement, and the presence of perifollicular pigmentation on baseline dermoscopic examination was found to be associated with a 12-fold higher probability of having a positive therapeutic outcome. Similarly, face localization was also correlated with clinical amelioration, with a sevenfold higher probability for improvement. No association (p > 0.05) between therapeutic outcomes (either good or poor) and other dermoscopic or local clinical variables (including leukotrichia) was observed. Conclusions Therapeutic response of vitiligo to Nb-UVB phototherapy may be positively affected by local features of the lesions, i.e., face localization and presence of perifollicular pigmentation on baseline dermoscopic examination, which might be considered as positive response predictor factors to optimize treatment of vitiligo.
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Affiliation(s)
- Enzo Errichetti
- Department of Medical Area, Institute of Dermatology, University of Udine, Udine, Italy.
| | - Enrico Zelin
- Department of Dermatology and Venereology, University of Trieste, Trieste, Italy
| | - Caterina Pinzani
- Department of Medical Area, Institute of Dermatology, University of Udine, Udine, Italy
| | - Athanassios Kyrgidis
- Department of Otolaryngology-Head and Neck Surgery, Aristotle University, Thessaloniki, Greece
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Giuseppe Stinco
- Department of Medical Area, Institute of Dermatology, University of Udine, Udine, Italy
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18
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Golińska J, Sar‐Pomian M, Rudnicka L. Dermoscopy of plaque psoriasis differs with plaque location, its duration, and patient's sex. Skin Res Technol 2020; 27:217-226. [DOI: 10.1111/srt.12933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/18/2020] [Accepted: 06/25/2020] [Indexed: 01/06/2023]
Affiliation(s)
- Joanna Golińska
- Department of Dermatology Medical University of Warsaw Warsaw Poland
| | - Marta Sar‐Pomian
- Department of Dermatology Medical University of Warsaw Warsaw Poland
| | - Lidia Rudnicka
- Department of Dermatology Medical University of Warsaw Warsaw Poland
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19
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Çetinarslan T, Türel Ermertcan A, Temiz P. Dermoscopic clues of palmoplantar hyperkeratotic eczema and palmoplantar psoriasis: A prospective, comparative study of 90 patients. J Dermatol 2020; 47:1157-1165. [PMID: 32691449 DOI: 10.1111/1346-8138.15487] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 06/03/2020] [Indexed: 11/30/2022]
Abstract
Diagnosis can be difficult in isolated palmar and plantar lesions in patients with psoriasis and eczema. The purpose of our study is to compare the dermoscopic findings in patients with palmoplantar psoriasis and palmoplantar hyperkeratotic eczema. This prospective, comparative study included 90 patients histopathologically diagnosed with eczema or psoriasis (35 psoriasis and 55 eczema). The age range was 18-75 years. The most common vessel type was dot vessel in psoriasis. Red globular ring vessels were seen in five patients with psoriasis, but not in any with eczema (P = 0.007). The most common vascular distribution pattern was regular in psoriasis (40%). Patchy vascular pattern was significant in eczema. The most common background color was light red in psoriasis (48.6%) (P < 0.001). Brownish-orange globules were observed in 25.7% of patients with eczema and 5.7% in patients with psoriasis (P = 0.02). There is only one study in the published work about dermoscopy of palmoplantar psoriasis and eczema. In our study, yellow crusts, patchy scale distribution, patchy vascular pattern, yellow scale color, dull red background color and brownish-orange globules were significant in patients with palmoplantar eczema. On the other hand, patients with psoriasis had light red background color, regular vascular distribution pattern and white scale color. We observed globule structures with a pale center and dark peripheral rim only in patients with eczema, which was not identified in previous studies. This globule structure may be a new finding in eczema.
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Affiliation(s)
| | - Aylin Türel Ermertcan
- Departments of, Department of, Dermatology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Peyker Temiz
- Department of, Pathology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
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20
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Abstract
A prompt recognition of life-threatening and severe acute rashes is of utmost importance to start an appropriate therapy as soon as possible. Consequently, clinicians often must rely only on clinical data to make a diagnosis because some diagnostic procedures may take a relatively long time to be performed (eg, histologic examination, microbiologic tests). In this scenario, dermatoscopy may be useful as an auxiliary tool to support the diagnosis by highlighting subclinical features. We have provided an up-to-date overview on the use of dermatoscopic assessment in life-threatening and severe acute dermatoses, including erythroderma (due to psoriasis, eczema, pityriasis rubra pilaris, mycosis fungoides, and drugs), pustular eruptions (pustular psoriasis and acute generalized exanthematous pustulosis), bullous eruptions (staphylococcal scalded skin syndrome, toxic epidermal necrolysis, and pemphigus vulgaris), hemorrhagic eruptions (necrotizing vasculitis and calciphylaxis), and erythematous eruptions (erythema multiforme major, Sweet syndrome, and DRESS syndrome).
