Dermoscopy for the Pediatric Dermatologist
Part I: Dermoscopy of Pediatric Infectious and
Inflammatory Skin Lesions and Hair Disorders
Elena C. Haliasos, M.D.,* Miryam Kerner, M.D.,† Natalia Jaimes-Lopez, M.D.,†
Lidia Rudnicka, M.D., Ph.D.,‡ Iris Zalaudek, M.D.,¶ Josep Malvehy, M.D.,#
Rainer Hofmann-Wellenhof, M.D.,¶ Ralph P. Braun, M.D.,** and Ashfaq A. Marghoob, M.D.†
*Private practice, Warren, New Jersey, †Memorial Sloan Kettering Cancer Center, Hauppauge, New York,
‡Department of Dermatology, Central Clinical Hospital, Ministry of Internal Affairs and Faculty of Health Sciences,
Warsaw, Poland, ¶Divison of Dermatology, Medical University of Graz, Graz, Austria, #Department of
Dermatology, Melanoma Unit, Hospital Clinic i Provincial de Barcelona, August Pi i Sunyer Biomedical Research
Institute, Barcelona, Spain, **Department of Dermatology, UniversitatsSpital Zurich, Zurich, Switzerland
clinical clues, confirm naked-eye clinical diagnoses, and monitor treatment
progress while posing little threat to the young patient. This review
summarizes important dermoscopic structures seen in infectious and
inflammatory skin conditions and hair disorders in children. Scabies,
are well characterized dermoscopically by delta-shaped structures, ovoid-
shaped nits, the crab louse, red corona, brown strands or spicules, and
multiple densely packed papilla with a central black dot surrounded by a
diagnosis and its utility in monitoring treatment progress. Dermoscopy has
also been shown to significantly improve the clinician’s diagnostic and
characterized dermoscopically by uniformly distributed dotted blood
vessels, and lichen planus, which is characterized by whitish lines on a
purple to reddish background. Dermoscopy of the hair and scalp (trichos-
copy) facilitates the differential diagnosis of hair diseases in children,
including alopecia areata, trichotillomania, and tinea capitis. It can also
assist in the diagnosis of multiple genetic hair shaft disorders, such as
The dermoscope allows physicians to examine the macro-
Address correspondence to Ashfaq A. Marghoob, M.D.,
Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial
Highway, 2nd Floor, Hauppauge, NY 11788, or
© 2013 Wiley Periodicals, Inc.
Pediatric Dermatology Vol. 30 No. 2 163–171, 2013
The efficient practice of pediatric dermatology
requires a physician who is clinically attuned to
pediatric skin diseases and aware of parental and
patient anxieties. Because visualizing skin lesions
using a dermoscope poses neither physical discomfort
nor emotional stress, it is ideal for examining pediatric
skin lesions. Dermoscopy has been shown to improve
the clinician’s diagnostic accuracy significantly above
that of a naked eye examination. This noninvasive, in
vivo technique facilitates the visualization of subsur-
face skin structures, which are not visible to the
unaided eye. There are three ways to perform
dermoscopy: nonpolarized dermoscopy, polarized
contact dermoscopy, and polarized noncontact der-
moscopy. Nonpolarized dermoscopy requires direct
contact between the scope and the skin in addition to
a liquid interface (mineral oil or alcohol) that is placed
between the dermoscope and the skin. In contrast,
polarized dermoscopy can be used with or without
contact. Polarized dermoscopy uses cross-polarized
filters, which eliminates the reflected light from the
skin surface, allowing the reflected light from deeper
layers to reach the observer’s retina, permitting
visualization of structures below the stratum corneum
(1). For obvious reasons, polarized noncontact
dermoscopy may be particularly well suited for
The presence or absence of specific dermoscopic
structures can help correctly classify numerous skin
lesions, including inflammatory and infectious entities
(2). This review summarizes the important dermo-
scopic features of common infectious, inflammatory,
and hair disorders encountered in children.
