18512 The significance of dermoscopy and trichoscopy in differentiation of erythroderma due to various dermatologic disorders

Abstract

The diagnosis of an underlying cause of erythroderma may be difficult and often pose a challenge for dermatologist. There are only few case reports describing dermoscopic features in erythroderma of various origin. None of the previous studies analyzed trichoscopic patterns in this group of patients. The studied group comprised 19 adult patients with erythroderma (12 female/7 male, overall age range 18-88 y) in whom demographic data, disease course and duration, previous treatment, as well as dermoscopic and trichoscopic features were analyzed. There were 5 patients with the diagnosis of atopic dermatitis (AD), 6 patients with mycosis fungoides (MF), and 3 patients with Sezary syndrome (SS). The others were diagnosed with: allergic eczema (AE; n = 1), dermatomyositis sine myositis (DsM; n = 1), psoriasis (Pso; n = 1), actinic reticuloid (AR; n = 1), and crusted scabies (CS; n = 1). White scale, white-pinkish structureless areas, and combination of dotted, linear irregular, and spermatozoon-like shape vessels were the most common structures observed in MF (each in 100%); brown structureless areas were present in 66.7%. In patients with AD white scale, white-pinkish structureless areas, and dotted vessels were present in 100%; linear irregular vessels were present in 80%. In SS the most common structures were: white scale, dotted vessels, linear irregular vessels (each in 100%); glomerular vessels and gray dots were present in 66.7%. Characteristic dermoscopic/trichoscopic patterns seem to be particularly useful in initial recognition of SS, DsM, CS, and Pso. Trichoscopy provides additional, not previously reported, clues that may be useful in initial clinical differentiation of erythroderma due to various dermatologic disorders.