Spectrum of Dermoscopic Patterns in Lichen Planus: A Case Series from China

Abstract

Background: Dermoscopy has been shown to be a promising method to faciiitate the diagnosis of lichen pianus (LP| outside of China.Objective: To investigate the spectrum of dermoscopic patterns in Chinese LP patients. Methods:The clinical data and dermoscopic patterns of nine LP cases with a total of 43 lesions were evaluated. Results: To the naked eye, 20.97% of the lesions exhibited graying Wickham striae (WS); however, 37.5% presented with white streaks of annular, reticular, or leaf venation patterns under dermoscopy. Blue-white veils were occasionally observed in the center. Pigment patterns varied from dots, globules, and peppered pigment to pigmented lines, which were unrelated to the pigment network of the skin. At the periphery of the WS, red fine lines ran parallel to the delicate white streaming lines.Conclusions: WS exhibits five morphological patterns (leaf venation, reticular, white dots, circular and radial streaming) and three color patterns (homogeneous crystalline white, blue-white veil and yellowish-white). The pigment patterns consisted of dots/ globules, peppered pigments and pigment, streaming lines.Contexte: La dermatoscopie s'est révélée, à l'extérieur de la Chine, un examen prometteur dans la pose du diagnostic de lichen plan (LP).Objectif: L'étude visait à examiner les différentes formes dermatoscopiques de LP, observées chez des patients chinois.Méthode: II y a eu évaluation de données cliniques ainsi que des différentes formes dermatoscopiques de LP, observées dans 9 cas, qui totalisaient 43 lésions.Résultats: Après examen, 20.97% des lésions présentaient, à l'oeil nu, des stries de Wickham grisâtres, tandis que 37.5% présentaient, à la dermatoscopie, des stries blanches de forme annulaire ou réticulaire ou encore des nervures en forme de feuille. Des voiles blanc bleuté ont parfois été observés au centre. La pigmentation prenait la forme de points, de globules, d'amas parsemés de points pigmentés, ou de filets pigmentés, toutes des formes non liées au réseau de pigmentation de la peau. À la périphérie des stries de Wickham, de petites lignes rouges couraient parallèlement aux fins filets blancs.Conclusions: Les stries de Wickham se présentaient sous cinq grandes formes (nervures en forme de feuille, points réticulaires ou blancs, filets circulaires ou radiaux) et en trois couleurs (blanc cristallin homogène, voile blanc bleuté, blanc jaunâtre). La pigmentation prenait la forme de points, de globules, d'amas parsemés de points pigmentés, ou de filets pigmentés. D ERMOSCOPY is a well-established diagnostic tool to improve the clinical recognition of a broad spectrum of skin disorders, including melanoma, basal cell carcinoma, and seborrheic keratosis. Lichen planus (LP) is an *The two authors contributed equally to the manuscript.

Dermoscopic features and types of orf and milker’s nodule

“…In a study by Zaballos et al , white streaks have been determined in 70% of 10 pilomatrixoma cases [ 10 ]. Similar structures have been observed in juvenile xanthogranuloma and lichen planus [ 11 , 12 ]. White streaks structures have been encountered in pictures of a study about Merkel cell carcinoma although it has not been indicated [ 13 ].…”

Dermoscopic patterns in active and regressive lichen planus and lichen planus variants: a morphological study

“…In our study, we detected nine additional WS patterns beyond the “classical reticular” pattern. Leaf venation, circular, and radial streaming patterns were previously defined by Tan et al [ 7 ]. In the current study, leaf venation WS pattern was not detected, but circular and radial streaming WS patterns were detected similar to the Tan et al study.…”

Dermoscopic findings in different clinical variants of lichen planus. Is dermoscopy useful?

“…Dermoscopy findings consist of polymorphic pearly whitish structures that correspond to WS with arboriform “fern leaf” projections. At the borders linear vessels (radial capillaries) and erythematous globules may be observed ( Figure 1 ), WS dermoscopic patterns [ 2 ] ( Table I ): Reticular (the most common) Circular Radial streaming Leaf venation: characterized by delicate secondary striae branching from the centered WS venation, linked together at either end, mimicking the crystal structure of snow Starry sky/white dots: clustered, follicular white dots …”