Dermoscopy Research Articles

Efficacy evaluation of compound glycyrrhizin injection in the treatment of melasma

Objective To evaluate the clinical efficacy of compound glycyrrhizin injection in the treatment of melasma. Methods A total of 30 melasma patients with blood vessel scores of ++ or +++ and melanin scores of ++ or +++, which were evaluated by dermoscopy and reflectance confocal microscopy (RCM) respectively, were collected from the Department of Dermatology of Hangzhou Third Hospital between May 2015 and July 2016. All the patients were randomly divided into 2 groups by drawing lots: treatment group treated with intravenous drips of compound glycyrrhizin injection at a dose of 40 ml once every three days for 8 sessions, oral vitamin C tablets at a dose of 0.2 g thrice a day, and oral vitamin E tablets at a dose of 0.1 g once a day, and control group treated with oral vitamin C and vitamin E tablets at the same dose as the treatment group. Three months after starting the treatment, the therapeutic effect was evaluated using melasma area and severity index (MASI) . Meanwhile, RCM, dermoscopy and VISIA skin detector were used to detect skin lesions, and the melanin score, blood vessel score and brown spot and erythema indices were calculated. Results For the treatment group, the melanin score and blood vessel score were both significantly decreased at 3 months after starting the treatment compared with those before the treatment (Z=2.773, 3.135, P= 0.006, 0.002, respectively) , so were the brown spot index (38.3 ± 3.1 vs. 43.9 ± 5.8, Z= 3.091, P= 0.002) and erythema index (26.5 ± 5.6 vs. 33.3 ± 7.7, t= 2.752, P= 0.010) . For the control group, the melanin score significantly decreased at 3 months after starting the treatment compared with those before the treatment (P= 0.023) , while no significant differences were observed in the blood vessel score or VISIA indices (P > 0.05) . Three months after starting the treatment, 9 cases showed marked improvement, and 6 showed improvement in the treatment group; 3 cases showed marked improvement, 11 improvement, and 1 showed no improvement in the control group. The therapeutic effect in the treatment group was significantly superior to that in the control group (Z= 2.276, P= 0.029) . Conclusion Compound glycyrrhizin injection is effective for the treatment of melasma, and RCM, dermoscopy and VISIA skin detector can be used to assist efficacy evaluation in melasma. Key words: Chloasma; Glycyrrhizic acid; Microscopy, confocal; Dermoscopy; Treatment outcome; Compound glycyrrhizin injection

Dermoscopy of Striae Rubrae.

Dermoscopy of Striae Rubrae.

Dermoscopy of Trichoepithelioma: A Clue to Diagnosis.

Dermoscopy of Trichoepithelioma: A Clue to Diagnosis.

Use of Filters in Dermatoscopy to Capture Better Images.

Use of Filters in Dermatoscopy to Capture Better Images.

A Comment on Trichoscopy.

Trichoscopy is the term coined for the use of dermatoscope for the evaluation of hair and scalp. Dermatologists involved in the management of hair and scalp disorders have discovered dermatoscope to be useful in their daily clinical practice, and expert studies suggest that dermoscopy may improve diagnostic capability beyond simple clinical inspection. Therefore, trichoscopy has gained popularity as a tool in the differential diagnosis of hair and scalp disorders. Despite the enthusiasm emerging with its establishment as a valuable dermatologic tool, caution is warranted not to elevate trichoscopy to something like a fetish status. As a diagnostic procedure, trichoscopy remains to be understood as representing an integral part of a comprehensive dermatological examination. Furthermore, trichoscopy represents an integral part of surface or epiluminescence microscopy of the skin or dermoscopy. It seems that the dermatoscope for the evaluation of the hair and scalp picks up from the culture of a stethoscope within internal medicine, in terms of being a time-tested, sophisticated, hand-held diagnostic medical instrument conferring an uncontested dignity in the hands of a physician attending hair and scalp disorders.