Infestation with Sarcoptes scabiei in children usually
presents with pruritus. Primary scabetic lesions
consist of small, erythematous papules and burrows,
with signs and symptoms often mimicking other
conditions, including insect bites, folliculitis, viral
exanthema, and papular urticaria (3). The definitive
diagnosis of scabies is made by visualizing mites, eggs,
or feces under the microscope. The most common way
to accomplish this is scalpel blade–assisted scraping.
Although scraping the skin is a simple procedure, the
mere sight of a sharp blade can cause anxiety in
children andbea traumatic
inadvertent laceration causes bleeding or discomfort.
Dermoscopy has proven to be an effective in vivo,
nontraumatic method of diagnosing scabies. Visual-
izing the end of a burrow, which consists of a thin
tract of whitish scale, using a dermoscope may reveal
a small, dark-brown, delta-shaped structure. The
delta-shaped structure represents the anterior body
of the adult female mite. The dermoscopic morphol-
ogy of the mite and burrow looks like a delta-shaped
jet airplane followed by its whitish condensation trail
(contrail) (Fig. 1) (4). Other diagnostic features
include a burrow filled with eggs, which on dermos-
copy appears as a “string of pearls” (5). Dupuy et al
(6) found that the sensitivity of dermoscopy for the
diagnosis of scabies (91%) was comparable with that
of conventional microscopic examination of skin
scrapings (90%). Similarly, Walter et al (7) compared
dermoscopy (83%) with skin scraping (68%) and the
adhesive tape test (46%) and reported greater sensi-
tivity for dermoscopy than for the other two modal-
ities. When dermoscopy was used to guide treatment
decisions, fewer patients were left untreated than
when dermoscopy was not used (6). In the treatment
setting, dermoscopy has been used to monitor treat-
ment response by counting the number of delta-
shaped structures or analyzing their morphology.
Haas et al (8) found that by the end of 2 weeks of
antiscabietic treatment, mites begin to decompose and
their appearance becomes blurry and indistinct under
Pediculosis of the Scalp
The differential diagnosis for an itchy, scaly scalp in a
child is broad and includes tinea capitis, atopic
dermatitis, seborrheic dermatitis, and pediculosis
capitis. The identification of nits (eggs) located within
1 to 2 mm of the scalp’s surface suggests active
pediculosis infestation (9). Although the adult louse
Figure 1. Scabies. One serpiginous burrow can be
clearly seen. At each end of the burrow is a small dark
triangular structure called a delta. Each delta-shaped
structure represents one scabies mite.
164Pediatric Dermatology Vol. 30 No. 2 March/April 2013
can be elusive and difficult to find, the diagnosis can
be confirmed by identifying nits on the hair shaft.
Dermoscopy can aid in the detection of nits and
in monitoring treatment response by determining
whether nits contain viable or dead nymphs or are
Under dermoscopy, nits containing nymphs have
a brown color and ovoid shape, whereas empty nits
appear translucent, with an oval shape that is
disfigured by a flattened free end (Fig. 2) (11). Dead
nits also contain a collapsed nymph, which appears
as a focal brown area within the nit, and can have an
air pocket, which appears as a translucent area
within the egg (Fig. 2) (11). Polarized noncontact
dermoscopy is preferred over contact dermoscopy
because it minimizes the risk of infestation transmis-
sion to other patients. Alternatively, one can snip
hairs on which presumed adherent nits are present,
place them on the sticky side of transparent tape, and
place a contact dermoscope on the nonsticky side of
the tape (12). This method enables direct visualiza-
tion of the hair and helps differentiate nits from
pseudonits (hair casts) while eliminating the risk of
Pubic lice or crabs are occasionally seen in children.
Lice are usually found attached to the terminal hair
shaft within hair-bearing areas such as the genitalia,
eyelashes, and scalp, although on occasion, they may
be found on other body sites containing vellus hair.
Dermoscopy can easily help diagnose this condition
by identifying the crab through its characteristic louse
morphology (Fig. 3) (13,14).
