Accuracy of dermoscopic criteria for the diagnosis of psoriasis, dermatitis, lichen planus and pityriasis rosea

State Clinic of Dermatology, Hospital of Skin and Venereal Diseases, Delfon 124, 54643 Thessaloniki, Greece.
British Journal of Dermatology (Impact Factor: 4.28). 02/2012; 166(6):1198-205. DOI: 10.1111/j.1365-2133.2012.10868.x
Source: PubMed


Dermoscopy is useful in evaluating skin tumours, but its applicability extends also to the field of inflammatory skin disorders. Plaque psoriasis (PP), dermatitis, lichen planus (LP) and pityriasis rosea (PR) are common inflammatory skin diseases, but little is currently known about their dermoscopic features.
To determine and compare the dermoscopic patterns associated with PP, dermatitis, LP and PR and to assess the validity of certain dermoscopic criteria in the diagnosis of PP.
Patients with PP, dermatitis, LP and PR were prospectively enrolled. The single most recently developed lesion was examined dermoscopically and histopathologically. Variables included vascular morphology, vascular arrangement, background colour, scale colour, scale distribution and presence of Wickham striae. Univariate and adjusted odds ratios were calculated. Discriminant functions were used to plot receiver-operator characteristic curves.
Eighty-three patients with PP and 86 patients with either dermatitis, LP or PR were included in the study. Dotted vessels in a regular arrangement over a light red background and white scales were highly predictive for the diagnosis of PP, whereas dermatitis more commonly showed yellow scales and dotted vessels in a patchy arrangement. PR was characterized by yellowish background, dotted vessels and peripheral scales; whitish lines (Wickham striae) were seen exclusively in LP.
PP, LP, PR and dermatitis show specific dermoscopic patterns that may aid their clinical diagnosis. Certain combinations of dermoscopic features can reliably predict the diagnosis of PP.

Download full-text


Available from: Athanasios Karatolias
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Sir, Sir, We read with admiration the case report by Brzezinski and Sinjab on pityriasis rosea (PR) in a 12-month-old infant [1]. Despite more than a century of research, the underlying viral aetiologies, immunopathogenesis, diagnostic methods, specific diagnostic investigations, and optimal evidence-based management of PR are not yet within reach. There exist many case reports which, like the present report, are outstanding in supplementing individual clinical data to original studies on PR. However, original studies in PR [2-4] were typically performed on a relatively small number of patients, say below 100 patients. Owing to these small numbers, the powers of individual studies are low. Theoretically, these studies can be meta-analysed to achieve high statistical powers and high clinical significance. However, a Cochrane review [5] has pointed out that such meta-analyses cannot be validly performed as the diagnosis of PR is clinical and various investigators adopt different inclusion and exclusion criteria in their studies. The high heterogeneity between study populations limits not only meta-analyses but also systematic reviews. We have previously reported a study on 1379 patients with PR [6]. However, we admit that as our data was from three geographical locations with differing diagnostic criteria, the heterogeneity of these patients was high. Based on our previous experience on validating a diagnostic criteria for another paraviral exanthem, namely Gianotti-Crosti syndrome [7, 8], we have proposed a diagnostic criteria for typical and atypical PR [9, 10]
    Preview · Article · Apr 2012
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study aimed to present the clinical and colposcopic terminology of the vulva (including the anus) of the International Federation of Cervical Pathology and Colposcopy. The terminology has been developed by the International Federation of Cervical Pathology and Colposcopy Nomenclature Committee during 2009-2011. The terminology is part of a comprehensive terminology of the lower genital tract, allowing for standardization of nomenclature by colposcopists, clinicians, and researchers taking care of women with lesions in these areas. The terminology includes basic definitions and normal findings that are important for the clinician lacking experience with management of vulvar disease. This terminology introduces definitions for abnormal findings recently accepted by the International Society for the Study of Vulvovaginal Disease and includes patterns to identify malignancy. The terminology differs from past terminologies in that it includes colposcopic patterns and anal colposcopy. Nevertheless, the role of the colposcope in the management of vulvar disease is limited.
    Full-text · Article · May 2012 · Journal of Lower Genital Tract Disease
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Granuloma faciale (GF) is a rare benign inflammatory dermatosis that usually develops as a solitary brownish-red plaque on the face. It clinically mimics and is often misinterpreted as, sarcoidosis, lupus erythematosus, lupus vulgaris, lymphoma or basal cell carcinoma.Dermoscopy, which is valuable for evaluation and differentiation between malignant and benign skin tumors, allows better visualization of dermal vascular structures and color variations. In this context, it might serve as an adjuvant diagnostic tool in the differentiation of inflammatory disorders, too. In the current manuscript, we present the dermoscopic features observed in a lesion of GF and discuss them in correlation with the underlying histopathological alterations.
    Full-text · Article · Jun 2012 · Journal of Dermatological Case Reports
Show more