Dermoscopic features of clinically inflammatory dermatoses and their correlation with histopathologic reaction patterns

Abstract

Dermoscopy can be used in diagnosis of some chronic inflammatory dermatoses. In this study, the single most recent, fully developed lesion in 74 patients with clinically inflammatory dermatoses was examined dermoscopically and correlated histopathologically with psoriasiform, lichenoid, or spongiotic reaction patterns. Vascular component (morphology and arrangement) was the most prominent feature in the studied patterns mostly in the shape of dots (45 specimens, 60.8 %), globules (30 specimens, 40.5 %), and lines (45 specimens, 60.8 %). Psoriasiform pattern showed vascular dots (20 specimens, 76.92 %), and/or red globules (15 specimen, 57.69 %), regularly distributed (17 specimens, 65.38 %), on intense red background (15 specimens, 57.69 %), and diffuse (13 specimens, 50 %) white scales (18 specimen, 69.23 %), with probability of these features together 100 %. Lichenoid pattern showed red lines (23 cases, 65.71 %), on dull or light red background (14 cases, 40 % for each), with discolored areas (15 cases, 42.86 %), brown reticular pigmentation (21 cases, 60 %), and white scales (13 cases, 37.14 %). Spongiotic pattern was characterized by follicular component and diffuse or peripheral scale distribution, with probability of both features together 100 %. The main histopathologic features of inflammatory dermatoses, which influenced their dermoscopic patterns, are depth and size of vessels, presence and shape of epidermal hyperplasia, presence of spongiosis, and degree of dermal inflammation and oedema. These features influenced vascular morphology and distribution, corneal component, and background color. Among the studied reaction patterns, psoriasiform pattern showed the most consistent correlation with dermoscopic features. Dermoscopic picture of lichenoid reaction was the most contradictory. Spongiotic reaction showed absent specific vascular component.