Molluscum contagiosum (MC) is a cutaneous viral
infection caused by a DNA poxvirus. Although most
MC lesions are easily diagnosed based on the charac-
teristic umbilicated morphology consisting of an
umbilicated white papule, some are indistinguishable
Dermoscopically MC displays a central umbilica-
tion surrounded by polylobular, white to yellow,
amorphous structures that correspond to hyperplastic
squamous epithelium in the dermis. The central
umbilication is usually surrounded by blood vessels
displaying a crown pattern, also known as the red
corona (15) This pattern is characterized by vessels
emanating from the periphery of the lesion and
radiating toward its center but rarely, if ever, crossing
the center of the lesion. This crown pattern may be
explained by compression and separation of the
vessels by collagenous septae (Fig. 4) (15,16).
Because most MC lesions are self-limiting, treat-
ment is not always required, but if treatment is sought,
numerous topical and surgical options are available.
Further research is needed to determine the utility of
dermoscopy for treatment monitoring. Cryoscopy is a
newly emerging modality in which dermoscopy is used
to image skin after it has been subjected to a cryogenic
source. It is said to offer greater image clarity,
especially of exophytic lesions, and it may prove to
be a useful tool for in vivo skin examination of treated
MC lesions (17).
Figure 2. Nits. This image has examples of empty nits,
nits containing dead nymphs, and nits containing live
nymphs. The nit on the far left of the image has a brown
color and oval shape, representing a developing nymph.
The nit in the middle of the image is empty and appears
translucent with an oval shape with a flattened free end.
The nit on the far right is a stillbirth nit containing a
collapsed nymph. These nits reveal focal brown areas and
an air pocket.
Figure 3. Phthiriasis. Crab louse shown clinging to hair
Haliasos et al: Dermoscopy for the Pediatric Dermatologist, Part 1165
Tinea nigra (TN) is a superficial fungal infection
caused by Hortaea (Phaeoannellomyces) werneckii,
formerly called Cladosporium werneckii or Exophiala
werneckii (18). TN typically presents as an asymp-
tomatic, irregular, brown to black macule, often
mottled in coloration, with the darkest color at the
advancing border. H. werneckii commonly infects the
stratum corneum of the palms and soles of children
living in or visiting South and Central America, Asia,
and Africa, although it can also occur in the United
States and Europe. TN may mimic junctional nevi or
acrolentiginous melanoma (19). The diagnosis of TN
is easily confirmed using potassium hydroxide exam-
ination, which reveals brown to olive-colored, thick,
branching hypha and budding yeast cells (23),
although the diagnosis of TN is frequently overlooked
and many of these patients undergo unnecessary
biopsies to exclude melanoma.
Fortunately dermoscopy can prevent biopsy of
these lesions. With TN, dermoscopy reveals fine,
wispy brown strands or “pigmented spicules” that
represent pigmented hyphae in the stratum corneum
(20–22). The pigment in TN does not follow or respect
the dermatoglyphic furrows and ridges (Fig. 5) (21).
Thus TN does not have any melanocytic pattern
associated with nevi or melanomas located on gla-
brous skin (parallel furrow or ridge patterns). Piliou-
ras et al (23) reported that the diagnosis of TN was
significantly improved with dermoscopy, with 53.8%
of the cases diagnosed correctly using dermoscopy, in
contrast to none without. Common treatment modal-
ities for TN include topical antifungal creams, anti-
keratolytic compounds, and thiabendazole solution
(18). Treatment is considered complete once the
existing lesions have resolved and the aforementioned
dermoscopic features are no longer visible (20).
Verrucae Vulgaris (Warts)
Infection of epidermal keratinocytes with human
papillomavirus can result in warts, consisting of
localized benign epithelial hyperplasia with overlying
surface hyperkeratosis. Warts can sometimes be
difficult to distinguish from cutaneous lesions such
as calluses, corns, or even amelanotic melanomas
(24,25). Dermoscopic examination of these lesions can
aid in distinguishing between these various entities.
