Trichoscopy of connectivitises: Discoid lupus erythematosus or dermatomyositis?

Abstract

ABSTRACT Background: Discoid lupus erythematosus (DLE) and Sdermatomyositis (DM) are two connectivitises with frequent scalp involvement and similar clinical features. Objective: The objective of this study was to evaluate and compare the trichoscopic findings in patients with DM and DLE and to determine the distinctive feature of each pathology that may help in the differential diagnosis. Materials and Methods: We performed an analytical, comparative primary study of trichoscopic images belonging to 32 patients (18 cases of lupus and 14 of dermatomyositis) with a total of seventy lesions over a period of two years. Results: Eighteen cases of discoid lupus and fourteen cases of dermatomyositis were included. Trichoscopic founding revealed that abnormalities of follicular openings, pigment disorders, white structures, and downy hair were more frequent in lupus, and vascular patterns and dystrophic and circular hair were more prominent in dermatomyositis. The analytical study revealed that the absence or reduced number of follicular openings (p = 0.024), the presence of sliding sheaths (p = 0.048) were significant signs in favor of lupus; and the presence of perifollicular erythema (p = 0.0001), linear fine vessels and telangiectasia (p = 0.031), and pseudo-lake structures (p = 0.002) were associated with dermatomyositis. Conclusion: Trichoscopic examination is a valuable tool for the diagnosis of connectivitis. Key words: Trichoscopy, Scalp, Dermatomyositis, Lupus