Escabiosis: la dermatoscopia puede ser la clave

Escabiosis: la dermatoscopia puede ser la clave

Innovative modification of the USB dermatoscope for mucoscopy

Innovative modification of the USB dermatoscope for mucoscopy

Diagnosis and treatment of dermatofibrosarcoma protuberans

Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous and subcutaneous mesenchymal malignant tumor characterized by high rates of local recurrence and low risk of metastasis. Histopathological and immumohistochemical study can be used to diagnose DFSP. Recent studies have shown that cell genetics and molecular biology, imagiology, dermatoscopy and cutaneous computed tomography (reflectance confocal microscopy) can also play an important auxiliary role in the diagnosis, treatment and evaluation of DFSP. At present, the surgical treatment of DFSP mainly includes wide local excision (WLE) and Mohs micrographic surgery (MMS) . Each of the two approaches has its advantages and disadvantages. After surgery, radiation therapy and comprehensive immunological treatment can serve as adjuvant treatment. Cryotherapy is effective in patients with recurrent DFSP, and the targeted agent imatinib can be combined for inoperable patients or patients with positive surgical margins. In addition, antiestrogenic drugs (such as tamoxifen) or the new targeted agent heparanase inhibitor roneparstat (SST0001) may have some therapeutic effects. Key words: Dermatofibrosarcoma; Pathology, clinical; Diagnosis; Mohs surgery; Therapeutic Uses

Differential Diagnosis of Seborrheic Keratosis: Clinical and Dermoscopic Features.

<p>Seborrheic keratosis (SK) is a benign epidermal keratinocytic tumor that is extremely common, particularly in individuals over the age of 50. Most individuals with SK will have more than one lesion and the presence of over 10 lesions in the same person is not uncommon. Although the clinical morphology of most SK with their stuck-on, symmetric, keratotic, and waxy appearance makes them easy to identify, many manifest a morphology resembling melanoma or squamous cell carcinoma. One can argue that such cases will ultimately not prove to be problematic since a simple biopsy will easily reveal their benign nature and eliminate any concerns. However, the cost and morbidity associated with the biopsy of benign lesions should not be underestimated. Methods to improve our in vivo ability to correctly identify SK will prove beneficial not only to the health care system in general but to the individual patient specifically. The issue of greater concern resides with skin cancers that mimic SK or when skin cancers arise in association with SK. Needless to say, in vivo methods to help identify malignancy and differentiate them from benign lesions would be welcomed by all. Fortunately, we do now have in vivo imaging methods such as dermoscopy that can improve the clinician's diagnostic accuracy. In this article, we summarize the current knowledge regarding the clinical and dermoscopic features of SK, and provide clues to aid in their diagnosis.</p> <p><em>J Drugs Dermatol. 2017;16(9):835-842.</em></p>.

Diagnostic value of reflectance confocal microscopy combined with dermoscopy for melanocytic nevus

Objective To evaluate the diagnostic value of dermoscopy and reflectance confocal microscopy (RCM) alone or in combination for melanocytic nevus. Methods A total of 37 patients with clinically diagnosed melanocytic nevus were collected. Skin lesions were firstly examined by dermoscopy and RCM, then were resected to be subjected to histopathological examination for final diagnosis. The imaging features of melanocytic nevus were summarized. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of different skin imaging techniques were calculated, and the consistency was analyzed between skin imaging techniques and histopathological examination. Results Based on the dermoscopic and RCM findings, 2 kinds of nevus cells with different morphological features were observed in the dermis of intradermal nevus. One kind of nevus cells was characterized by a non-fusional, highly-refractive round structure in the papillary dermis under RCM, and by a brown or light brown homogenous pattern under dermoscopy, which was observed in 5 skin lesions. The other kind of nevus cells appeared as irregular, highly-refractive cell clumps in the papillary dermis under RCM, and by a cobblestone or globular pattern under dermoscopy, which was observed in 31 skin lesions. For the diagnosis of melanocytic nevus, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of RCM combined with dermoscopy were 91.7%, 87.5%, 90.9%, 97.1% and 70% respectively, those of RCM were 86.1%, 75%, 84%, 93.9% and 54.5% respectively, and those of dermoscopy were 77.8%, 87.5%, 75%, 96.3% and 41.2% respectively. All the diagnostic indices of RCM combined with dermoscopy were higher than those of RCM or dermoscopy alone, except that the specificity was equal to that of dermoscopy alone. RCM showed higher sensitivity, accuracy and negative predictive value, but lower specificity and positive predictive value compared with dermoscopy. There were no significant differences in the diagnostic yield in melanocytic nevus between RCM combined with dermoscopy or RCM alone and histopathological examination (χ2= 0.25, 0.57, P= 0.63, 0.45, Kappa value= 0.72, 0.53, respectively) . However, a significant difference in the diagnostic yield in melanocytic nevus was observed between dermoscopy and histopathological examination (χ2= 5.81, P= 0.012) . Conclusion RCM combined with dermoscopy shows higher diagnostic accuracy for melanocytic nevus compared with RCM or dermoscopy alone. Key words: Nevus; Microscopy, confocal; Dermoscopy; Pathology, clinical; Diagnostic techniques and procedures