With dermoscopy, warts display “multiple densely
packed papilla, each containing a central red or black
dot or loop, which is surrounded by a whitish halo”
(20) (Fig. 6A, B). The red dots and loops and the
black dots and loops represent normal and throm-
bosed capillaries, respectively (26). Flat warts have
regularly distributed, tiny red dots with a light-brown
to yellow background (27). The dermoscopic mor-
phology of genital warts consists of mosaic, knob-like,
finger-like or nonspecific patterns with different vas-
cular morphologies, including hairpin, glomerular,
and dotted vessels (28). Plantar warts show slightly
different features under dermoscopy. The effects of
pressure due to weight bearing and trauma on the sole
results in an irregular distribution of black dots or
streaks, corresponding to thrombosed vessels and
microhemorrhages, respectively (20). In contrast,
calluses demonstrate homogeneous opacities, and
corns exhibit a translucent central core .
Bae et al (24) performed a study to determine
whether dermoscopy can be used to assess the
resolution of warts after treatment. They reported
Figure 4. Molluscum contagiosum. Whitish to yellowish
lobules surrounded by a crown of blood vessels.
Figure 5. Tinea nigra on the foot. Dermoscopy shows
pigmented spicules that do not follow dermatoglyphic
ridges or furrows (images courtesy of Wilhelm Stolz).
166 Pediatric Dermatology Vol. 30 No. 2 March/April 2013
that dermoscopy helped them monitor treatment
progress and assisted in determining whether clear-
ance was achieved or further treatments were neces-
It is estimated that one-third of patients with psoriasis
present before age 16 years (29). Although the
diagnosis of psoriasis is usually straightforward, at
times it may be challenging to differentiate it from
other papulosquamous skin conditions. Under der-
moscopy, psoriatic lesions most often reveal uni-
formly distributed, dotted vessels, which correlate to
the dilated capillaries found within the regularly
spaced dermal papillae (Fig. 7) (30). Red globules
and twisted hairpin and glomerular vessels can also be
seen and represent ectatic and elongated capillaries
within elongated papillae (31,32). Kim et al (33)
reported that red dots and globules were the most
significant dermoscopic finding in scalp psoriasis and
were found in 87% of patients with scalp psoriasis,
versus none with seborrheic dermatitis. Using video-
dermoscopy, Ross et al (34) found interfollicular
twisted hairpin vessels in all cases of psoriasis on the
The mainstay of topical treatment for psoriasis is
corticosteroids. Dermoscopy has been used to
monitor treatment response, identify patients who
may be overusing topical corticosteroids, and influ-
ence treatment decisions (strength, duration, and
frequency of topical steroids). In a series of 20 cases
with biopsy-proven psoriasis, dermoscopy was used
to evaluate early signs of steroid-induced skin
atrophy. Red lines on and around the psoriatic
plaques were found under dermoscopy in patients
who overused clobetasol cream, but they resolved if
the medication was discontinued for 2 months.
These red lines were regarded as signs of impending
skin atrophy. It is speculated that steroid-induced
epidermal thinning makes these vessels become
Lichen planus (LP) is usually encountered in adults,
but can occur in infants as young as 3 weeks of age
(35). LP can affect the skin, mucosae, hair follicles,
and nails. Although the presence of conspicuous
whitish lines or reticulation, also known as Wickham
striae, facilitates the clinical diagnosis of mucosal LP,
the diagnosis of cutaneous lesions may be challenging
because the Wickham striae tend to be relatively
inconspicuous. Dermoscopy permits the recognition
of pathognomonic Wickham striae in cutaneous
lesions, which appear as whitish lines, centrally
located, on a purple to reddish background, often
surrounded by dotted or linear vessels. The afore-
mentioned pattern is usually seen in active LP lesions.
In contrast, regressing lesions reveal a homogeneous
brown pigmentation pattern or granular pattern
characterized by multiple gray dots and granules
(Fig. 8). The difference between these two regressive
patterns may be helpful in predicting the clinical
course of the disease. The homogeneous brown
pattern is related to superficial epidermal hyperpig-
mentation and is usually associated with transient,
self-limiting disease. Conversely, the granular pattern
correlates with the presence of pigment-laden mela-
nophages in the dermis and tends to correlate with
more persistent lesions (36,37).