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Affiliation(s)
- Enzo Errichetti
- Institute of Dermatology, Santa Maria della Misericordia University Hospital, Udine, Italy.
| | - Giuseppe Stinco
- Institute of Dermatology, Santa Maria della Misericordia University Hospital, Udine, Italy
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21
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Errichetti E. Dermoscopy of Inflammatory Dermatoses (Inflammoscopy): An Up-to-Date Overview. Dermatol Pract Concept 2019; 9:169-180. [PMID: 31384489 DOI: 10.5826/dpc.0903a01] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2019] [Indexed: 10/31/2022] Open
Abstract
In addition to its use in pigmented and nonpigmented skin tumors, dermoscopy is gaining appreciation in assisting the diagnosis of nonneoplastic diseases, especially inflammatory dermatoses (inflammoscopy). In this field, dermoscopic examination should be considered as the second step of a "2-step procedure," always preceded by the establishment of a differential diagnosis on the basis of clinical examination. In this paper, we sought to provide an up-to-date overview on the use of dermoscopy in common inflammatory dermatoses based on the available literature data. For practical purposes, the analyzed dermatoses are grouped according to the clinical presentation pattern, in line with the 2-step procedure principle: erythematous-desquamative and papulosquamous dermatoses, papulokeratotic dermatoses, erythematous facial dermatoses, sclero-atrophic dermatoses, and miscellaneous.
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Affiliation(s)
- Enzo Errichetti
- Institute of Dermatology, Santa Maria della Misericordia University Hospital, Udine, Italy
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22
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Kumar S, Vinay K, Radotra BD. Dermoscopy of Erythrodermic Pityriasis Rubra Pilaris. Indian Dermatol Online J 2019; 10:500-501. [PMID: 31334088 PMCID: PMC6615401 DOI: 10.4103/idoj.idoj_156_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sheetanshu Kumar
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bishan D Radotra
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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23
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Golińska J, Sar‐Pomian M, Rudnicka L. Dermoscopic features of psoriasis of the skin, scalp and nails – a systematic review. J Eur Acad Dermatol Venereol 2019; 33:648-660. [DOI: 10.1111/jdv.15344] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 10/01/2018] [Indexed: 12/11/2022]
Affiliation(s)
- J. Golińska
- Department of Dermatology Medical University of Warsaw Warsaw Poland
| | - M. Sar‐Pomian
- Department of Dermatology Medical University of Warsaw Warsaw Poland
| | - L. Rudnicka
- Department of Dermatology Medical University of Warsaw Warsaw Poland
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24
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Jha AK, Lallas A, Sonthalia S, Jhakar D, Udayan UK, Chaudhary RKP. Differentiation of pityriasis rubra pilaris from plaque psoriasis by dermoscopy. Dermatol Pract Concept 2018; 8:299-302. [PMID: 30479860 PMCID: PMC6246058 DOI: 10.5826/dpc.0804a10] [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: 02/08/2018] [Accepted: 07/03/2018] [Indexed: 11/17/2022] Open
Abstract
Background Diagnosing and differentiating pityriasis rubra pilaris (PRP) from other disorders can be a challenging task. Although histopathology remains the gold standard, it may not be feasible at times, especially in children. Being noninvasive, dermoscopy can be of great diagnostic importance in such a scenario. Dermoscopy overcomes the refractive properties of stratum corneum by interface medium or cross-polarization enabling easier visualization of lesions. Objective To study the dermoscopic features of PRP and compare them with dermoscopic features of psoriasis. Patients and Methods Retrospective observational analysis of dermoscopic characteristics of 28 patients with PRP (16) and psoriasis (12). Polarized dermoscopy at 10× magnification was performed and photographs were captured by Apple iPhone 7. The selection of dermoscopic variables was based on preexisting literature on the dermoscopic patterns of the 2 entities. Results The most frequent dermoscopic criteria of PRP were the presence of a central hair (16/16; 100%), follicular plugs (11/16; 68.7%), and perifollicular yellow/orange halos (9/16; 56.2%). No vascular structures were seen in our cases of PRP. Psoriasis was characterized by regularly distributed dotted vessels (12/12; 100%) and white scales (8/12; 66.6%). Conclusions Round-to-oval yellowish areas surrounding a central hair with or without follicular plugs represents the most frequent dermoscopic pattern of PRP.
