Differences among Dermoscopic Findings in Riehl's Melanosis of the Cheek and Neck

Yim, June Hyuck; Kang, In-Hye; Shin, Min Kyung; Lee, Mu-Hyoung

doi:10.5021/ad.2019.31.4.460

Cited by 8 publications

(9 citation statements)

References 8 publications

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“…The histopathological examination has good value in the diagnosis of Riehl’s melanosis. The most significant findings of Riehl’s melanosis are vacuolar degeneration of the basal layer and pigment incontinence of the dermis [ 2 , 4 ]. It could help us differentiate from other pigmentary disorders like melasma, lichen planus pigmentosus, exogenous ochronosis, and nevus of Ota [ 23 , 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…A contact polarized mode with ultrasound gel for immersion was utilized. Based on previously published works [ 4 , 14 ], six features, including pseudo network, gray dots or granules, telangiectatic vessels, perifollicular whitish halo, tiny scales, and follicular keratotic plugs, were evaluated. The dermoscopic findings were defined as present if all authors reached a consensus.…”

Section: Methodsmentioning

confidence: 99%

“…The pigmentation is more pronounced on the forehead, neck, and lateral face, including the zygomatic and temporal region, with relative sparing in the central part [ 3 ]. It is believed to be primarily due to contact or photocontact sensitivity caused by certain cosmetics’ fragrances, preservatives, or bactericides [ 4 ]. Thus, a patch or photopatch test may be helpful to screen for possible causative factors.…”

Section: Introductionmentioning

confidence: 99%

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Riehl’s Melanosis: A Multimodality, In Vivo, Real-Time Skin Imaging Study with Cellular Resolution Optical Coherence Tomography and Advanced Skin Diagnosis System in a Tertiary Medical Center

et al. 2022

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Background: Riehl’s melanosis is a psychologically devastating hyperpigmentary disorder that typically occurs on the face and neck. The study of Riehl’s melanosis is limited due to its rarity, variable morphology, and lack of noninvasive diagnostic tools. Recent advances in skin imaging analysis and diagnostic systems improve diagnostic accuracy and enable the noninvasive, real-time evaluation of pigmentary disease. A comprehensive study of Riehl’s melanosis clinical morphology with multimodality and in vivo skin imaging systems has yet to be reported. Objectives: To investigate the clinical features and in vivo advanced skin imaging findings of Riehl’s melanosis. Methods: We retrospectively investigated the clinical characteristics, dermoscopic, and histopathological features of Riehl’s melanosis. We further utilized multimodality skin imaging analysis systems, including a cellular resolution optical coherence tomography (OCT) and new skin diagnosis system, to investigate the features of Riehl’s melanosis. In addition, we compared OCT findings with histopathological features and clinical assessment. Results: We evaluated 30 patients with Riehl’s melanosis at a tertiary medical center from 2010 to 2022. The average age was 47.7 ± 12.3 (mean ± SD) years, predominantly female patients (female: n = 23; male: n = 7). Cellular resolution OCT imaging from lesion skin shows increased melanocyte capping, disrupted basement membrane, telangiectatic blood vessels, and melanophages in the dermis. The advanced skin diagnosis system captured subclinical erythema of the skin, highlighting the inflammatory nature of the disease. The results correlated well with histopathological findings. Limitations: This is a single-center, cross-sectional study. Conclusions: We highlight the features of Riehl’s melanosis through a novel cellular resolution OCT and photographic skin diagnosis system. A multimodality skin diagnosis system can serve as a real-time, in vivo, noninvasive method for evaluating pigmentary disorders.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Riehl’s Melanosis: A Multimodality, In Vivo, Real-Time Skin Imaging Study with Cellular Resolution Optical Coherence Tomography and Advanced Skin Diagnosis System in a Tertiary Medical Center

et al. 2022

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“…Dermatologists should thus provide alternative non-invasive methods for diagnosis and treatment of skin lesions. In this regard, dermoscopy can be a useful supplemental tool 6 7 . Given that the lesion was a solitary, erythematous, and brown shiny papule, clinical examination favored a diagnosis of CCA.…”