Hair loss is a distressing medical problem for many
children and their parents. Dermoscopy of the hair
Figure 6. (A)
surrounded by a white halo (image courtesy of Harold
Rabinovitz). (B) Verruca with thrombosed capillaries.
Verrucavulgariswith blood vessels
Figure 7. Psoriasis. This psoriatic plaque has numerous
Haliasos et al: Dermoscopy for the Pediatric Dermatologist, Part 1167
and scalp, also known as trichoscopy, facilitates the
diagnosis of several disorders in children, includ-
ing alopecia areata (AA), trichotillomania, tinea
capitis, and genetic hair shaft dystrophies, without
the need to pluck out hairs for light microscopic
Alopecia areata (AA) is a nonscarring alopecia that
typically presents as a well-demarcated, nummular
lesion affecting the scalp. The presence of “exclama-
tion mark” hairs and dermoscopic black dots is
frequently seen in AA, and correspond to fractured or
tapered hair shafts (39,40). Histologically these struc-
tures correlate with incompletely differentiated hair
shaft remnants lodged in the follicular infundibulum.
Although black dots and exclamation mark hairs can
be seen in trichotillomania and telogen effluvium as
well as AA, the presence of yellow folliculocentric
dots is a feature that is not consistently found in
trichotillomania or in telogen effluvium, but it is
commonly seen in AA (Fig. 9) (34,40). Histologically
these yellow dots correspond to distended follicular
infundibula filled with sebum and degraded keratin-
ous material (34), although in young children with low
sebaceous gland activity, these yellow dots are rarely
seen (39). Dermoscopy has been used to follow
treatment response in patients with AA because it
can help the clinician visualize newly growing vellus
hairs sooner in patients undergoing steroid therapy
Figure 8. Lichen planus lesion exhibiting gray granularity.
Figure 9. Alopecia areata. Dermoscopy shows yellow
folliculocentric dots with exclamation point hairs.
Figure 11. Tinea capitis. Comma hairs (arrows) are a
characteristic trichoscopy feature of tinea capitis.
Figure 10. Trichotillomania. Coiled hairs with frayed ends
(arrow) are a characteristic trichoscopy feature of
trichotillomania. Other typical features of trichotillomania
are also visible: short hairs with trichoptilosis (split ends),
broken hairs, a black dot.
168Pediatric Dermatology Vol. 30 No. 2 March/April 2013
Trichotillomania is the most common differential
diagnosis for AA. Alopecia secondary to trichotillo-
mania results from the habitual, repetitive removal of
one’s hair (42). Under trichoscopy, a chaotic pattern
of hair shafts of differing length is observed. The most
common types of broken hairs are irregularly coiled
hairs with frayed ends, short hairs with trichoptilosis
(split ends), and flame hairs (43,44). The presence of
coiled hairs (Fig. 10) is an important clue to differen-
tiate trichotillomania from AA. Other nonspecific
trichoscopy findings include nonspecific amorphous
hair residues, exclamation mark hairs, and black dots
(34). The latter two findings in trichotillomania may
lead to a misdiagnosis of AA.
Although light microscopy of infected hairs and myco-
logical culture remain the criterion standard for diag-
clinical diagnosis. Comma and corkscrew hairs are two
hair shaft abnormalities frequently observed in TC.
Commahairs (Fig. 11) arecurved,C-shapedhairshafts
associated with ectothrix- and endothrix-type fungal
invasion. They are seen in TC caused by Microsporum
canis and Trichophyton tonsurans. Corkscrew-shaped
hairs have been observed in dark-skinned patients with
tinea capitis caused by Trichophyton violaceum, Tricho-
phyton soudanense, and Microsporum langeroni. Other
nonspecific trichoscopy findings in TC include broken
hairs, black dots, and tufted folliculitis (45).
