Background:
Clinical diagnosis of vesiculobullous disorders (VBD) is not always straightforward. It is a challenge for a dermatologist to make the right diagnosis noninvasively in a short time.
Objective:
To evaluate dermoscopic patterns associated with vesiculobullous disorders.
Methods:
A total of 230 patients, irrespective of age and gender, with a history and clinical presentation suggestive of VBD (including primarily infectious, inflammatory, genetic, antibody-mediated, mechanical, environmental, metabolic, and drug-related) were recruited into the study. Patients with secondarily infected lesions were excluded. Dermoscopic examination along with Tzanck smear/skin biopsy smear test was performed on the most representative lesions. Data were compiled and statistically analyzed using SPSS version 21.0.
Results:
Lesions with erythematous (vascular) and yellowish (serum) translucent background with regular margins were seen in most of the VBD studied. Chickenpox (CP) and herpes zoster (HZ) lesions evolved with the progress of their clinical stages. Follicular and eccrine openings were commonly seen, but the pigmentation around them was specific to pemphigus vulgaris. A distorted pigment network was noted in bullous pemphigoid. White rosettes (keratin blockage) were characteristic of epidermolysis bullosa, Wickham striae (orthokeratosis) of lichen planus, and crumpled fabric appearance (flaccidity) of Hailey-Hailey disease. Globules/dots (microvesicles) of different colors were also seen in various VBD. Blue/black color usually corresponded to retained melanin.
Conclusion:
Some dermoscopic patterns are observed consistently with certain diseases, and these can be used for their diagnosis, complementary to histopathological examination.
Background:
Clinical diagnosis of vesiculobullous disorders (VBD) is not always straightforward. It is a challenge for a dermatologist to make the right diagnosis noninvasively in a short time.
Objective:
To evaluate dermoscopic patterns associated with vesiculobullous disorders.
Methods:
A total of 230 patients, irrespective of age and gender, with a history and clinical presentation suggestive of VBD (including primarily infectious, inflammatory, genetic, antibody-mediated, mechanical, environmental, metabolic, and drug-related) were recruited into the study. Patients with secondarily infected lesions were excluded. Dermoscopic examination along with Tzanck smear/skin biopsy smear test was performed on the most representative lesions. Data were compiled and statistically analyzed using SPSS version 21.0.
Results:
Lesions with erythematous (vascular) and yellowish (serum) translucent background with regular margins were seen in most of the VBD studied. Chickenpox (CP) and herpes zoster (HZ) lesions evolved with the progress of their clinical stages. Follicular and eccrine openings were commonly seen, but the pigmentation around them was specific to pemphigus vulgaris. A distorted pigment network was noted in bullous pemphigoid. White rosettes (keratin blockage) were characteristic of epidermolysis bullosa, Wickham striae (orthokeratosis) of lichen planus, and crumpled fabric appearance (flaccidity) of Hailey-Hailey disease. Globules/dots (microvesicles) of different colors were also seen in various VBD. Blue/black color usually corresponded to retained melanin.
Conclusion:
Some dermoscopic patterns are observed consistently with certain diseases, and these can be used for their diagnosis, complementary to histopathological examination.
“…Weißliche Bereiche sind oft durch rötlich-rosa Furchen getrennt, die wie ein „zerknittertes Gewebe“ aussehen. Es können auch polymorphe Gefäße und Schuppen zu sehen sein [ 5 , 14 , 23 ]. …”
Section: Erkrankungen Der Epidermalen Strukturenunclassified
“…Auch bei Ichthyosen sowie bei akantholytischen Genodermatosen (MD und MHH) kann die Dermatoskopie genutzt werden, um das Ansprechen auf die Therapie zu verfolgen, indem man das Hintergrunderythem, die Hyperkeratose und das Hervortreten der Interkeratinozytenräume sichtbar macht [ 5 , 7 , 8 , 14 , 19 , 23 , 25 , 29 ]. Da verschiedene neuartige Therapien für die Behandlung von Genodermatosen erforscht und eingeführt werden, darunter neue und neu ausgerichtete Medikamente, Proteinersatz, Chaperone, Zell- und Gentherapien und andere Ansätze, könnte der Einsatz der Dermatoskopie zur Therapieüberwachung in Zukunft eine ergänzende Anwendung darstellen [ 22 ].…”
ZusammenfassungGenodermatosen sind eine Gruppe erblicher Hautkrankheiten, deren Diagnose aufgrund ihrer Seltenheit sowie klinischen und genetischen Vielfalt eine Herausforderung darstellt. Die meisten Genodermatosen werden autosomal oder X‑chromosomal vererbt, auch Mosaikformen werden beobachtet. Genodermatosen umfassen verschiedene Phänotypen, die von einer begrenzten kutanen Erkrankung bis hin zu einer schweren kutanen und extrakutanen Beteiligung reichen. Sie können auch Zeichen multisystemischer Störungen sein. Trotz der jüngsten Fortschritte in der Gentechnologie und den bildgebenden Verfahren der Haut stellt die Dermatoskopie für das Screening, die Diagnostik und die therapeutische Nachsorge eine nützliche Untersuchungsmethode dar. Bei der ektopischen Mineralisierungsstörung Pseudoxanthoma elasticum und der lysosomalen Speicherkrankheit Morbus Fabry können die Symptome auf der Haut auf Beteiligungen innerer Organe hinweisen. Bei Keratinisierungskrankheiten wie Ichthyosen und akantholytischen Dyskeratosen wie Morbus Darier und Morbus Hailey-Hailey kann die Dermatoskopie helfen, die Wirksamkeit der Therapie zu zeigen, indem sie Hintergrunderythem, Hyperkeratose und den interkeratinozytären Raum sichtbar macht. Die Dermatoskopie ist eine nichtinvasive In-vivo-Untersuchung, die in der allgemeinen Dermatologie zunehmend an Bedeutung gewinnt und ein nützliches, leicht zugängliches Instrument zur Erkennung charakteristischer Merkmale von Genodermatosen sein kann.
Dermatoscopy is a relevant in vivo diagnostic tool for inflammatory diseases of the skin that aids not only in diagnosis, but also in monitoring the response to treatment. The inflammatory diseases show dermoscopic patterns involving the vessels, scales, follicles, background hue, and special clues. This review aims to provide an overview on the use of dermoscopy in inflammatory dermatoses based on the available literature and the deviation from it in the skin of color (SOC) as there is paucity of literature in dermoscopy of inflammatory disorders in SOC. The dermatoscopic patterns in most of the inflammatory diseases in SOC are similar to that of white skin, with pigmentary changes being the prominent dermoscopic findings while vascular patterns and erythema being less evident.
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