Study of the Dermoscopic Findings and Their Correlation with Histopathological Findings in Various Lichenoid Dermatoses

Abstract

Background: Lichenoid disorders are often difficult to diagnose clinically. Dermoscopy can act as an alternative technique to skin biopsy for diagnosis of various lichenoid dermatoses. Study aim: To study the correlation of dermoscopic with histopathological findings in various lichenoid dermatoses Methods: Fifty patients with clinical picture of lichenoid dermatoses were examined first under the dermoscope, followed by skin biopsy from the same site. The findings of both methods were recorded and correlated. Results: Nonvascular findings were the predominant features on dermoscopy out of which white structures were present in 93.33% of patients of classical lichen planus, 50% of actinic lichen planus, 90% of lichen planus hypertrophicus, 50% of lichen planopilaris and in only the case of lichen simplex chronicus. In classical lichen planus patients, a particular pattern of white structures with linear streaks arranged in a radial manner (starburst pattern) was observed. In lichen planus, it is suggested that the white structures on dermoscopy corresponded histologically to hyperkeratosis. Gray-blue dots or brown punctate areas represented melanophages in dermis. In lichen planus pigmentosus and ashy dermatosis patients, no specific patterns could be observed. In lichen planus hypertrophicus, white structures, corn pearls and comedolike openings appeared to represent hyperkeratosis and hypergranulosis, while pigmentation of variable colors could be due to presence of melanophages in the dermis. Conclusion: Dermoscopy can be a valuable tool for the dermatological diagnosis and may obviate need for skin biopsy.

Dermoscopic Features of Psoriasis, Lichen Planus, and Pityriasis Rosea in Patients with Skin Type IV and Darker Attending the Regional Dermatology Training Centre in Northern Tanzania

“…Follicular changes were some of the less observed findings, with comedo-like openings at 16.4% similar to the 20% reported by Garg et al [18]. Pigmentary changes were seen in 69.1% of lesions, and this could be related to more pigmentation in dark skin [9].…”

Clinicopathological Compatibility Rates with Regard to Skin Punch Biopsies

“…Biopsy is avoided for cosmetic reasons in certain cases such as pediatric patients and patients with lesions on facial regions (2). In fact, a biopsy is performed to diagnose, stage the disease, and evaluate the response of treatment (3).…”

Dermatoscopy of Inflammatory Diseases in Skin of Color

“…[ 13 ] In SOC, in all subtypes of LP, non-vascular findings are the predominant dermoscopic features which include white structures with linear streaks and gray-blue dots or brown punctate areas (melanophages in dermis). [ 17 ] The background color in classical LP is reddish in early lesions, whitish in active lesions, brown in resolving and diffuse brown background with fine or coarse gray-blue dots in resolved lesions. [ 18 ] The vessels are dotted, globular, or linearly arranged at the periphery of the lesion and less appreciable in dark skin.…”

“…[ 22 ] Dermoscopy also helps in assessing if post-inflammatory pigmentation persists for long, as presence of pigment granules indicates a long course [ Figure 2a - d ]. [ 17 ]…”