Dermoscopy is a new diagnostic tool in diagnosis of common hypopigmented macular disease: A descriptive study

Abstract

One of the most frequent complaints in dermatology clinics is the eruption of hypopigmented patchy skin lesions. The aim of the study was to investigate the utility of dermoscopy in common hypopigmented macular diseases. Patients with the followings diseases were examined by dermoscopy: vitiligo, pityriasis alba, nevus depigmentosus, achromic pityriasis versicolor, idiopathic guttate hypomelanosis, and extragenital guttate lichen sclerosus. This study showed that these hypopigmented macular diseases might display specific dermoscopic features. In vitiligo, the mean dermoscopic features were the presence of a diffuse white glow with perifollicular pigment, perilesional hyperpigmentation, leukotrichia and the pigmentary network. In idiopathic guttate hypomelanosis, the characteristic features were the presence of multiple, shiny, scaly macules with welland ill-defined edges borders that coalesced into polycyclic macules. For nevus depigmentosus, the mean features were hypopigmented patches with irregular border with a faint reticular network. For pityriasis alba, the fairly ill-demarcated hypopigmented macules with fine scales were the mean feature. In lichen sclerosus, there were white structureless areas, perilesional erythematous halo, follicular plugging and white chrysalis like structures. Dermoscopy of achromic pityriasis versicolor showed a fairly demarcated white area with fine scales localized in the skin creases.

A study to compare clinico-histopathological and dermoscopic findings in patients of vitiligo

“…On evaluating the dermoscopic features in our study with other authors, we found that perifollicular pigmentation was present in stable and repigmenting diseases in greater numbers when compared to unstable cases which was similar to the findings of Purnima et al and Wali et al 4,20 Jha et al and Al-Refu also found perifollicular pigmentation in 22.2% and 75% of patients respectively. 21,22 Similarly, perilesional/marginal hyperpigmentation in this study was 76.5% in stable and 36.4% in unstable cases which was concordant with the findings of Purnima et al (100% and 12%) but much more than Wali et al (23% and 0%), while Jha et al and Al-Refu had seen perilesional/marginal hyperpigmentation in 22% and 75% of cases. 4,[20][21][22] Also, intra/perilesional erythema with telangiectasia though not observed by many authors it was the most common finding in my study with 88.2% in stable disease and 84.8% in unstable disease.…”

“…21,22 Similarly, perilesional/marginal hyperpigmentation in this study was 76.5% in stable and 36.4% in unstable cases which was concordant with the findings of Purnima et al (100% and 12%) but much more than Wali et al (23% and 0%), while Jha et al and Al-Refu had seen perilesional/marginal hyperpigmentation in 22% and 75% of cases. 4,[20][21][22] Also, intra/perilesional erythema with telangiectasia though not observed by many authors it was the most common finding in my study with 88.2% in stable disease and 84.8% in unstable disease. Intra/perilesional erythema with telangiectasia was also seen by Jha et al in 37% cases and Al-Refu K in 8% cases.…”

“…4,21 Leukotrichia was also observed by Jha et al (12.1%) and Al-Refu (70%) in their studies. Starburst pattern, comet tail appearance, micro koebner's phenomenon and tapioca sago appearance all suggestive of unstable disease were present in significant numbers in our study too in unstable vitiligo like that of Purnima et al, Jha et al and Wali et al 4,[20][21][22] On calculating the significance of these findings statistically we found that only perilesional/marginal Hyperpigmentation was significant in stable disease (p=0.016), but perifollicular depigmentation (p=0.028), trichrome pattern (p=0.037), comet tail appearance (p=0.018), micro koebner's phenomenon (p=0.002) and tapioca sago appearance (p=0.05) were all significant for unstable disease.…”

“…Intra/perilesional erythema with telangiectasia was also seen by Jha et al in 37% cases and Al-Refu K in 8% cases. 20,22 Various other findings like perifollicular depigmentation was seen in 75.8% of unstable cases in our study which was concordant with the result of Purnima et al (82.4%) but discordant with Jha et al (9%), trichrome pattern was also seen more often in unstable disease with 60.6% in our study and 41% and 39% in studies of Purnima et al and Wali et al respectively, leukotrichia though a marker of unstable disease was present in almost equal ratios in both stable and unstable disease, 47.1% and 45.5% respectively. 4,21 Leukotrichia was also observed by Jha et al (12.1%) and Al-Refu (70%) in their studies.…”

Non-Invasive Evaluation and Differential Diagnosis for Pediatric Leukoderma in a Single Institute

“…Whether the depigmentation of a spot is complete or incomplete has been evaluated by dermoscopy in recent years, and this has contributed to the diagnosis of vitiligo [9]. However, dermoscopy is associated with a disadvantage in that it is based on local observation within very narrow range.…”