Dermatoscopic features of pigmentary diseases in ethnic skin

Vinay, Keshavamurthy; Ankad, Balachandra S

doi:10.4103/idoj.idoj_561_20

Cited by 19 publications

(16 citation statements)

References 29 publications

(21 reference statements)

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“…A white structureless area without a pigment network is called 'white glow,' indicating the total absence of melanin in the basal layer. This peculiar pattern is not found in PA, PLE, and even other hypopigmented or depigmented lesions, except idiopathic guttate hypomelanosis (14). Pigmentation in the form of residual or faint pigment network is noted either in evolving vitiligo lesions (12).…”

Section: Discussionmentioning

confidence: 86%

Facial Pityriasis Alba, Polymorphous Light Eruption, and Vitiligo in Children: A Dermoscopic Distinction

et al. 2022

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Background: Hypopigmentary skin disorders are the most worrisome complaints from Indian and Indian subcontinent people. Pityriasis alba (PA), polymorphic light eruption (PLE), and vitiligo are clinically look-alike conditions commonly seen in children. Objectives: We attempted to characterize the dermoscopic features of PA and PLE and differentiate them from vitiligo in the facial region in skin of color. Methods: Dermoscopic evaluation was done using a handheld dermoscope at 10X magnification on facial lesions of a total of 60 patients with PA, PLE, and vitiligo. Dermoscopic features of all three conditions were compared and correlated with histological features. Results: Out of 60 patients, 30 (50%), 20 (33.33%), and 10 (16.66%) patients were diagnosed with PA, PLE, and vitiligo clinically and histologically, respectively. Dermoscopy of PA showed white structureless areas (100%), ill-defined margins (86%), faint brownish pigmentation (70%), and fine scales (70%) (P value = 0.001). Besides, 70% of PLE cases showed white structureless areas and ill-defined margins, and 10% showed faint brownish pigmentation (P value = 0.0001). Coarse scales and clustered dots were the most common findings (75%) in PLE lesions, followed by light brown background (60%), crusts (40%), and yellow clods (30%) (P value = 0.0001). Also, 40% and 35% of the PLE cases showed white and brown course scales, respectively (P value = 0.0001). Moreover, 13.33% of PA cases showed coarse white scales, and 3.33% showed a light brown background. All vitiligo cases showed a white glow appearance (100%), followed by perifollicular pigmentation, leukotrichia, and koebnerization shown by 40% of the cases (P value = 0.0001). Finally, 20% of the cases showed perilesional pigmentation and satellite lesions. Conclusions: PA lesions are dermoscopically characterized by ill-defined white areas with fine branny scales, whereas PLE shows coarse brown scales, ring scales, crusts, and yellow clods along with the above findings. Vitiligo lesions are devoid of scales with various pigment network abnormalities, perilesional and perifollicular pigmentation, and leukotrichia.

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Section: Discussionmentioning

confidence: 86%

Facial Pityriasis Alba, Polymorphous Light Eruption, and Vitiligo in Children: A Dermoscopic Distinction

et al. 2022

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“…Cristae and sulci are better appreciated in nonpolarized mode, and pigmented dots and globules (specific clues for FAN) are better seen in polarized mode. [ 8 ] In histopathological correlation, linear crista cutis represents uplifted and pigmented epidermis by papillomatous projections of the dermis, while sulcus cutis represents equally pigmented surrounding epidermis. [ 9 ] The white color of sulci cutis is due to the basket weave stratum corneum filled in the valley of downwardly progressed epidermis.…”

