Juan Raul Castro-Ayarza; Luisa Fernanda Montenegro
Abstract
Background: Basal cell carcinoma (BCC) represents nearly 80% ofcutaneous malignancies. Dermoscopy is a useful tool to increasethe precision of diagnosis, but its findings for BCC are mainlydescribed in patients from Europe, the US, and Australia. BCCdermoscopy patterns are not fully known in patients ...
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Background: Basal cell carcinoma (BCC) represents nearly 80% ofcutaneous malignancies. Dermoscopy is a useful tool to increasethe precision of diagnosis, but its findings for BCC are mainlydescribed in patients from Europe, the US, and Australia. BCCdermoscopy patterns are not fully known in patients with skinphoto-types III and IV in Latin America, especially in Colombia.We aimed to describe dermoscopy findings in patients with BCCand III-IV Fitzpatrick skin types in a Colombian population.Methods: A descriptive, retrospective and prospectiveobservational study was carried out on patients with BCC.Clinical and dermoscopy photos were taken, with the diagnosisconfirmed via histopathology.Results: Thirty-six tumors were evaluated. Women were moreaffected. The main BCC feature was a nodular clinical andhistological subtype. The more frequent dermoscopy findingswere arboriform microvessels, thin telangiectasias, and multiplegray-blue globules. Tumors greater than 6 mm predominantlyshowed ulceration and polymorphic vessels. The presence ofovoid nests, structures in maple leaves, and polymorphic vesselswere related to the superficial clinical subtype.Conclusions: Different features related to size, clinical pattern, andthe presence of vascular and pigmentary changes in dermoscopywere present in this population. A new dermoscopy finding ofa yellowish type “amber background” in BCC was described.
Jaspriya Sandhu; Sunil Kumar Gupta; Shriya Garg; Sheerin Shah; Bhavna Garg
Abstract
Bowen’s disease (BD) is an in situ squamous cell carcinoma ofthe skin. Pigmented Bowen’s disease (pBD) is a rare variant,representing less than 2% of all BD cases. We report a case ofGiant pBD arising from seborrheic keratosis in a 65-year-old man.The dermoscopy showed a scaly surface, structureless ...
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Bowen’s disease (BD) is an in situ squamous cell carcinoma ofthe skin. Pigmented Bowen’s disease (pBD) is a rare variant,representing less than 2% of all BD cases. We report a case ofGiant pBD arising from seborrheic keratosis in a 65-year-old man.The dermoscopy showed a scaly surface, structureless brown togrey-black areas with dotted vessels, glomerular and reticulatevessels, and a few brown globules. Histopathology was classicalwith a “windblown appearance”; prominent melanophages wereseen in the dermis. Owing to the size and thickness of the plaque,a wide excision with a split-skin graft was done. The graft uptakewas good, and the patient was followed up on days 4 and 26post-surgery. We present our experience with the diagnosis andmanagement of this rare case of giant pBD. To the best of ourknowledge, such a case has not been previously reported.
Anu George T; Vinutha Rangappa; Jayadev Betkerur
Abstract
Background: Periorbital hyperpigmentation (POH), a common problem of multifactorial etiology, is obvious on the face and can affect patients’ quality of life (QoL). It is essentially a clinical diagnosis, but dermoscopy might aid in further classification of the disease. Also, it might give us ...
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Background: Periorbital hyperpigmentation (POH), a common problem of multifactorial etiology, is obvious on the face and can affect patients’ quality of life (QoL). It is essentially a clinical diagnosis, but dermoscopy might aid in further classification of the disease. Also, it might give us a clue regarding the etiology and help in the treatment, as different types of POH respond to varying treatments. We aimed to assess clinical, dermoscopic patterns and quality of life using the Melasma Quality of Life (MELASQOL) scale in POH and to compare it with controls.Methods: Detailed histories were obtained from 100 patients with POH. The clinical and dermoscopic examination was done, and the obtained results were compared against 100 controls. The MELASQOL scale was used to assess QoL.Results: Family history (P = 0.013), lack of sleep (P = 0.003), stress (P = 0.001), and eye rubbing (P = 0.01) were the probable risk factors. Blotchy pattern (P < 0.0001), speckled pattern (P < 0.0001), and telangiectasia (P = 0.007) were the significant dermoscopic findings. Controls showed pseudoreticular (P < 0.001) and superficial dilated veins (P < 0.0001). Quality of life was affected in 30.6% of patients; it was more affected in grade 4 POH.Conclusion: Dermoscopy will aid in the classification of POH. Blotchy pattern, speckled pattern, and telangiectasia are the typical dermoscopic patterns, more so in higher grades. QoL may be affected in POH. However, MELASQOL is not adequate to assess QoL in POH.