Figure 12. Genetic hair shaft disorders in trichoscopy. (A) In trichorrhexis invaginata, small nodules at irregular intervals
along the shaft are observed. (B) Trichoscopy of trichorrhexis nodosa reveals nodular thickening along the hair shaft. (C)
Trichoscopy of pili torti shows multiple twists along the length of the hair shafts. (D) Trichoscopy of pili annulati shows white
bands corresponding to clusters of air-filled spaces in the hair cortex. (E) Trichoscopy of monilethrix shows regular variation
in hair shaft thickness with characteristic constrictions. Arrows point to the characteristic fragments of hair shafts in these
Haliasos et al: Dermoscopy for the Pediatric Dermatologist, Part 1169
Trichorrhexis invaginata (TI), also known as bamboo
on itself at several points along its shaft. Together with
ichthyosis and atopic diathesis, it makes up part of the
clinical triad found in Netherton’s syndrome. At stan-
irregular intervals along the shaft (Fig. 12A). At higher
magnification (>509), an invagination of the distal
portion of the hair shaft into its proximal part is seen.
Several authors have indicated that if TI is present, the
hairs with the highest yield for revealing these bamboo
hairs are those of the eyebrows (46).
In trichorrhexis nodosa (TN), the hair shafts split
longitudinally into numerous small fibers in focal area
along the shafts. The outer fibers bulge out, causing a
segmental increase in the hair diameter (nodules). TN
rarely presents as an isolated abnormality (5.6% of
children) (47), but in most cases is a manifestation of a
more complex inherited or acquired condition (48).
Trichoscopy of TN reveals nodular thickening along
the hair shaft (Fig. 12B). Higher magnification allows
the observation of numerous small fibers resembling
two brushes aligned in opposition (43).
Pili torti (PT) is characterized by hair shafts with
flattened sections at irregular intervals along the shaft
that cause the shaft to rotate 180º around its long axis
(49), creating a helix-like pattern. PT can be seen in
two genetic forms (Ronchese type and Beare type) or
in an acquired form, which usually affects adults. The
classic Ronchese type is frequently observed in early
childhood in girls with blond hair. The Beare type
occurs after puberty, frequently in dark hair (49).
Trichoscopy of PT shows multiple twists along the
length of the hair shafts (Fig. 12C).
Pili annulati (PA) is an autosomal dominant disorder
characterized byhair shafts with alternating white and
dark bands; white bands correspond to clusters of air-
filled spaces in the hair cortex and dark bands are
sections of hair shaft that remain unaltered. Trichos-
the diagnosis of PA, and assists in differentiating it
from pseudo-PA, in which there is partial twisting of
the hair shafts but no evidence of any white bands
(Fig. 12D) (50).
Monilethrix is an autosomal dominant hair disorder
characterized by periodic constrictions of the hair
shafts, that results in the tendency for the hair to
fracture at these constriction points. Trichoscopy
shows a regular variation in hair shaft thickness with
intermittent nodosities and constrictions (Fig. 12E)
We thank Dr. Adriana Rakowska and Dr. Monika
Slowinska from the Department of Dermatology, Cen-
tral Clinical Hospital, Ministry of Internal Affairs,
Warsaw, Poland, for helpful discussion about trichos-
photographs in this article.
1. Pan Y, Gareau DS, Scope A et al. Polarized and
nonpolarized dermoscopy: the explanation for the
observed differences. Arch Dermatol 2008;144:828–829.
2. ZalaudekI,ArgenzianoG,DiStefaniAet al.Dermoscopy
in general dermatology. Dermatology 2006;212:7–18.
3. Chosidow O. Clinical practices. Scabies. N Engl J Med
4. Argenziano G, Fabbrocini G, Delfino M. Epilumines-
cence microscopy. A new approach to in vivo detection
of Sarcoptes scabiei. Arch Dermatol 1997;133:751–753.
5. Rubegni P, Mandato F, Risulo M et al. Non-invasive
diagnosis of nodular scabies: the string of pearls sign.
Australas J Dermatol 2011;52:79.
6. Dupuy A, Dehen L, Bourrat E et al. Accuracy of
standard dermoscopy for diagnosing scabies. J Am
Acad Dermatol 2007;56:53–62.
