Dermoscopic Features of Actinic Cheilitis and Other Common Inflammatory Cheilitis: A Multicentric Retrospective Observational Study by the International Dermoscopy Society

Background: Clinical differentiation between different cheilitis variants may be difficult. Application of mucoscopy, in addition to clinical background, could provide additional diagnostic clues facilitating initial patient management. Objectives: To determine mucoscopic clues differentiating actinic cheilitis from the main forms of inflammatory cheilitis, including eczematous cheilitis, discoid lupus erythematosus, and lichen planus of the lips. Methods: This was a retrospective, multicenter study being a part of an ongoing project "Mucoscopy - an upcoming tool for oral mucosal disorders" under the aegis of the International Dermoscopy Society. Cases included in the current study were collected via an online call published on the IDS website (www.dermoscopy-ids.org) between January 2019 and December 2020. Results: Whitish-red background was found in actinic cheilitis as well as in cheilitis due to discoid lupus erythematous and lichen planus. Polymorphous vessels were more likely to be seen in actinic cheilitis compared to other causes of cheilitis. White scales, ulceration, and blood spots predominated in actinic cheilitis and lichen planus, whereas yellowish scales typified eczematous and discoid lupus erythematous cheilitis. Radiating white lines although most common in lichen planus patients were also seen in actinic cheilitis. Conclusion: Despite differences in the frequency of mucoscopic structures, we have not found pathognomonic features allowing for differentiation between analyzed variants of cheilitis

Dermoscopy of Hair and Scalp Disorders (Trichoscopy) in Skin of Color—A Systematic Review by the International Dermoscopy Society “Imaging in Skin of Color” Task Force

Hair and scalp disorders are of significant interest for physicians dealing with dark phototypes due to their prevalence and potential aesthetic impact resulting from a higher tendency for scarring. In order to facilitate their non-invasive diagnosis, several dermoscopic studies have been published, yet data are sparse and no systematic analysis of the literature has been performed so far. This systematic literature review summarizes published data on trichoscopy of hair and scalp diseases (trichoscopic findings, used setting, pathological correlation, and level of evidence of studies). A total of 60 papers addressing 19 different disorders (eight non-cicatricial alopecias, nine cicatricial alopecias, and two hair shaft disorders) were assessed, for a total of 2636 instances. They included one cross-sectional analysis, 20 case-control studies, 25 case-series, and 14 single case-reports, so the level of evidence was V and IV in 65% and 33% of cases, respectively, with only one study showing a level of evidence of III. Notably, although there is a considerable body of literature on trichoscopy of hair/scalp diseases, our review underlined that potentially significant variables (e.g., disease stage or hair texture) are often not taken into account in published analyses, with possible biases on trichoscopic patterns, especially when it comes to hair shaft changes. Further analyses considering all such issues are therefore needed

Dermoscopy of Infectious Dermatoses (Infectiouscopy) in Skin of Color—A Systematic Review by the International Dermoscopy Society “Imaging in Skin of Color” Task Force

Dermoscopy has been showed to facilitate the non-invasive recognition of several infectious disorders (infectiouscopy) thanks to the detection of peculiar clues. Although most of the knowledge on this topic comes from studies involving light-skinned patients, there is growing evidence about its use also in dark phototypes. This systematic literature review summarizes published data on dermoscopy of parasitic, 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 66 papers addressing 41 different dermatoses (14 bacterial, 5 viral, 11 fungal infections, and 11 parasitoses/bites and stings) and involving a total of 1096 instances were included in the analysis. The majority of them displayed a level of evidence of V (44 single case reports and 21 case series), with only 1 study showing a level of evidence of IV (case-control analysis). Moreover, our analysis also highlighted a high variability in the terminology used in the retrieved studies. Thus, although promising, further studies designed according to a systematic and standardized approach are needed for better characterization of dermoscopy of infectious skin infections

Dermoscopy of Cutaneous Neoplasms in Skin of Color – A Systematic Review by the International Dermoscopy Society “Imaging in Skin of Color” Task Force

