Dermoscopy of Type 1 Lepra Reaction in Skin of Color

Jha, Abhijeet Kumar; Zeeshan, Md.; Tiwary, Pankaj Kumar; Singh, Anupama; Roy, Prasoon Kumar; Chaudhary, R K P

doi:10.5826/dpc.1003a83

Cited by 10 publications

(17 citation statements)

References 8 publications

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“…Dermoscopy is an upcoming diagnostic modality that holds leverage over other imaging techniques in being rapid and noninvasive [18]. Although many disease-specific signs have been delineated by dermoscopy, studies regarding the use of this modality in leprosy are meager.…”

Section: Discussionmentioning

confidence: 99%

Dermoscopy in Leprosy: A Clinical and Histopathological Correlation Study

Mohta

Jain

Agrawal

et al. 2021

Dermatol Pract Concept

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Background: Leprosy, an insidious infectious granulomatous disease, is diagnosed traditionally through clinical examination coupled with skin smears and histopathology. It has myriad clinical presentations that pose diagnostic challenges. Lately, dermoscopy has emerged as a rapid, noninvasive diagnostic modality for many dermatoses. Objectives: We evaluated the dermoscopic findings of various manifestations of leprosy and correlated them with clinical and histopathological features. Methods: This prospective, cross-sectional study was conducted in our skin outpatient department for a period of 1 year. Patients newly diagnosed as having leprosy or those undergoing leprosy treatment for less than 6 months were included. The most representative lesion was dermoscopically evaluated and later biopsied. Results: We included 73 patients in the study. Results indicated an obvious correlation between dermoscopic findings and histopathology. We noted orangish yellow and white structureless areas, steadily throughout the spectrum, depicting dermal granuloma. Additionally, we observed focal vascular structures such as branching, linear, and crown vessels that result from the pressure of granuloma pushing the dilated vessels upwards. The relative absence of skin appendages aided in differentiating leprosy from other granulomatous disorders. Novel findings of our study were the detection of a branch-like pattern of clofazimine-induced pigmentation on dermoscopy and orange globules on onychoscopy. Other unique findings included violaceous structureless areas, characteristic large telangiectatic vessels, follicular plugging, star-shaped silvery-white scaling, and white globules in type 1 reaction; white shiny steaks were observed in patients with borderline lepromatous leprosy, and central white dots and keratotic plugs were observed in patients with histoid leprosy. Conclusions: Dermoscopy, as a noninvasive modality, could aid in the quick diagnosis of leprosy and should be used as a handy tool to complement other investigative tools for this disease.

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Section: Discussionmentioning

confidence: 99%

Dermoscopy in Leprosy: A Clinical and Histopathological Correlation Study

Mohta

Jain

Agrawal

et al. 2021

Dermatol Pract Concept

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“…These conditions may occur before, during, or even after regimen completion. 36 Also called reverse reaction, the type 1 leprosy reaction often affects dimorphic clinical forms and is the consequence of a cellular immune response associated with late hypersensitivity. 26 On dermoscopy, the lesions have a diffuse erythematous background, 27 , 29 , 36 associated with yellowish-orange 27 , 36 or reddish-orange areas.…”

Section: Bacterial Infectionsmentioning

confidence: 99%

“… 36 Also called reverse reaction, the type 1 leprosy reaction often affects dimorphic clinical forms and is the consequence of a cellular immune response associated with late hypersensitivity. 26 On dermoscopy, the lesions have a diffuse erythematous background, 27 , 29 , 36 associated with yellowish-orange 27 , 36 or reddish-orange areas. 36 Arboriform vessels, short linear fine vessels, and blurred linear vessels have also been observed.…”

Section: Bacterial Infectionsmentioning

confidence: 99%

Dermoscopy of skin infestations and infections (entomodermoscopy) – Part I: dermatozoonoses and bacterial infections

Bakos

Reinehr

Escobar

et al. 2021

Anais Brasileiros de Dermatologia

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Dermoscopy is an essential in vivo diagnostic technique in the clinical evaluation of skin tumors. Currently, the same can also be said about its implications when approaching different clinical situations in Dermatology. A growing number of reports on dermatological scenarios and diseases have been published, in which dermoscopy has been of great diagnostic help. The term “entomodermoscopy” was coined to describe dermoscopic findings in skin infestations and also in dermatoses of infectious etiology. In part I of this article, the main dermoscopic descriptions of zoodermatoses and bacterial infections will be addressed. In many of them, such as scabies, pediculosis, myiasis, and tungiasis, it is possible to identify the pathogen and, consequently, attain the diagnosis more quickly and use the technique to follow-up therapeutic effectiveness. In other situations that will be described, dermoscopy can allow the observation of clinical findings with greater detail, rule out differential diagnoses, and increase the level of confidence in a clinical suspicion.

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“…4 The dermoscopic features described for the type I reaction are yellowish-orange area, erythematous background and out-of-focus short linear vessels. 5 Other dermoscopic differentials are fixed drug eruption (grouped brown, gray to steel blue dots) and lichen planus pigmentosus (diffuse brown color, pseudopigment network, slate gray to blue dots and globules, hem-like pigment pattern and periadnexal brown to blue-gray pigment). 6,7 Figure 3b: Histology shows perivascular lymphohistiocytic infiltration and fine and coarse brown granular pigment within macrophages.…”

Section: Conflicts Of Interestmentioning

confidence: 99%