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Background Leprosy is known to be a great mimicker. Its dermatoscopic evaluation may be of value in establishing diagnosis. Objective To study the dermatoscopic findings encountered across the leprosy spectrum. Methods This was a multi-centre cross-sectional study of leprosy patients, where after a thorough cutaneous and neurological evaluation, representative skin lesions from the study patients were photographed in standard settings, and the most representative skin lesions were chosen for dermatoscopic evaluation. Data was entered in a structured proforma and a descriptive analysis of dermatoscopic patterns was carried out. Results A total of 53 cases of ages between 14 and 80 years, ranging from tuberculoid to the lepromatous spectrum of disease, with active skin lesions in the form of patches and plaques were included. The spectrum of leprosy as per Ridley-Jopling classification at diagnosis was indeterminate in 1 (1.9%), tuberculoid in 1 (1.9%), borderline tuberculoid in 25 (21.5%), borderline lepromatous in 9 (17%), lepromatous in 14 (26.4%) and histoid in 3 (5.7%). Dermatoscopic features included distorted pigment network in 48 (90.6%), focal white areas in 40 (75.5%), reduced eccrine and follicular openings in 43 (81.1%), widened skin lines in 28 (52.8%), circle hairs in 15 (28.3%) and white shiny streaks in 17 (32.1%). Conclusion Dermatoscopy is a practical, non-invasive device to assess skin lesions of leprosy and provide cues to its diagnosis, spectral classification and differentiating it from other granulomatous disorders. However, dermatoscopy alone cannot reliably differentiate between the various types of leprosy and future large-scale studies are required. Limitations of the study The numbers for each subtype were variable and few in some spectrum of leprosy patients. A dermatoscopic-histologic correlation was not done.
Background Leprosy is known to be a great mimicker. Its dermatoscopic evaluation may be of value in establishing diagnosis. Objective To study the dermatoscopic findings encountered across the leprosy spectrum. Methods This was a multi-centre cross-sectional study of leprosy patients, where after a thorough cutaneous and neurological evaluation, representative skin lesions from the study patients were photographed in standard settings, and the most representative skin lesions were chosen for dermatoscopic evaluation. Data was entered in a structured proforma and a descriptive analysis of dermatoscopic patterns was carried out. Results A total of 53 cases of ages between 14 and 80 years, ranging from tuberculoid to the lepromatous spectrum of disease, with active skin lesions in the form of patches and plaques were included. The spectrum of leprosy as per Ridley-Jopling classification at diagnosis was indeterminate in 1 (1.9%), tuberculoid in 1 (1.9%), borderline tuberculoid in 25 (21.5%), borderline lepromatous in 9 (17%), lepromatous in 14 (26.4%) and histoid in 3 (5.7%). Dermatoscopic features included distorted pigment network in 48 (90.6%), focal white areas in 40 (75.5%), reduced eccrine and follicular openings in 43 (81.1%), widened skin lines in 28 (52.8%), circle hairs in 15 (28.3%) and white shiny streaks in 17 (32.1%). Conclusion Dermatoscopy is a practical, non-invasive device to assess skin lesions of leprosy and provide cues to its diagnosis, spectral classification and differentiating it from other granulomatous disorders. However, dermatoscopy alone cannot reliably differentiate between the various types of leprosy and future large-scale studies are required. Limitations of the study The numbers for each subtype were variable and few in some spectrum of leprosy patients. A dermatoscopic-histologic correlation was not done.
Introduction: Rosettes are a cluster of shiny white dots in the shape of a four-leaf clover seen under polarized dermoscopic light. Historically, rosettes were primarily reported in actinic keratoses and squamous cell carcinoma. However, rosettes have also been reported in other conditions. Objectives: The objective of this systematic review to elucidate the breadth of diagnoses exhibiting this unique dermoscopic phenomenon. Methods: A review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Literature searches were performed in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science, as well as a manual search of the reference lists of screened articles. Results: A total of 73 articles met the inclusion criteria. Out of these, 47 distinct diagnoses with rosette were identified. Among neoplastic conditions, keratinizing neoplasms had the highest number of articles reported (n=19). Discoid lupus was the most commonly reported diagnosis within the inflammatory category (n = 6). Molluscum contagiosum was the predominant diagnosis among infectious entities (n = 3), while acroangiodermatitis was the sole diagnosis reported in the vascular category (n = 1). Conclusion: These findings confirm rosettes are not specific to keratinocytic growths and are observed in a wide range of conditions. Knowledge of the breadth of conditions with rosettes may aid clinicians when developing a differential diagnosis of a growth or an eruption with rosettes under dermoscopy.
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