Arun Achar; Lokhnath Ghoshal; Smriti Chowdhury; Samiran Bisai
Abstract
Background: Palmoplantar psoriasis (PPP) and hyperkeratotic eczema (HPKE) are common and troublesome entities affecting the palms and soles. The diagnosis is made clinically, but differentiation is difficult; histopathology helps but is often impossible in daily practice. Dermoscopy is increasingly utilized ...
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Background: Palmoplantar psoriasis (PPP) and hyperkeratotic eczema (HPKE) are common and troublesome entities affecting the palms and soles. The diagnosis is made clinically, but differentiation is difficult; histopathology helps but is often impossible in daily practice. Dermoscopy is increasingly utilized to diagnose inflammatory disorders and has been used to differentiate PPP from HPKE. The present study was carried out to evaluate the role of dermoscopy in the differentiation of PPP and HPKE in a tertiary care center of eastern India.Methods: This hospital-based observational study included 20 patients with each of clinically diagnosed PPP and HPKE. Dermoscopy examinations were done, and the results were tabulated and summarized. Fisher’s exact test was employed to assess statistical significances in differences.Results: Diffuse white and yellow scales were found in both PPP and HPKE without any significant difference. Brown orange globules, clustered dotted vessels, yellow, orange crusts, and perilesional scaling were found more in HPKE (P < 0.05). On the other hand, uniformly dotted vessels and background erythema were more characteristic of PPP (P < 0.05). The results of the current study had deviations from the results of studies done abroad, which can be ascribed to differences in skin color.Conclusion: Dermoscopy is a valuable tool to sort out diagnostic dilemmas in cases of PPP and HPKE. It should be used more commonly to gain more experience and information in the diagnosis of inflammatory dermatoses.
Fatemeh Sari Aslani; Nasrin Saki; Mohammad Sasannia
Abstract
Background: Since its recognition, frontal fibrosing alopecia (FFA) has increasingly been studied globally in terms of its diverse aspects. Having found no studies describing this condition in Southern Iran, we examined the different clinicopathological features of patients with FFA who referred to Faghihi ...
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Background: Since its recognition, frontal fibrosing alopecia (FFA) has increasingly been studied globally in terms of its diverse aspects. Having found no studies describing this condition in Southern Iran, we examined the different clinicopathological features of patients with FFA who referred to Faghihi Hospital, Southern Iran, between 2013 and 2018. Methods: We searched the archives of the Pathology Department of Faghihi Hospital for the cases with a diagnosis of FFA. Due to its similar histopathologic features with lichen planopilaris, the final diagnosis was made using clinical correlations. Results: Twenty-two patients were enrolled; all were female. Fifteen (68.2%) presented with the disease before menopause. Besides frontal and/or temporal hairline involvement in all the patients, eyebrow alopecia, eyelash loss, body hair loss, and facial papules were present in 81.8%, 27.3%, 50%, and 68.2% of them, respectively. Dermoscopic findings included follicular opening loss (100%), honeycombing of the scalp (81.8%), multiple white dots (77.3%), perifollicular erythema (63.6%), and perifollicular scales (59.1%). The histopathologic examination revealed follicular dropout (95.4%), perifollicular lymphocytic infiltration in the infundibulum and isthmus of the follicles (81.8%), perifollicular fibroplasia (77.3%), intact interfollicular epidermis (59.1%), mild perivascular lymphocytic infiltration in the upper dermis (54.5%), and apoptotic keratinocytes in the infundibulum and isthmus (50%). The most common comorbidity was hypothyroidism (40.9%). Conclusions: Thediagnosis of FFA should be considered in both premenopausal and postmenopausal women. Eyebrow alopecia, eyelash loss, body hair involvement, and facial papules are helpful clues in the diagnosis. The coexistence of hypothyroidism with FFA suggests immunological involvement in the pathogenesis.
Francesc Messeguer; Anna Agusti-Mejias; Celia Requena Caballero
Abstract
Angiosarcomas of the scalp are aggressive invasive tumors that, more often than not, mimic benign painless skin lesions. We here report a case of angiosarcoma that was timely diagnosed and treated thanks to the dermoscopic rainbow pattern.
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Angiosarcomas of the scalp are aggressive invasive tumors that, more often than not, mimic benign painless skin lesions. We here report a case of angiosarcoma that was timely diagnosed and treated thanks to the dermoscopic rainbow pattern.