Dermoscopy of Venous Stasis Dermatitis

Zaballos, Pedro; Salsench, Elisabeth; Puig, Susana; Malvehy, Josep

doi:10.1001/archderm.142.11.1526

Cited by 18 publications

(11 citation statements)

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“…In addition, dermoscopic examination of 3 cases of venous stasis dermatitis by Zaballos et al [28] revealed glomerular-like vessels and a scaly surface. However, it should be noted that ivory white scar-like areas and reticular pigmentation seen in livedoid vasculopathy lesions were not found in these 3 cases of chronic venous stasis.…”

Section: Discussionmentioning

confidence: 99%

“…[46–50] In addition, it has been found in chronic venous stasis. [28] The mechanisms responsible for the formation of glomerular vessels in chronic venous stasis and livedoid vasculopathy may be similar. Both these diseases are associated with chronic severe ischemia of the involved skin, which may promote angiogenesis and lead to an increased number of dermal blood vessels in the surrounding skin.…”

Section: Discussionmentioning

confidence: 99%

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Dermoscopic features of livedoid vasculopathy

Chen

Lin

et al. 2017

Medicine

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Livedoid vasculopathy (atrophie blanche) is a form of thrombotic vasculopathy. It is characterized by small ulcers that become crusted, and heal after several months to produce white atrophic scars. The most commonly affected sites are the lower legs, in particular the dorsum of the feet and ankles. To date, the dermoscopic features of livedoid vasculopathy have not been clearly described in the literature. In this observational study, we sought to evaluate the dermoscopic patterns of livedoid vasculopathy and determine whether the dermoscopic features are associated with certain histopathological characteristics. We evaluated 9 patients with livedoid vasculopathy by dermoscopy. Skin biopsy specimens were stained with hematoxylin and eosin for histopathologic examination, and dermoscopic features were correlated with histopathological characteristics. In the majority of patients with livedoid vasculopathy, examination with dermoscopy revealed central crusted ulcers or ivory white areas associated with peripheral pigmentation in a reticular pattern. In addition, increased vascular structures including linear and glomerular vessels were found. On histopathological examination, the central ivory white areas correlated with dermal fibrosis, the reticular pigmentation corresponded to epidermal basal layer hyperpigmentation or melanin within melanophages in the dermal papillae, and the vascular structures correlated with dilatation and proliferation of capillaries in the upper dermis. In summary, the most common dermoscopic features of livedoid vasculopathy identified in this study were central crusted ulcers or ivory white scar-like areas associated with peripheral reticular pigmentation and increased vascular structures. The characterization of dermoscopic criteria for livedoid vasculopathy may improve the accuracy in the clinical diagnosis and follow-up of this disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Dermoscopic features of livedoid vasculopathy

Chen

Lin

et al. 2017

Medicine

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Section: Skin Conditions That Can Occasionally Be Orangementioning

confidence: 99%

“…The term pigmented purpuric dermatosis (PPD) is used for a group of dermatoses that are clinically characterized by an eruption of pinpoint purpuric lesions with yellow, orange, red and/or brown, pigmented areas. 69,70 Haemorrhagic blisters in the setting of genital or extragenital lichen sclerosus have been described and it is known as bullous lichen sclerosus. 71 In bullous areas we have observed haemorrhagic and orange homogeneous areas (Fig.…”

Section: Inflammatorymentioning

confidence: 99%

Yellow and orange in cutaneous lesions: clinical and dermoscopic data

Bañuls

Arribas

Berbegal

et al. 2015

Acad Dermatol Venereol

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Colour of the lesions is clue for the clinical and dermoscopic diagnosis. Nevertheless, we have detected in the literature an uneven relevance of the colours as a diagnostic criterion. Thus, while red, brown and blue have taken important role in dermoscopic descriptions, other like yellow and orange have been given much less importance. This article reviews those lesions in which the yellow and orange colours have been considered constitutive or essential for diagnosis, and on the other hand it emphasizes the entities in which may appear these colours and are not well reflected in the literature. We believe that organize all this information will help us in a better understanding of these pathologies.

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“…The rainbow shown in the image was less convincing, involving some whitish areas and some variations of colour, but not really forming the different colours of the rainbow as shown in our previous paper. Again, the vascular network found in lesions of stasis dermatitis may explain the colour variations in the dermoscopic image 7 …”

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confidence: 96%

Dermoscopic rainbow pattern in non-Kaposi sarcoma lesions - reply

Cheng

et al. 2009

British Journal of Dermatology

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in the reported incidence of cutaneous malignant melanoma (CMM) without a proportional rise in melanoma mortality in most European countries. The paper suggests that the large increase is likely to be due to diagnostic drift which classifies benign lesions as stage 1 melanoma. 1,2 Histology is the gold standard for the diagnosis of CMM, but the assessment of small and thin melanocytic lesions, that constitute a growing proportion of lesions submitted for histology, is problematic, and interobserver agreement is moderate at best. 3,4 Histological indicators of malignancy have largely been derived from larger lesions, and it is unknown if they are equally applicable for small lesions. As the consequences of overdiagnosis are generally limited to a small local re-excision and increased patient stress, whereas underdiagnosis results in an increased chance of recurrence and death, judgement tends to be skewed towards malignancy. 2,4 In our clinic, members of melanoma families have been under surveillance since 1981. In many of these families, a mutation (p16-Leiden) in the high-penetrance melanoma susceptibility gene CDKN2A has been identified. 5 During surveillance of 37 families with a p16-Leiden mutation, melanomas have been diagnosed in 105 genetically tested relatives, 12 of whom (11%) were noncarriers. These 12 noncarriers had a total of 13 melanomas.As part of a study on the effect of surveillance (manuscript in preparation) the slides of 126 melanomas were reviewed. These consisted of all in situ melanomas (n = 63), and invasive melanomas with missing data or of a nonsuperficial spreading histological type (n = 52) that had been diagnosed in mutation carriers within these 37 families. All melanomas of the 12 noncarriers that were available for histological review (seven in situ and four invasive melanomas from 10 patients) were added to the set. Slides were revised by a pathologist who is a member of the Dutch melanoma panel (W.J.M.). Revisions were performed blinded for the patients' mutation status.After disclosure of the mutation status a disproportionately high proportion of (in situ) melanomas reclassified as benign melanocytic lesions turned out to be cases of noncarriers. Eight (seven in situ and one invasive) of the 11 melanomas of noncarriers were reclassified as benign (73%), compared with only 13 of the other 115 cases (11%). In seven of 10 mutation-negative relatives a history of melanoma was therefore not confirmed.These results touch on two important issues. Firstly, the value of genetic testing for CDKN2A mutations has been discredited because of a reported increased melanoma incidence among mutation-negative relatives. 6 Our data show that overdiagnosis may account for a significant proportion of this observation. Secondly, increased screening and surveillance of individuals with a low a priori melanoma risk may result in removal of increased numbers of small and histologically equivocal lesions, some of which will be overdiagnosed as cancers and (especially in the case of individuals wit...

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Dermoscopy of Venous Stasis Dermatitis

Cited by 18 publications

References 0 publications

Dermoscopic features of livedoid vasculopathy

Dermoscopic features of livedoid vasculopathy

Yellow and orange in cutaneous lesions: clinical and dermoscopic data

Dermoscopic rainbow pattern in non-Kaposi sarcoma lesions - reply

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