7. Walter B, Heukelbach J, Fengler G et al. Comparison
of dermoscopy, skin scraping, and the adhesive tape test
for the diagnosis of scabies in a resource-poor setting.
Arch Dermatol 2011;147:468–473.
8. Haas N, Sterry W. The use of ELM to monitor the
success of antiscabietic treatment. Epiluminescence
9. Paller A, Mancini A. Bites and infestations. In: Paller A,
A Textbook of Skin Disorders of Childhood and
Adolescence, 3rd ed. Philadelphia: Elsevier Saunders,
10. Criado PR. Entodermoscopy: dermoscopy for the diag-
nosis of pediculosis. An Bras Dermatol 2011;86:
11. Di Stefani A, Hofmann-Wellenhof R, Zalaudek I.
Dermoscopy for diagnosis and treatment monitoring
170Pediatric Dermatology Vol. 30 No. 2 March/April 2013
of pediculosis capitis. J Am Acad Dermatol 2006;54: Download full-text
12. Bakos RM, Bakos L. Dermoscopy for diagnosis of
pediculosis capitis. J Am Acad Dermatol 2007;57:
13. Chuh A, Lee A, Wong W et al. Diagnosis of Pediculosis
toscopy. J Eur Acad Dermatol Venereol 2007;21:837–838.
14. DeFazio JL, Spencer P. Images in clinical medicine.
Dermoscopy of phthiriasis. N Engl J Med 2010;362:e33.
15. Morales A, Puig S, Malvehy J et al. Dermoscopy of
molluscum contagiosum. Arch Dermatol 2005;141:1644.
16. Zaballos P, Ara M, Puig S et al. Dermoscopy of
molluscum contagiosum: a useful tool for clinical
diagnosis in adulthood. J Eur Acad Dermatol Venereol
17. Nikkels AF, Pierard GE. Cryoscopy: a novel enhancing
method of in vivo skin imaging. Skin Res Technol
18. Paller A, Mancini A. Skin disorders due to fungi. In:
Paller A, Mancini A, eds. Hurwitz Clinical Pediatric
Dermatology: A Textbook of Skin Disorders of Child-
hood and Adolescence, 3rd ed. Philadelphia: Elsevier
19. Babel DE, Pelachyk JM, Hurley JP. Tinea nigra
masquerading as acral lentiginous melanoma. J Der-
matol Surg Oncol 1986;12:502–504.
20. Zalaudek I, Giacomel J, Cabo H et al. Entodermos-
copy: a new tool for diagnosing skin infections and
infestations. Dermatology 2008;216:14–23.
21. Smith SB, Beals SL, Elston DM et al. Dermoscopy in
the diagnosis of tinea nigra plantaris. Cutis 2001;68:377
22. Gupta G, Burden AD, Shankland GS et al. Tinea nigra
secondary to Exophiala werneckii responding to itrac-
onazole. Br J Dermatol 1997;137:483–484.
23. Piliouras P, Allison S, Rosendahl C et al. Dermoscopy
improves diagnosis of tinea nigra: a study of 50 cases.
Australas J Dermatol 2011;52:191–194.
24. BaeJM,KangH,KimHOet al.Differentialdiagnosisof
plantar wart from corn, callus and healed wart with the
aid of dermoscopy. Br J Dermatol 2009;160:220–222.
25. Dalmau J, Abellaneda C, Puig S et al. Acral melanoma
simulating warts: dermoscopic clues to prevent missing
a melanoma. Dermatol Surg 2006;32:1072–1078.
26. Fazel N, Wilczynski S, Lowe L et al. Clinical, histopath-
ologic, and molecular aspects of cutaneous human papil-
lomavirus infections. Dermatol Clin 1999;17:521–536.
27. Micali G, Lacarrubba F, Massimino D et al. Derma-
toscopy: alternative uses in daily clinical practice. J Am
Acad Dermatol 2011;64:1135–1146.
