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Introduction: Differentiation between Chronic Hand Eczema (CHE) and Palmoplantar Psoriasis (PP) is a diagnostic challenge. Dermoscopy can helpto distinguish between the two conditions. Aim: To establish and compare the dermoscopic findings of the CHE and PP using DermLite DL4 dermoscope and to confirm the accuracy of the dermoscopic findings with the histopathological findings. Materials and Methods: A cross-sectional study was conducted at Navodaya Medical College, Hospital and Research Centre, Raichur, Karnataka, India, from January 2017 to June 2018. Fifty patients each of CHE (26 male and 24 female subjects) and PP (25 male and 25 female subjects) were included in the study. A detailed clinical history, cutaneous clinical and dermoscopic findings of each case were noted. A 4 mm punch biopsy was taken from 30 patients for histopathological analysis. The data was tabulated, analysed and tested for significance using the Chi-square test. Results: The mean age of the patients was 46±4 years. On dermoscopic examination, diffuse white scales in 45 (90%) patients, over a red background in 49 (98%) patients with regularly arranged dots and globules in 45 (90%) patients was seen in PP. Patchy yellow scales 46 (90%), yellow dots, globules and yellow to brown crusts against a yellow background was seen in all patients (100%) of CHE (p-value <0.001). Histopathological findings are in agreement with dermoscopic findings in 9/16 and 10/14 cases of CHE and PP respectively. Conclusion: Dermoscope is a useful non invasive clinical aid to differentiate between CHE and PP. The presence of diffuse white scales over a red background and regularly arranged vessels indicates PP, whereas the presence of patchily distributed yellow scales, yellow dots and globules; and yellow to brown crusts against a yellow background is more suggestive of CHE.

Summary 中面部幼儿剥脱综合征 (MiTES) 是一种新被认识的疾病,  在此病中,  表面健康儿童持续搔抓鼻梁中央的局部面部。这一问题在出生后第一年开始, 导致深在伤口和严重瘢痕。这可能易被误认为虐待儿童。此病的原因不明,  但一篇发表于 2015 年的论文提供了线索, 这篇论文描述了 11 个对疼痛先天不敏感家庭,  这些家庭在一个新认识的名为 PRDM12 的基因存在突变, 该基因负责编码疼痛受体神经发生必须的一种蛋白。大部分 PRDM12 突变患者的肢体发生切断性伤害, 因为他们缺乏避免伤害的疼痛反应。但是,  11  个家庭中有一个受到的伤害较轻, 5 名受影响的兄弟姐妹存在一种被描述为“鼻周搔抓”的疾病(与 MiTES 看起来相同)。因此, 来自英国、印度和爱尔兰团队分析了 5 例新发 MiTES 病例中的PRDM12。4 名儿童, 其中 2 名为手足, 存在与在早期报告中相同的 PRDM12 的突变, 但在第 5 名儿童中未见任何突变。在大多数病例中, 父母有亲属关系, 在一个基因上携带突变, 而受影响儿童的两个基因均受到影响。这项研究证实 MiTES 为一种遗传性疾病,  在某些情况下因 PRDM12 隐性突变导致。这一新的发现将帮助我们了解这一使人痛苦的毁容疾病,  并有望对其进行管理。