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Kiptis PK, Mirembe SK, Aloyomola G, Mulyowa GK. Pityriasis rosea: dermoscopic features in Uganda. Int J Dermatol 2024; 63:611-617. [PMID: 38168865 DOI: 10.1111/ijd.16981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE The study aimed to describe the dermoscopic features of pityriasis rosea among patients attending the skin clinic at Mbarara Regional Referral Hospital. PATIENTS AND METHODS A hospital-based cross-sectional descriptive study conducted for a 6-month period in the skin clinic of MRRH in Southwestern Uganda. Data were collected from consecutively recruited patients using structured questionnaires. Patients with a clinical diagnosis of pityriasis rosea were examined using a dermoscope and subsequently sent for KOH and TPHA tests to rule out fungal skin infection and secondary syphilis, respectively, and then received routine care at the skin clinic. RESULTS There were 54 patients with pityriasis rosea seen. Dermoscopy was done on a total of 162 lesions of which 19 were herald patches, 51 were truncal lesions, 52 on the extremities while 40 were on the face and neck regions. Common dermoscopic features consisted of a violaceous background noted in 145 (89.51%), white scales in 161 (99.38%), diffuse scale distribution in 57 (35.19%), perifollicular scale type in 61 (37.65%), and brown-dotted pigmentary changes in 66 (40.74%). Other unique findings noted in a few lesions were cloudy structures, petechial spots, erosions, and punched out pits. CONCLUSION Most prevalent dermoscopic features included: a violaceous background, white scales, diffuse scale distribution, perifollicular scale type, brown-dotted pigmentary changes with no visible blood vessels nor follicular changes. Other unique less frequently seen findings were cloudy structures, petechial spots, erosions, and punched out pits.
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Affiliation(s)
- Paul K Kiptis
- Department of Dermatology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Stephen K Mirembe
- Department of Dermatology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Gladys Aloyomola
- Department of Dermatology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Grace K Mulyowa
- Department of Dermatology, Mbarara University of Science and Technology, Mbarara, Uganda
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Sławińska M, Żółkiewicz J, Behera B, Ding DD, Lallas A, Chauhan P, Khare S, Enechukwu NA, Akay BN, Ankad BS, Bhat YJ, Jha AK, Kaliyadan F, Kelati A, Neema S, Parmar NV, Stein J, Usatine RP, Vinay K, Sobjanek M, Errichetti E. Dermoscopy of Inflammatory Dermatoses (Inflammoscopy) in Skin of Color - A Systematic Review by the International Dermoscopy Society "Imaging in Skin of Color" Task Force. Dermatol Pract Concept 2023; 13:dpc.1304S1a297S. [PMID: 37874994 PMCID: PMC10824322 DOI: 10.5826/dpc.1304s1a297s] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2023] [Indexed: 10/26/2023] Open
Abstract
Dermoscopic patterns of inflammatory dermatoses (inflammoscopy) have been extensively studied in the recent years, though data on patients with darker phototypes (IV-VI) are sparse. The aims of this systematic review were to summarize the current state of knowledge on inflammoscopy applied to skin of color and provide a standardized nomenclature of reported findings. Besides dermoscopic features, type of setting and magnification, number of cases, and histopathological correlation were analyzed. Eighty-five papers addressing 78 different dermatoses (25 papulosquamous dermatoses, 19 hyperpigmented dermatoses, eight hypopigmented dermatoses, four granulomatous dermatoses, two sclerotic dermatoses, five facial inflammatory dermatoses, and 15 miscellaneous conditions) for a total of 2073 instances were retrieved. Only one study showed a level of evidence of III (cross-sectional study), whereas 10 and 74 displayed a level of evidence of IV (case-control studies) and V (case-series and case-reports), respectively. Moreover, our analysis also highlighted that most of papers focalized on a limited number of dermatoses, with several conditions having only single dermoscopic descriptions. Additionally, few studies compared findings among phototypes belonging to the "skin of color" spectrum. Further studies designed according to a systematic approach and considering the above-mentioned issues are therefore needed.
