Clinical and dermoscopic features of common warts

Spectrophotometric intracutaneous analysis findings and characteristics in plantar verrues

BACKGROUND

Spectrophotometric intracutaneous analysis (SIAscopy) is a non-invasive computerized method that provides insights beyond dermoscopic examination. This study aimed to show the various findings of the plantar verrucae with the SIAscopy evaluation, which displays the chromophores of the skin, melanin, hemoglobin, and collagen.

METHODS

Plantar verrucae lesions scanned using SIAscopy, and their color, total melanin, dermal melanin, collagen, and blood views were recorded on a computer. These SIAgraphs were examined individually and compared to dermoscopic literature findings.

RESULTS

The results of color view were in conformity with dermoscopic findings reported in the literature. Among the findings detected for the first time by a SIAscopic examination, a white halo around the vessel in view of total melanin, effacement in the keratinized areas, and whitening in the vascular areas were noted. There was a mottled collagen condensation, which was believed to be induced by dermal papillomatosis in the lesions in the view of collagen, and consequently, as a result of remittent light reflections due to the collagen structure in this area. There was a clarification in the vascular structures that were noticed in the color view in the blood view. It was noted that vascular structures that have not yet been thrombosed under the thickened epidermis could not be detected in color view.

CONCLUSION

Our study reveals that SIAscopy, a rapid, non-invasive, and easy-to-use examination method similar to dermoscopy, can also diagnose other skin diseases, particularly pathogenetic processes that induce epidermal and papillary dermis changes, apart from pigmented lesions.

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.

Cidofovir Intralesional Injection for Recalcitrant Common Warts: A Comparison with Sodium Tetradecyl Sulfate Intralesional Injection

Background

A novel treatment method is required for recalcitrant common warts.

Objective

This study aimed to compare the complete wart removal rate of cidofovir, a broad-spectrum antiviral agent, intralesional injection and sodium tetradecyl sulfate intralesional injection.

Methods

This retrospective study included 45 patients with recalcitrant common warts on the hands and/or feet, treated with cidofovir or sodium tetradecyl sulfate intralesional injection.

Results

The treatment results were evaluated in three groups as follows: (1) failure - recalcitrant common warts remaining despite three or more injections, (2) success - free from warts for more than 6 months after the injection, and (3) recurrence. The cidofovir group (n=22) showed significantly higher treatment success rates than the sodium tetradecyl sulfate group (n=23) (90.91% vs. 26.09%, p<0.001). Two immunosuppressed patients in the cidofovir group had recurrent lesions after 2 months of being declared free from warts. Considering adverse effects, two patients in the cidofovir group complained of bulla formation with severe pain requiring narcotic painkillers.

Conclusion

Although this study has the limitations of a small sample size and retrospective design, patients with recalcitrant common warts showed a dramatic response to the treatment with cidofovir intralesional injection, with minimal complications.

Entodermoscopy Update: A Contemporary Review on Dermoscopy of Cutaneous Infections and Infestations

Infectious cutaneous diseases are very common, especially in certain geographic and tropical regions. Sometimes they may simulate other dermatoses, ordering verification of diagnosis with particular investigations. Dermoscopy is among one of the most important tools readily available in the outpatient setting for the dermatologist to confirm the diagnosis. In this up-to date review, literature concerning the various dermoscopic features of parasitic, viral, dermatophytic and bacterial cutaneous infections is composed. In addition artefacts as well as practical issues in dermoscopy usage are discussed; with the aim to empower dermatologists to promptly and non-invasively diagnose and manage cutaneous infections and infestations.