Over the last few decades, dermoscopy has been showed to facilitate the non-invasive diagnosis of both benign and malignant skin tumors, yet literature data mainly comes from studies on light phototypes. However, there is growing evidence that skin neoplasms may benefit from dermoscopic assessment even for skin of color. This systematic literature review evaluated published data in dark-skinned patients (dermoscopic features, used setting, pathological correlation, and level of evidence of studies), also providing a standardized and homogeneous terminology for reported dermoscopic findings. A total of 20 articles describing 46 different tumors (four melanocytic neoplasms, eight keratinocytic tumors, 15 adnexal cutaneous neoplasms, seven vascular tumors, four connective tissue tumors, and eight cystic neoplasms/others) for a total of 1724 instances were included in the analysis. Most of them showed a level of evidence of V (12 single case reports and six case series), with only two studies featuring a level of evidence of IV (case-control analysis). Additionally, this review also underlined that some neoplasms and phototypes are underrepresented in published analyses as they included only small samples and mainly certain tones of “dark skin” spectrum (especially phototype IV). Therefore, further studies considering such limitations are required for a better characterization

Dermoscopy of Inflammatory Dermatoses (Inflammoscopy) in Skin of Color—A Systematic Review by the International Dermoscopy Society “Imaging in Skin of Color” Task Force

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 76 different dermatoses (25 papulosquamous dermatoses, 19 hyperpigmented dermatoses, seven hypopigmented dermatoses, four granulomatous dermatoses, two sclerotic dermatoses, five facial inflammatory dermatoses, and 14 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

Bone involvement in leprosy: Early changes

AbstractLeprosy (Hansen disease) is a slowly progressive, infectious, chronic granulomatous disease caused by Mycobacterium leprae. Bone involvement is one of the principal prognostic factors in leprosy. Imaging in leprosy could aid in the diagnosis of bone disease. Here, authors present a case of leprosy with trophic ulcer and its radiological changes

Dermoscopic evaluation of idiopathic guttate hypomelanosis: A preliminary observation

Background: Depigmented skin lesions are of great concern in the society, especially in the Indian subcontinent. These comprise many infective and inflammatory conditions that cause apprehension and anxiety among patients due to the social stigma attached to these conditions. Idiopathic guttate hypomelanosis (IGH) appears similar to many depigmented lesions and differentiation of IGH from these conditions is difficult clinically as well as histopathologically. Methods: Clinically suspected IGH were included in the study. All IGH lesions were confirmed by histopathology. Clinical data and dermoscopic patterns were analyzed and presented in proportions and percentages. Results: Thirty patients were included in the study with 16 females and 14 males. Dermoscopy showed amoeboid, feathery, petaloid and nebuloid patterns in 12, 7, 6 and 1 patients respectively. Four patients had combination of these patterns. Conclusion: Dermoscopy of IGH revealed consistent patterns. Hence, we propose these patterns were specific to IGH and help clinician to differentiate many depigmented skin lesions from IGH in clinical practice. However, histopathology must be done for confirmation of diagnosis. Further studies on dermoscopy of IGH with histopathology correlation are proposed

Dermoscopy of apocrine hydrocystoma: A first case report

Apocrine hydrocystoma (AH) is a translucent, skin-colored to bluish dome shaped cyst on the face. AH mimics basal cell carcinoma (BCC), blue nevus, amelanotic melanoma requiring histopathological confirmation. Dermoscopy shows specific patterns in skin conditions. Dermoscopy of AH is not described in the literature. Authors evaluated dermoscopic patterns in AH and observed characteristic patterns corresponding to histological features. To the best of our knowledge, it is a first report in literature

Dermoscopic patterns in confluent and reticulated papillomatosis: a case report

Confluent and reticulated papillomatosis (CRP) is an uncommon, progressive, distinctive dermatosis. It is characterized by persistent brown, scaly macules, papules, patches and plaques. It appears as tinea versicolor or acanthosis nigricans resulting in delay in the diagnosis. Hence a diagnostic tool which could help to diagnose this condition is dermoscopy. We reported a 24 year old male with skin lesions on upper back, neck and shoulders. Dermoscopic examination demonstrated fissures and ridges. Whitish structures were present on the ridges which are surrounded by grayish globules. These globules were lined by brown lines at the periphery. Fissures were brown in color. Global appearance was ‘crocodile skin-like’ pattern. Ridges and furrows in dermoscopy of CRP correspond to rete ridges in the histology. Whitish structures were there around follicular ostia which represent hyperkeratosis and acanthosis of follicular epidermis. Authors also observed sparse hairs in the involved area and V-sign under dermoscopy. Hence, pathogenesis of CRP probably revolves around hair follicles. CRP demonstrates specific dermoscopic patterns which correlate well with histopathologic changes. Therefore, authors propose that these patterns would aide in the diagnosis of CRP