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Affiliation(s)
- Martyna Sławińska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Poland
| | - Jakub Żółkiewicz
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Poland
| | - Biswanath Behera
- Department of Dermatology and Venereology, AIIMS, Bhubaneswar, India
| | - Delaney D Ding
- University of Florida College of Medicine, Gainesville, FL, USA
| | - Aimilios Lallas
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Payal Chauhan
- Department of Dermatology, All India Institute of Medical Sciences (AIIMS), Bilaspur, Himachal Pradesh, India
| | - Soumil Khare
- Department of Dermatology, Venereology and Leprosy, AIIMS, Raipur, India
| | - Nkechi Anne Enechukwu
- Nnamdi Azikiwe University/Nnamdi Azikiwe Teaching Hospital Nnewi, Anambra State, Nigeria
| | - Bengu Nisa Akay
- Department of Dermatology, School of Medicine, Ankara University, Ankara, Turkey
| | - Balachandra S Ankad
- Department of Dermatology, Venereology and Leprosy, SN Medical College, Bagalkot, Karnataka, India
| | - Yasmeen J Bhat
- Department of Dermatology, Venereology and Leprology, Government Medical College, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Abhijeet Kumar Jha
- Department of Dermatology & STD, Patna Medical College & Hospital, Patna, India
| | - Feroze Kaliyadan
- Department of Dermatology, Sree Narayana Institute of Medical Sciences, Ernakulum, India
| | - Awatef Kelati
- Dermatology Department, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Shekhar Neema
- Department of Dermatology, Venereology and Leprology, Armed Force Medical College, Pune, Maharashtra, India
| | - Nisha V Parmar
- Department of Dermatology, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Jennifer Stein
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA
| | - Richard P Usatine
- Department of Dermatology and Cutaneous Surgery, Department of Family and Community Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Michał Sobjanek
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Poland
| | - Enzo Errichetti
- Institute of Dermatology, “Santa Maria della Misericordia” University Hospital, Udine, Italy
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Müller C, Kittler H. [Dermoscopy of nonneoplastic diseases in dark skin]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023; 74:250-255. [PMID: 36859732 PMCID: PMC10049959 DOI: 10.1007/s00105-023-05121-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/27/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Dermoscopy is an important tool in general dermatology. OBJECTIVES To show differences of light and dark skin in nonneoplastic diseases with focus on dermoscopy. MATERIALS AND METHODS Using previously published studies, dermoscopic differences of various skin types as well as features of inflammatory diseases and pigmentary changes are illustrated. RESULTS Certain structures are more difficult to assess in dermoscopy of dark skin (e.g., vessels), while other structures (e.g., follicular openings) are more prominent. CONCLUSIONS The majority of studies on dermoscopy are from studies that predominantly included individuals with fair skin types. Further studies of individuals with skin type IV or higher are needed to improve diagnosis in these patients.