Analysis of dermoscopy and reflectance confocal microscopy features of verruca plana

Objective To evaluate imaging features of verruca plana by dermoscopy and reflectance confocal microscopy (RCM) . Methods Totally, 88 untreated patients with verruca plana were enrolled into this study. One typical skin lesion was chosen from each patient and subjected to dermoscopy and RCM separately, and imaging features were recorded and analyzed. Results Dermoscopy revealed a light red background in 48 cases (54.55%) , a light yellow background in 40 cases (45.45%) , and a various number of punctate hemorrhages in 84 cases (95.45%) . RCM showed concentric onion-skin-like structures in 48 patients (54.55%) . Among 57 patients with disease duration > 1 year, 44 (77.19%) had the concentric onion-skin-like pattern, while only 4 (12.90%) patients had similar structures among 31 patients with disease duration 1 year and those with disease duration < 1 year (χ2= 33.47, P < 0.05) . Of 88 patients, 86 (97.73%) had hyperpigmentation in the basal layer at the dermo-epidermal junction, intact dermal papillary rings, vasodilatation, hyperemia and 1-2 dilated capillaries in the dermal papillae. Eight patients were treated for 2 weeks, and the above features disappeared after the treatment under dermoscopy and RCM. Conclusion Based on clinical manifestations, dermoscopy and RCM features may be helpful for the diagnosis of verruca plana. Key words: Warts; Dermoscopy; Microscopy, confocal; Verruca planae

Application of dermoscopy in the diagnosis of cutaneous malignant melanoma

Application of dermoscopy in the diagnosis of cutaneous malignant melanoma

Progress in clinical application of dermoscopy

Progress in clinical application of dermoscopy

Frontal fibrosing alopecia: two case reports

Two cases of frontal fibrosing alopecia (FFA) were reported. Case 1, a 44-year-old woman, presented with progressive recession of the frontotemporal hairline for 4 years and multiple skin-colored facial papules for 2 years. Skin examination showed that the frontotemporal hairline was receded, the local skin was smooth and thin, and a few remaining fine hairs could be seen. Additionally, eyebrows, axillary and pubic hairs were partly shed, and plenty of millet-sized skin-colored papules were diffusedly distributed on the frontotemporal region and bilateral mandibular angles. Dermatoscopy showed reduced hair follicular openings, different hair shaft diameters, cicatricial white patches and perifollicular erythema. Case 2, a 55-year-old woman, presented with progressive frontotemporal hair loss for 2 years. Skin examination revealed the recession of bilateral frontotemporal hairline and partial loss of eyebrows, axillary and pubic hairs. Histopathological examinations of the 2 patients both revealed perifollicular infiltration of lymphocytes, liquefaction degeneration of basal cells and perifollicular lamellar fibrosis. Clinical manifestations and histopathological features of the 2 patients both confirmed the diagnosis of FFA. Key words: Alopecia; Frontal fibrosing alopecia

Dermoscopy of isolated syringoma of the vulva

Dermoscopy of isolated syringoma of the vulva

Tinea Capitis in Children and Trichoscopic Criteria.