28. Dong H, Shu D, Campbell TM et al. Dermatoscopy of
genital warts. J Am Acad Dermatol 2011;64:859–864.
29. Raychaudhuri SP, Gross J. A comparative study of
pediatric onset psoriasis with adult onset psoriasis.
Pediatr Dermatol 2000;17:174–178.
30. Zalaudek I, Argenziano G. Dermoscopy subpatterns
31. Vazquez-Lopez F, Manjon-Haces JA, Maldonado-
Seral C et al. Dermoscopic features of plaque psoriasis
and lichen planus: new observations. Dermatology
32. Vazquez-Lopez F, Marghoob AA. Dermoscopic assess-
ment of long-term topical therapies with potent steroids
in chronic psoriasis. J Am Acad Dermatol 2004;51:
33. Kim GW, Jung HJ, Ko HC et al. Dermoscopy can be
useful in differentiating scalp psoriasis from seborrhoeic
dermatitis. Br J Dermatol 2011;164:652–656.
34. Ross EK, Vincenzi C, Tosti A. Videodermoscopy in the
evaluation of hair and scalp disorders. J Am Acad
35. Paller A, Mancini A. Papulosquamous and related
disorders. In Paller A, Mancini A, eds. Hurwitz Clinical
Pediatric Dermatology: A Textbook of Skin Disorders
of Childhood and Adolescence, 3rd ed. Philadelphia:
36. Vazquez-Lopez F, Palacios-Garcia L, Gomez-Diez S
et al. Dermoscopy for discriminating between lichenoid
37. Vazquez-Lopez F, Maldonado-Seral C, Lopez-Escobar
M et al. Dermoscopy of pigmented lichen planus
lesions. Clin Exp Dermatol 2003;28:554–555.
38. Rudnicka L, Olszewska M, Rakowska A et al. Tri-
choscopy: a new method for diagnosing hair loss. J
Drugs Dermatol 2008;7:651–654.
39. Ardigo M, Tosti A, Cameli N et al. Reflectance
confocal microscopy of the yellow dot pattern in
alopecia areata. Arch Dermatol 2011;147:61–64.
40. Inui S, Nakajima T, Nakagawa K et al. Clinical
significance of dermoscopy in alopecia areata: analysis
of 300 cases. Int J Dermatol 2008;47:688–693.
41. Inui S, Nakajima T, Itami S. Dry dermoscopy in clinical
treatment of alopecia areata. J Dermatol 2007;34:
42. Witkowski AM, Schwartz RA, Janniger CK. Trichotil-
lomania: an important psychocutaneous disorder. Cutis
43. Rudnicka L, Olszewska M, Rakowska A et al.
Trichoscopy update 2011. J Dermatol Case Rep
44. Miteva M, Tosti A. Hair and scalp dermatoscopy. J Am
Acad Dermatol 2012;67:1040–1048.
45. Hughes R, Chiaverini C, Bahadoran P et al. Corkscrew
in black children. Arch Dermatol 2011;147:355–356.
46. Powell J. Increasing the likelihood of early diagnosis of
Netherton syndrome by simple examination of eyebrow
hairs. Arch Dermatol 2000;136:423–424.
47. Smith VV, Anderson G, Malone M et al. Light micro-
scopic examination of scalp hair samples as an aid in the
diagnosis of paediatric disorders: retrospective review of
more than 300 cases from a single centre. J Clin Pathol
48. Zlotogorski A, Marek D, Horev L et al. An autosomal
recessive form of monilethrix is caused by mutations in
hypotrichosis. J Invest Dermatol 2006;126:1292–1296.
49. Mirmirani P, Samimi SS, Mostow E. Pili torti: clinical
findings, associated disorders, and new insights into
mechanisms of hair twisting. Cutis 2009;84:143–147.
50. Rakowska A, Slowinska M, Kowalska-Oledzka E et al.
Trichoscopy in genetic hair shaft abnormalities. J
Dermatol Case Rep 2008;2:14–20.
Haliasos et al: Dermoscopy for the Pediatric Dermatologist, Part 1171