Section: Discussionmentioning

confidence: 99%

Non-Invasive Diagnosis of a Facial Tumor Using Dermoscopy and Successful Treatment with 595 nm Pulsed Dye Laser

et al. 2021

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Clear cell acanthoma (CCA) is an uncommon, benign epithelial tumor presenting as a well-defined, slow-growing solitary nodule. The diagnosis of CCA is usually based on clinical and histopathological evaluation of the tumor. However, when such type of benign tumor occurs on an exposed area, a biopsy is not always the best diagnostic option since it may leave scar. The recent advent of dermoscopy has offered an accurate and non-invasive method to diagnose CCA without resorting to skin biopsy. A 40-year-old male presented with a shiny, erythematous-to-brown, flattened nodule on the left cheek. Dermoscopic examination revealed a ‘string of pearls’ vascular pattern, a characteristic dermoscopic feature of CCA. Under the clinical and dermoscopic impression of CCA, a 595 nm pulsed dye laser (PDL) therapy targeting the vascular tissue in the superficial dermis of the lesion was chosen for a minimally invasive treatment. After repeated sessions of PDL, an optimal cosmetic outcome was achieved and no recurrence was recorded during the follow-up period. Herein, we report a case of presumed CCA which was successfully diagnosed and treated by utilizing non-invasive modalities.

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“…reflectance confocal microscopic examinations exhibited prominent telangiectatic vessels in addition to the consistently observed melanin in Riehl's melanosis. 4,6,7 These observations suggest that telangiectatic vessels in the dermis can also be considered as distinguishing features of Riehl's melanosis. Thus, we analysed histological findings on Riehl's melanosis, identifying increased dermal pigment and dilated vessels as potential targets for treatment.…”

mentioning

confidence: 89%

A novel treatment for Riehl's melanosis targeting both dermal melanin and vessels

Kim,

Park,

Baek

et al. 2023

Photoderm Photoimm Photomed

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Background/purposeRiehl's melanosis is a difficult‐to‐treat condition characterized by persisting dermal hyperpigmentation. This study aimed to evaluate the efficacy of a histology‐specific targeted therapy for Riehl's melanosis.MethodsSkin biopsy samples of Riehl's melanosis were assessed to identify histology‐specific targets for treatment. Subsequently, the efficacy of a combination involving a fractional picosecond laser and a pulsed dye laser (PDL) targeting the dermal melanin and vessels, respectively, was evaluated. Clinical improvement was assessed using the dermal pigmentation area and severity index (DPASI). The treatment outcomes were compared to those of a control, in this case a single laser treatment solely targeting pigmentation.ResultsHistological and immunohistochemical analyses identified dermal melanin pigment and dilated vessels as treatment targets for Riehl's melanosis. The combined treatment of the fractional picosecond laser and PDL showed a significant reduction of the DPASI scores, which was significantly better than the control group. Patients who underwent the combined laser treatment indicated high levels of satisfaction with no adverse events except of transient erythema and oedema.ConclusionThe combined treatment of a fractional picosecond laser and a PDL was more effective for Riehl's melanosis compared to single laser treatment. The treatment targets both dermal pigmentation and dilated vessels, offering promising results for those working to manage Riehl's melanosis.

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Differences among Dermoscopic Findings in Riehl's Melanosis of the Cheek and Neck

Abstract: is a pigmented dermatosis that presents as bilateral, symmetrical, grayish-purplish-brown reticulated hyperpigmentation on the face and neck 1. The etiol

Cited by 8 publications

References 8 publications

Riehl’s Melanosis: A Multimodality, In Vivo, Real-Time Skin Imaging Study with Cellular Resolution Optical Coherence Tomography and Advanced Skin Diagnosis System in a Tertiary Medical Center

Riehl’s Melanosis: A Multimodality, In Vivo, Real-Time Skin Imaging Study with Cellular Resolution Optical Coherence Tomography and Advanced Skin Diagnosis System in a Tertiary Medical Center

Non-Invasive Diagnosis of a Facial Tumor Using Dermoscopy and Successful Treatment with 595 nm Pulsed Dye Laser

A novel treatment for Riehl's melanosis targeting both dermal melanin and vessels

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