Entodermoscopia: dermatoscopia de epiluminescência para diagnose da pediculose

Abstract

Abstract:We report a clinical case in which contactless dermoscopy was used as an aid to the diagnosis of pediculosis and clinical evaluation of the effectiveness of treatment of this condition. Keywords: Dermoscopy; Lice infestations; Pruritus Resumo: Relata-se um caso clínico no qual a dermatoscopia de epiluminescência sem contato foi empregada como método auxiliar para o diagnóstico e a avaliação clínica da eficácia do tratamento da pediculose do couro cabeludo. ©2011 by Anais Brasileiros de Dermatologia IMAGES IN DERMATOLOGYA six-year-old infant was brought by his parents to our clinic, where he was seen for pruritus of the scalp of one month's duration. Physical examination with the aid of contactless dermoscopy (DE) revealed the presence of an empty nit case attached to a hair, which was removed so that it could be examined more closely ( Figure 1A). The parents were informed of the diagnosis and given advice on the appropriate treatment, namely, treatment with deltamethrin shampoo in two three-day treatment cycles separated by a one-week interval and manual removal of the nits.After one month the child returned to the clinic and presented with persistent pruritus of the scalp.Physical examination failed to reveal the presence of nits. However, using DE we were able to observe live lice (Pediculus humanus var. capitis) in the hair ( Figures 1B and 1C); more detailed pictures of the lice on a white surface are shown in Figures 1D and 1E.Although dermoscopy was initially developed for the diagnosis of pigmented lesions, 1 it has been used as an aid to diagnosis in squamous diseases, depigmenting diseases, pseudofolliculitis barbae, infections and infestations. 1 Dermoscopic patterns have already been described for viral warts, molluscum contagiosum and tinea nigra among other conditions. 1 The term "entodermoscopy" was coined to

Entodermatoscopia aplicada em um caso de pediculose do couro cabeludo/Entodermatoscopy applied in a case of pediculosis of the scalp

“…O tempo pode variar de acordo com comprimento do cabelo, durando em torno de 3 a 5 min 6 . Como as lêndeas se movem rapidamente, são muito pequenas e podem estar em baixo número, torna-se difícil detectalas, levando métodos tradicionais de diagnóstico ao insucesso, o que pode ser otimizado com o uso da dermatoscopia (DE) 5,7 .…”

“…A dermatoscopia é uma técnica não invasiva que permite observação in vivo e ampliada de detalhes e estruturas da pele não visíveis a olho nu 8 . Inicialmente, era empregada apenas no diagnóstico de lesões pigmentadas, porém vem sendo utilizada em desordens escamosas, despigmentações, "pseudofoliculite" da barba, infecções e infestações como uma modalidade de auxílio ao diagnóstico 7 .…”

Dermoscopy applied to pediculosis corporis diagnosis

“…2 Entodermoscopy or dermoscopy proved to be an useful auxiliary tool in the diagnosis and treatment follow-up of pediculosis, because it identifies Pediculus humanus corporis in detail on all sites infected by lice. 3 …”