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Affiliation(s)
- Christoph Müller
- Universitätsklinikum für Dermatologie, AKH Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
| | - Harald Kittler
- Universitätsklinikum für Dermatologie, AKH Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
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Hanumanthu V, Gupta S, Chatterjee D, Vinay K. Dermoscopy of Discoid Lupus Erythematosus of Palms. J Eur Acad Dermatol Venereol 2022; 36:e701-e702. [DOI: 10.1111/jdv.18156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/25/2022] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
Affiliation(s)
| | - Smriti Gupta
- Department of Dermatology, Venereology and Leprology
| | - Debajyoti Chatterjee
- Department of Histopathology Postgraduate Institute of Medical Education and Research Chandigarh India 160012
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Errichetti E, Ankad BS, Jha AK, Sonthalia S, Akay BN, Bakos R, Bhat YJ, Bosseila M, Braun R, Cabo H, Cohen Sabban EN, Chatterjee M, Daneshpazhooh M, Jakhar D, Kaliyadan F, Kelati A, Keshavamurthy V, Neema S, Sadek A, Salerni G, Swanson DL, Tejasvi T, Usatine R, Lallas A. International Dermoscopy Society criteria for non-neoplastic dermatoses (general dermatology): validation for skin of color through a Delphi expert consensus. Int J Dermatol 2022; 61:461-471. [PMID: 34216025 DOI: 10.1111/ijd.15729] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/13/2021] [Accepted: 05/26/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND The International Dermoscopy Society (IDS) recently released a set of five basic dermoscopic parameters (vessels, scales, follicular findings, "other structures," and specific clues) encompassing a total of 31 subitems to standardize the use of dermoscopy in non-neoplastic dermatoses, yet they have been developed taking into account Caucasian/Asian skin, with consequent possible limitations if used in dark skin. OBJECTIVES To validate the abovementioned criteria for the use in dark-skinned patients (phototypes IV-VI) through an expert consensus. METHODS The two-round Delphi method was adopted, with an iterative process consisting of two rounds of email questionnaires. Potential panelists were recruited via e-mail from all over the world based on their expertise on dermoscopy of non-neoplastic dermatoses in skin of color. RESULTS Twenty-two panelists took part in the validation process. All of the five originally proposed parameters and subitems reached agreement during the first round, aside from "follicular red dots." Additionally, during round 1, five new subitems were proposed (perifollicular scales distribution, follicular openings obliteration, broken hairs, eccrine pigmentation, and eccrine ostia obliteration), along with the possibility to change the denomination of parameter 3 (from "follicular findings" to "follicular/eccrine findings") and split it into two subparameters ("follicular findings" and "eccrine findings"). All such proposals reached agreement during the second round and therefore were included in the final list, for a total of 37 items. CONCLUSIONS Although nearly all the dermoscopic criteria originally proposed by the IDS are applicable even to darker phototypes, several additional variables need to be assessed.
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Affiliation(s)
- Enzo Errichetti
- Institute of Dermatology, "Santa Maria della Misericordia" University Hospital, Udine, Italy
| | - Balachandra S Ankad
- Department of Dermatology, Venereology and Leprosy, SN Medical College, Bagalkot, Karnataka, India
| | - Abhijeet K Jha
- Department of Dermatology & STD, Patna Medical College & Hospital, Patna, India
| | | | - Bengu N Akay
- Department of Dermatology, School of Medicine, Ankara University, Ankara, Turkey
| | - Roberto Bakos
- Department of Dermatology, Hospital de Clınicas de Porto Alegre, Porto Alegre, Brazil
| | - Yasmeen J Bhat
- Department of Dermatology, Venereology and Leprology, Government Medical College, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | | | - Ralph Braun
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Horacio Cabo
- Dermatology Department, Instituto de Investigaciones Médicas A. Lanari, University of Buenos Aires, Argentina
| | - Emilia N Cohen Sabban
- Dermatology Department, Instituto de Investigaciones Médicas A. Lanari, University of Buenos Aires, Argentina
| | - Manas Chatterjee
- Department of Dermatology, Command Hospital (Eastern Command), Kolkata, India
| | - Maryam Daneshpazhooh
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Razi Hospital, Tehran, Iran
| | - Deepak Jakhar
- Department of Dermatology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Feroze Kaliyadan
- Faculty of Dermatology, College of Medicine, Kind Faisal University, Al Ahsa, Saudi Arabia
| | - Awatef Kelati
- Dermatology Department, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Vinay Keshavamurthy
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shekhar Neema
- Department of Dermatology, Armed Forces Medical College, Pune, India
| | - Ahmed Sadek
- Department of Dermatology, Venereology and Andrology, Al-Azhar University Faculty of Medicine, Cairo, Egypt
| | - Gabriel Salerni
- Dermatology Department, Hospital Provincial del Centenario de Rosario, Universidad Nacional de Rosario, Argentina
| | | | - Trilokraj Tejasvi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Richard Usatine
- Department of Dermatology and Cutaneous Surgery, Department of Family and Community Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Aimilios Lallas
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
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