Reflectance confocal microscopy for the diagnosis of Galli‐Galli disease

Line-Field Confocal Optical Coherence Tomography of a Suspected Case of Galli-Galli Disease

“…Since the patient refused to undergo a second biopsy, we used non-invasive techniques for further investigations. We examined several papular and pigmented lesions with RCM (Vivascope 3000®, Caliber Imaging and Diagnostics): our findings were in accordance with the description of Coelho de Sousa et al ( Figure 2 ) [ 3 ]. At LC-OCT evaluation (DeepLive®, DAMAE Medical) several lesions showed intraepidermal dark areas with hyper refractile roundish elements within correlating respectively to acantholysis and dyskeratotic cells, a downward finger-like proliferation of the rete ridges into the papillary dermis and basal hyperpigmentation ( Figure 2 ).…”

“…When histology is only partially conclusive and/or the patient refuses invasive investigations, non-invasive imaging techniques could assist the diagnosis. Coelho de Sousa et al made the first reflectance confocal microscopy (RCM) evaluation of GGD [ 3 ]. Line-field confocal optical coherence tomography (LC-OCT) offers additional features compared to RCM, such as a superior penetration in depth (up to 500 μm), a dermoscopic view of the analyzed tissue, and the possibility to obtain vertical histology-like sections and 3D reconstructions of the examined tissue.…”

Galli–Galli Disease: A Comprehensive Literature Review

“…The first presentation, which is observed in the majority of patients (42/69) and consequently designated as typical, is characterized by progressive symmetrical, reticular, and partly lentiginous pigmentation of the flexures (the neck, axillary, mammary, and inguinal folds) in combination with erythematous brownish macules and papules, which sometimes coalesce into reticulated plaques (Figure 3) [1][2][3]6,8,9,18,[20][21][22]24,34,42,[46][47][48][49][52][53][54]. The second presentation, which has been identified in a minority of cases (25/69) and hence defined as atypical, is characterized by erythematous macules and papules widely distributed over the trunk, neck, back, abdomen, and limbs without the involvement of the flexural folds (Figure 4) [4,5,19,21,30,[43][44][45]50,51,[55][56][57]. The second presentation, which has been identified in a minority of cases (25/69) and hence defined as atypical, is characterized by erythematous macules and papules widely distributed over the trunk, neck, back, abdomen, and limbs without the involvement of the flexural folds (Figure 4) [4,5,19,21,…”

“…The second presentation, which has been identified in a minority of cases (25/69) and hence defined as atypical, is characterized by erythematous macules and papules widely distributed over the trunk, neck, back, abdomen, and limbs without the involvement of the flexural folds (Figure 4) [4,5,19,21,30,[43][44][45]50,51,[55][56][57]. The second presentation, which has been identified in a minority of cases (25/69) and hence defined as atypical, is characterized by erythematous macules and papules widely distributed over the trunk, neck, back, abdomen, and limbs without the involvement of the flexural folds (Figure 4) [4,5,19,21,30,[43][44][45]50,51,[55][56][57].…”

Dermoscopy: A valuable tool in the diagnosis of flexural acantholytic dyskeratosis disorders

“…[ 4 ] Dowling Degos disease is another flexural disorder that can have an irregular star-shaped brown outline on a red-brown background on dermoscopy, and Galli Galli disease, which is its acantholytic variant has been reported to have central brown, mottled area surrounded by whitish halo, similar to that of afore mentioned conditions. [ 5 6 ] Thus, all these flexural disorders with acantholytic dyskeratosis have overlapping reproducible features on dermoscopy. This helps in differentiating these disorders from other flexural conditions like inverse psoriasis (regularly distributed dotted vessels in the absence of scales), eczema including atopic dermatitis (yellowish crusts and dotted vessels in patchy distribution in acute stage, white scales and clusters of red dots in chronic stage), Fox-Fordyce disease (hair follicle-centered papules, traumatized terminal hairs, and blackheads) and Langerhans cell histiocytosis (reddish-purple areas in a geographic pattern and brown dots).…”