Dermoscopy of discoid lupus erythematosus – a systematic review of the literature

Abstract

Background Discoid lupus erythematosus (DLE) may lead to disfiguring scarring and permanent hair loss. Dermoscopy may serve as a noninvasive tool useful in the preliminary diagnosis of hair loss and inflammatory skin diseases. The aim of the paper was to summarize and analyze the dermoscopic features of DLE lesions in various anatomical locations.Methods A systematic review of PubMed, Scopus and Web of Science was performed using the search terms: 'lupus' OR 'discoid lupus' OR 'cutaneous lupus' combined with 'dermoscopy' OR 'dermatoscopy' OR 'videodermoscopy' OR 'videodermatoscopy' OR 'trichoscopy' OR 'mucoscopy' OR 'onychoscopy'.Results About 29 out of 318 initially identified papers were included in the analysis. In scalp DLE (n = 166), the most common findings were: white structureless areas (62%), arborizing vessels (57.8%), white scales (54.2%), follicular keratotic plugs (47%), absent follicular openings (45.8%), perifollicular scaling (43.9%), pink-white background (40.4%), speckled brown pigmentation (38%), and fibrotic white dots (33.7%). In non-scalp DLE (n = 129), the most frequent features were: follicular keratotic plugs (66.7%), white perifollicular halo (65.9%), white scale (39.5%), speckled brown pigmentation (38.8%), white structureless areas (37.2%), and arborizing vessels (34.9%). There are scarce data in the literature on dermoscopic findings in labial (n = 8), mucosal (n = 3) and ungual DLE (n = 1).Conclusions DLE is characterized by a wide variety of dermoscopic findings with variable frequencies depending on the location of the lesions. Nevertheless, further studies are needed in order to reliably assess frequencies, correlation with disease stage and significance of individual dermoscopic features.

Dermoscopic spectrum of mycosis fungoides: a retrospective observational study by the International Dermoscopy Society

“…follicular psoriasis, keratosis pilaris, pityriasis rubra pilaris, follicular lichen planus, phrynoderma, lichen spinulosus, follicular eczema and infectious folliculitis) that usually do not display these two features 21,22 . Notably, besides follicular plugs, active lesions of discoid lupus erythematosus may also rarely feature dilated follicles/lack of hairs, yet this condition is commonly typified by linear vessels with branches and interfollicular white structureless areas that are less frequently seen in folliculotropic MF 23 …”

Chronic Cutaneous Lupus Erythematosus in a White Population: Dermoscopic Characteristics by Clinical Subtype, Lesion Location and Disease Duration

“…Dermoscopic and trichoscopic features of DLE have been analyzed in several studies in various populations [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. However, those analyses were predominantly conducted in individuals with dark-skinned phototypes (III and higher) [10,11,[13][14][15][16][17][18][19].…”

“…So far, the (video)dermoscopic features of DLE have been the subject of several studies [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. However, most of those reports focused on trichoscopic features of the scalp DLE [11,[14][15][16][17][18][19].…”

Dermoscopy and Trichoscopy in Dermatomyositis—A Cross-Sectional Study

“…(Video)dermoscopy is a non-invasive diagnostic technique that has a well-established role in the early diagnosis of melanoma and non-melanoma skin cancer. In recent years, this method has also been increasingly used in the assessment of inflammatory dermatoses [5,6]. So far, only a few reports have been published on the dermoscopic features of DM [7][8][9][10][11][12][13][14][15].…”