Tinea capitis is the most common pediatric superficial dermatophyte infection. The causative species vary, as for instance, Microsporum canis predominates in Europe, while Trichophyton tonsurans predominates in North America. Tinea capitis does not respond well to topical therapy alone, thus oral therapy is requisite. The drug of choice is griseofulvin; however in some countries, it is no longer available. Fungal culture should be requested in the persistent, scalp lesion and trichoscopy can put forward a speedy diagnosis by its characteristic findings. Scalp dermoscopy or “trichoscopy” represents a valuable, noninvasive technique for the evaluation of patients with hair loss due to tenia capitis. It is simple, quick, and easy to perform.

Dermoscopy of Rare Pigmented Variant of Bowen's Disease

How to cite this article Agarwal SA, Dhurat RS, Agarwal S, Sharma A, Ghate S. Dermoscopy of Rare Pigmented Variant of Bowen's Disease. Int J Dermoscop 2017;1(2):56-59.

Dermoskopi ile Bir Stukko Keratoz Olgusu

Dermoskopi ile Bir Stukko Keratoz Olgusu

Nailfold capillaroscopic parameters and skin telangiectasia patterns in patients with systemic sclerosis

ObjectiveTo correlate nailfold capillaroscopic parameters with the presence of skin telangiectases (TAs) in systemic sclerosis patients (SSc). MethodsThirty-three consecutive patients (28 women and 5 men, mean age 59±21years) affected by SSc according to the ACR/EULAR criteria, 30 with limited (lcSSc) and 3 with diffuse (dcSSc) skin disease, displaying the presence of skin TAs on face, hands, forearms, neck, and décolleté were recruited. Nailfold videocapillaroscopy (NVC) was performed to classify the patients into one of the three main patterns of SSc microangiopathy (“early”, “active”, “late”), and to calculate the microangiopathy evolution score (MES). SSc patients underwent also dermoscopy (DS) for the analysis of the TA score and patterns (spot or reticular). Possible correlations between clinical findings, serum autoantibodies, TA patterns and both NVC patterns and MES were investigated. ResultsThe “late” NVC pattern was found associated with a highest total number of TAs (p=0.005): in particular both “spot” and “reticular” TA patterns were found equally distributed in SSc patients with the “late” pattern. High MES values were found associated with the highest total number of TAs (p=0.003), with the “reticular” but not with the “spot” DS pattern (p=0.003) and with the “late” pattern of microangiopathy (p=0.001). ConclusionsThe severity of nailfold microangiopathy seems to correlate in SSc patients with both progressive cutaneous microvascular abnormalities and Medsger's severity score, as evaluated by NVC analysis and DS. The assessment of the microvascular damage may be useful not only during the onset of SSc for the early diagnosis, but also to monitor its evolution.

Dermoscopy and reflectance confocal microscopy features of hypopigmented mycosis fungoides in children

Objective To investigate dermoscopy and reflectance confocal microscopy (RCM) features of hypopigmented mycosis fungoides (HMF) in children, and to evaluate the consistency in diagnosis of HMF between histopathological examination and the combination of dermoscopy with RCM. Methods A total of 15 outpatients with suspected HMF who visited the Department of Dermatology were enrolled into this study from November 2014 to October 2015, and their dermoscopy and RCM images were collected. All the patients underwent histopathological, immunohistochemical and other related examinations. Results Based on dermoscopy and RCM images, 15 cases were suspected to be HMF, and 13 cases were confirmed to be HMF. Dermoscopy images of HMF showed obvious skin lines, white scurf-like scales, reticular, zebra-like or dotted depigmentation, and blood vessels distributed in punctiform, short linear, spermatozoa-like or stellate patterns. RCM images of HMF showed many highly refractive cells in each layer of the epidermis and dermal-epidermal junction, Pautrier's microabscess in some regions, and dermal papillary rings with decreased refractivity which were surrounded by many highly refractive cells in the basal layer. Conclusion HMF has characteristic dermoscopy and RCM images, so dermoscopy and RCM can serve as useful methods for early screening and auxiliary diagnosis of HMF in children. Key words: Mycosis fungoides; Dermoscopy; Microscopy, confocal; Depigmentation