BackgroundThe usual stereotypical dermoscopic pattern associated with dermatofibromas is a pigment network and central white patch. However, this pattern may be difficult to diagnose in some variant cases. We aimed to describe dermoscopic patterns of dermatofibroma according to its histopathological subtypes, with special emphasis on new and rare dermoscopic features.MethodsThis prospective study, which was conducted between September 2015 and May 2016 in the Department of Dermatology, University Hospital Hassan II, Fez, Morocco, included 100 cases of dermatofibroma confirmed on clinical and histological grounds. Each lesion was scored for classic, previously reported, or new dermoscopic features.ResultsAll our Moroccan patients had a dark skin phototype (Fitzpatrick scale types IV and V). A total of 14 morphological dermoscopic structures were distinguished, and 17 dermoscopic patterns were observed, with the most common pattern being the central white patch and peripheral pigment network (21%). New patterns observed in our study were a white ring around an ulceration (6%), a pigment network with a pigmented ring around follicular openings (2%), and a discreet peripheral network and starlike white patch (3%). A patchy network with white patches was significantly noted in atrophic dermatofibroma (p = 0.01); vascularization was described in both aneurysmal and hemosiderotic dermatofibromas (p = 0.002); and a white ring around an ulceration was noted in aneurysmal dermatofibroma (p < 0.001).ConclusionsWe provide a description of dermoscopic patterns of dermatofibroma according to its histological subtypes in a dark skin phototype, along with a new report of a white ring around an ulceration as a significant pattern in aneurysmal dermatofibroma.
BackgroundGlomus tumors are rare, benign, vascular neoplasms arising from the glomus body. Although they can develop in any part of the body, they commonly do so in the upper extremities, most frequently subungual areas. They can be either solitary or multiple. Most typically they present as a small, round, bluish nodule visible through the nail plate with a classic triad of symptoms: hypersensitivity to cold, heightened pinprick sensitivity, and paroxysmal pain. Several tests can help in diagnosing these tumors with multiple imaging tools such as X-ray, magnetic resonance imaging, and ultrasonography. However, only histology can confirm the diagnosis. Complete surgical excision of the tumor is the only effective treatment to achieve pain relief and low recurrence rate.Case presentationWe report here a rare case of a 54-year-old Moroccan Berber woman presenting with a 10-year history of a glomus tumor at an unusual site. Dermoscopy and histology were helpful to confirm the diagnosis.ConclusionsWe aim to discuss clinical, dermoscopical aspects of this tumor and surgical modalities. We also emphasize the importance of keeping this tumor in mind among the possibilities of differential diagnosis of painful digital nodules.
BackgroundGlomus tumor is a benign and vascular hamartoma that originates from the neuromyoarterial cells of the normal glomus apparatus in the reticular dermis. The etiology of glomus tumors is unknown. It usually presents as a small, slightly raised, bluish or pinkish-red, painful nodule of the fingertips and the pulp. we report an atypical case of a patient of painless glomus tumor.Case presentationOur patient, a 60-year-old Moroccan man, had a 2.5 cm purplish painless soft tumor, covered with melliciric and hemorrhagic crusts, involving the first phalanx of his right index finger. This tumor was compressing his nail plate. No bony lesions were identified by radiographic studies, but magnetic resonance imaging was suggestive of glomus tumor. Surgical excision was performed with directed healing.ConclusionsThe diagnosis of a glomus tumor is an eventuality even in the absence of pain.
IntroductionTinea capitis is a scalp infection caused by different fungi. Etiological diagnosis is based on suggestive clinical findings and confirmation depends on the fungus growth in culture. However, it is not always possible to perform this test due to lack of availability. The association of clinical and dermatoscopic findings in suspected cases of tinea capitis may help the identification of the etiological agent, facilitating precocious, specific treatment.Materials and methodWe report a prospective descriptive analytical study of 34 children with tinea capitis. We performed a trichoscopic examination of all patients; only six children were able to have the mycological culture.ResultsTrichoscopy was abnormal in all 34 patients; it showed hair shaft abnormalities and, in some cases, scalp disorders too. We found that the comma and corkscrew appearance was found in microsporic tinea capitis, V-shaped hair was mainly seen in inflammatory tinea capitis, scales and follicular keratosis in non-inflammatory tinea capitis, and crusts and follicular pustules in inflammatory tinea capitis. Finally, erythema was seen in trichophytic and inflammatory tinea capitis.ConclusionWe propose a classification of trichoscopic signs of tinea capitis. This classification will enable rapid diagnosis and prediction of the type of fungus before mycological culture, thus a faster and more adapted management.Our study shows the importance of trichoscopy in the diagnosis and monitoring of tinea capitis. We suggest further prospective studies with a larger number of patients with tinea capitis, having performed mycological culture, to confirm this classification.
Introduction: Frontal fibrosing alopecia (FFA) is a form of primary lymphocytic scarring alopecia characterized by a progressive recession of the fronto-temporal hairline. Although the clinical presentation of FFA is very typical, biopsy for histopathological examination is still recommended to confirm the diagnosis. Currently, a growing number of skin and mucosal inflammatory diseases are diagnosed with modern noninvasive techniques such as dermoscopy without the necessity of a biopsy. Objectives: The International Dermoscopy Society (IDS) aimed to test the ability of its members to diagnose classic FFA through clinical and dermoscopic parameters and to compare acquired data to the largest cohort studies published since 1994. Methods: This is an observational, cross-sectional study describing patient demographics, clinical presentation and diagnostic tools used in a sample of FFA patients collected by IDS members. A literature search was then performed using Pubmed to review studies reporting more than 100 cases. Results: IDS members submitted 188 cases demonstrating a predominant female population (98.4%). In 71.8% of the cases, the clinical presentation and the trichoscopic findings allowed for the diagnosis. Out of 24 revised studies, 13 showed that clinical and trichoscopic features were decisive for the diagnosis in almost all cases. Conclusions: Demographic and clinical data of our cohort were mostly comparable to previous reported data on FFA. The relevant role of the clinical and trichoscopic features in diagnosing FFA was confirmed by our study and the reviewed literature. Trichoscopy could be considered a worldwide-acknowledged non-invasive technique for the diagnosis of FFA.
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