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Affiliation(s)
- Abhijeet Kumar Jha
- Department of Skin & VD, Patna Medical College and Hospital, Patna, Bihar, India
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | - Deepak Jhakar
- Department of Dermatology, Deen Dayal Upadhyay Hospital, New Delhi, India
| | - Uday K Udayan
- Department of Skin & VD, Patna Medical College and Hospital, Patna, Bihar, India
| | - R K P Chaudhary
- Department of Skin & VD, Patna Medical College and Hospital, Patna, Bihar, India
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25
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Cuellar-Barboza A, Ocampo-Candiani J, Herz-Ruelas M. Eritrodermia en el adulto: un enfoque práctico para el diagnóstico y tratamiento. ACTAS DERMO-SIFILIOGRAFICAS 2018; 109:777-790. [DOI: 10.1016/j.ad.2018.05.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 04/20/2018] [Accepted: 05/23/2018] [Indexed: 01/19/2023] Open
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26
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A Practical Approach to the Diagnosis and Treatment of Adult Erythroderma. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2018.05.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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27
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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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28
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Alternative uses of dermoscopy in daily clinical practice: An update. J Am Acad Dermatol 2018; 79:1117-1132.e1. [PMID: 29920317 DOI: 10.1016/j.jaad.2018.06.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 05/30/2018] [Accepted: 06/11/2018] [Indexed: 01/06/2023]
Abstract
Dermoscopy is a noninvasive diagnostic tool that is currently being used for neoplastic skin lesions, several inflammatory and infectious diseases, and skin appendage disorders. As the clinical applications of dermoscopy beyond pigmented lesions are constantly increasing, the aim of this article is to provide an update on this topic. This comprehensive review substantiates how several diseases may show peculiar dermoscopy features so as to enhance the diagnosis and avoid (in selected cases) unnecessary histologic confirmation. In other cases, dermoscopy features may be shared with other conditions, with the advantage of narrowing down the differential diagnosis by ruling out those dermatoses with similar clinical aspect but different dermoscopic presentation.
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29
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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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30
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Zabotti A, Errichetti E, Zuliani F, Quartuccio L, Sacco S, Stinco G, De Vita S. Early Psoriatic Arthritis Versus Early Seronegative Rheumatoid Arthritis: Role of Dermoscopy Combined with Ultrasonography for Differential Diagnosis. J Rheumatol 2018; 45:648-654. [DOI: 10.3899/jrheum.170962] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2017] [Indexed: 01/08/2023]
Abstract
Objective.Exclusion of psoriatic skin/nail lesions is important in differentiating early seronegative rheumatoid arthritis (ERA) from early polyarticular psoriatic arthritis (EPsA) and such manifestations may go unnoticed in atypical or minimally expressed cases. The aim of this study is to assess the usefulness of integrated rheumatological-dermatological evaluation in highlighting dermatological lesions missed on rheumatological examination and to investigate the role of ultrasonography (US) and dermoscopy in improving the recognition of subclinical psoriatic findings.Methods.Patients with a new diagnosis of seropositive or seronegative ERA and EPsA with prevalent hands involvement were recruited. All were reassessed for the presence of psoriatic lesions during an integrated rheumatological-dermatological clinical evaluation and underwent hands US and proximal nailfold dermoscopy.Results.Seventy-three consecutive subjects were included in the study: 25 with seropositive ERA, 23 with seronegative ERA, and 25 with EPsA. One-fourth of the subjects initially diagnosed as seronegative ERA presented cutaneous or nail psoriasis on integrated rheumatological-dermatological evaluation, thereby being reclassified as EPsA. The presence of at least 1 extrasynovial feature on hand US and dotted vessels on proximal nailfold dermoscopy was significantly associated with EPsA, with a sensitivity of 68.0% and 96.0% and a specificity of 88.1% and 83.3% for US and dermoscopy, respectively. When used together, specificity for PsA diagnosis raised to 90.5%.Conclusion.Integrated rheumatological-dermatological clinical evaluation may be helpful in identifying patients with EPsA misclassified as seronegative ERA. Additionally, US and dermoscopy may be used as supportive tools in identifying subclinical psoriatic features, which may come in handy in distinguishing EPsA from ERA.
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Sławińska M, Sobjanek M, Olszewska B, Nowicki R, Sokołowska-Wojdyło M. Trichoscopic spectrum of folliculotropic mycosis fungoides. J Eur Acad Dermatol Venereol 2017; 32:e107-e108. [DOI: 10.1111/jdv.14596] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M. Sławińska
- Department of Dermatology, Venerology and Allergology; Medical University of Gdańsk; Gdańsk Poland
| | - M. Sobjanek
- Department of Dermatology, Venerology and Allergology; Medical University of Gdańsk; Gdańsk Poland
| | - B. Olszewska
- Department of Dermatology, Venerology and Allergology; Medical University of Gdańsk; Gdańsk Poland
| | - R. Nowicki
- Department of Dermatology, Venerology and Allergology; Medical University of Gdańsk; Gdańsk Poland
| | - M. Sokołowska-Wojdyło
- Department of Dermatology, Venerology and Allergology; Medical University of Gdańsk; Gdańsk Poland
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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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