Section: Discussionmentioning

confidence: 99%

Clinico-investigative study of facial acanthosis nigricans

Shah

Rambhia

Mukhi

et al. 2022

Indian Dermatol Online J

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Background: Facial acanthosis nigricans (FAN) is an underrecognized and underdiagnosed entity. The typical presentation of acanthosis nigricans (AN) seen elsewhere on the body like axillae and groins is not seen on the face, making it mimic other pigmentary disorders. Moreover, FAN is seldom not accompanied with AN on the classical sites making the diagnosis challenging. The aims of this study were to determine clinical, dermoscopic, and histopathological features of FAN and to estimate the prevalence of obesity and insulin resistance (IR) in FAN. Methods: Forty cases of FAN and forty healthy nonobese individuals with comparable ages and gender were included in the study. Body mass index, waist circumference, hip circumference, waist to hip ratio, and serum fasting lipid levels were used to evaluate obesity, whereas serum fasting insulin and Homeostatic Model of Assessment of Insulin Resistance (HOMA-IR) were used to evaluate IR. Dermoscopy was performed in all cases. Histopathological features of the skin biopsies were reviewed. Results: Out of the 40 cases, 24 were male and 16 were female. The patterns of facial pigmentation in addition to the classic pattern were a hyperpigmented band over forehead (55%), periorbital darkening (25%), perioral (10%), and generalized darkening (10%). Dermoscopy in all cases revealed linear crista cutis, sulcus cutis, and hyperpigmented dots in crista cutis. Biopsy of 20 cases showed mild hyperkeratosis, acanthosis, papillomatosis, and increase in basal melanin. Clinico-dermoscopic-histological correlation showed that milder (light brown) variants of FAN had follicular plugging and subtle sulci pattern with irregular brown globules and perifollicular pigmentation on dermoscopy and mild hyperkeratosis and hypermelanization of the basal layer with minimal acanthosis and papillomatosis on histopathology. On the other hand, chronic variants (dark brown and black) showed prominent sulci, larger brown globules, and perifollicular hyperpigmentation on dermoscopy and moderate hyperkeratosis and hypermelanization of the basal layer with moderate to severe acanthosis and papillomatosis on histopathology. Fasting blood glucose, insulin, HOMA-IR, fasting serum triglyceride, and total cholesterol were statistically significantly high in cases in comparison with controls ( P -value <0.05). Conclusions: Varied clinical presentations of FAN were observed. Dermoscopy and histopathology provide a good aid. FAN may be considered as a cutaneous marker of obesity and IR. Thus, FAN should be suspected in patients presenting with facial melanosis who are obese and have AN over other sites, although FAN can also present de novo.

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“…Frictional dermatoses of genitalia due to sexual practices Frictional trauma to nails 10 • Clear linear demarcation between light and dark skin • Seen along embryonic suture lines • Childhood/pubertal onset Dermoscopy: 75,76 • Clear borders of abrupt transition from light to dark • Contact dermatitis (cane reed)…”

Section: Increased Frictional Rubbingmentioning

confidence: 99%

Current understanding of frictional dermatoses: A review

Arora¹,

Khandpur

Bansal

et al. 2022

IJDVL

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Human skin is continually exposed to internal and external forces, dynamic as well as static. The skin is normally flexible and can resist mechanical trauma due to friction, pressure, vibration, suction and laceration to a considerable degree. However, an excess of these forces can abnormally affect the structure and function of the skin, setting the stage for the development of a skin disorder. Repetitive trauma can cause lichenification, hyperpigmentation, erythema, scaling, fissuring, blisters, ulceration and chronic alterations. Frictional dermatoses is an under-recognised entity with no clear-cut definition and encompasses a variety of terms such as frictional dermatitis, frictional melanosis, frictional pigmentary dermatoses and certain other named entities, many of which are confusing. The authors propose to define frictional dermatoses as ‘a group of disorders caused by repetitive trauma to the skin as a result of friction of varied aetiology which can have a wide range of cutaneous manifestations depending on the type of insult.’ The exact prevalence of frictional dermatoses as a separate entity is unknown. Authors who conducted this review include a group of dermatologists and post graduate students from various institutions. Literature was reviewed through PubMed, Medscape, Medline, ResearchGate and Google Scholar using the terms ‘frictional dermatitis,’ ‘friction and skin,’ ‘dermatoses and culture,’ ‘clothing dermatitis,’ ‘friction melanosis,’ ‘PPE induced dermatoses in COVID-19 era,’ etc. A total of 122 articles were reviewed and 100 articles among them were shortlisted and included in the study, after removing duplications. The review was followed up with further deliberation which resulted in the formulation of a new definition and classification of frictional dermatoses taking into account the morphology, histopathological characteristics, anatomical region affected and the major predisposing factors. The rising incidence of mechanical dermatoses in the COVID-19 era was also emphasised.

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Dermatoscopic features of pigmentary diseases in ethnic skin

Cited by 19 publications

References 29 publications

Facial Pityriasis Alba, Polymorphous Light Eruption, and Vitiligo in Children: A Dermoscopic Distinction

Facial Pityriasis Alba, Polymorphous Light Eruption, and Vitiligo in Children: A Dermoscopic Distinction

Clinico-investigative study of facial acanthosis nigricans

Current understanding of frictional dermatoses: A review

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