Advertisement

Dermoscopy for Inflammatory Diseases

  • Francesco Lacarrubba
  • Anna Elisa Verzì
  • Giuseppe Micali
Chapter
  • 16 Downloads

Abstract

Dermoscopy is a noninvasive technique that is useful for the diagnosis and treatment monitoring of several inflammatory cutaneous disorders. In this chapter, the dermoscopy features of the main diseases in which dermoscopy may aid in clinical practice are reported and discussed. The list includes Darier’s disease, discoid lupus erythematous, eczematous dermatitis, erythematous-telangiectatic rosacea, granulomatous diseases, lichen planus, lichen sclerosus, pigmented purpuric dermatoses, pityriasis lichenoides, pityriasis rosea, porokeratosis, psoriasis, urticaria pigmentosa, and Zoon’s mucositis. In their evaluation, different dermoscopic features should be considered, including background color, vascular pattern, color and distribution of scales, follicular structures, and other variable findings depending on the disorder. In some cases, the use of dermoscopy is diagnostic, in others it may help to narrow down the spectrum of possible diagnoses, thus reducing the need for biopsy.

Keywords

Darier’s disease Discoid lupus erythematous Eczema Rosacea Lichen Pigmented purpuric dermatoses Pityriasis Porokeratosis Psoriasis Urticaria pigmentosa Zoon’s mucositis 

References

  1. 1.
    Micali G, Lacarrubba F, Massimino D, Schwartz RA. Dermatoscopy: alternative uses in daily clinical practice. J Am Acad Dermatol. 2011;64(6):1135–46.PubMedGoogle Scholar
  2. 2.
    Lallas A, Zalaudek I, Argenziano G, Longo C, Moscarella E, Di Lernia V, et al. Dermoscopy in general dermatology. Dermatol Clin. 2013;31:679–94.PubMedGoogle Scholar
  3. 3.
    Lacarrubba F, Verzì AE, Dinotta F, Scavo S, Micali G. Dermatoscopy in inflammatory and infectious skin disorders. G Ital Dermatol Venereol. 2015;150(5):521–31.PubMedGoogle Scholar
  4. 4.
    Micali G, Verzì AE, Lacarrubba F. Alternative uses of dermoscopy in daily clinical practice: an update. J Am Acad Dermatol. 2018;79(6):1117–32.e1.PubMedGoogle Scholar
  5. 5.
    Lacarrubba F, D’Amico V, Nasca MR, Dinotta F, Micali G. Use of dermatoscopy and videodermatoscopy in therapeutic follow up: a review. Int J Dermatol. 2010;49:866–73.PubMedGoogle Scholar
  6. 6.
    Micali G, Lacarrubba F. Dermatoscopy: instrumental update. Dermatol Clin. 2018;36(4):345–8.PubMedGoogle Scholar
  7. 7.
    Lacarrubba F, Verzì AE, Errichetti E, Stinco G, Micali G. Darier’s disease: dermoscopy, confocal microscopy and histological correlations. J Am Acad Dermatol. 2015;73(3):e97–9.PubMedGoogle Scholar
  8. 8.
    Errichetti E, Stinco G, Lacarrubba F, Micali G. Dermoscopy of Darier’s disease. J Eur Acad Dermatol Venereol. 2016;30(8):1392–4.PubMedGoogle Scholar
  9. 9.
    Errichetti E, De Francesco V, Pegolo E, Stinco G. Dermoscopy of Grover’s disease: variability according to histological subtype. J Dermatol. 2016;43(8):937–9.PubMedGoogle Scholar
  10. 10.
    Lacarrubba F, Boscaglia S, Nasca MR, et al. Grover’s disease: dermoscopy, reflectance confocal microscopy and histopathological correlation. Dermatol Pract Concept. 2017;7(3):51–4.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Sadayasu A, Maumi Y, Hayashi Y, Dekio I, Ishizaki S, Fujibayashi M, Tanaka M. Dermoscopic features of a case of transient acantholytic dermatosis. Australas J Dermatol. 2017;58(1):50–2.PubMedGoogle Scholar
  12. 12.
    Giacomel J, Zalaudek I, Argenziano G. Dermatoscopy of Grover’s disease and solitary acantholytic dyskeratoma shows a brown, star-like pattern. Australas J Dermatol. 2012;53:315–6.PubMedGoogle Scholar
  13. 13.
    Lallas A, Apalla Z, Lefaki I, Sotiriou E, Lazaridou E, Ioannides D, et al. Dermoscopy of discoid lupus erythematosus. Br J Dermatol. 2013;168(2):284–8.PubMedGoogle Scholar
  14. 14.
    Inui S, Itami S, Murakami M, Nishimoto N. Dermoscopy of discoid lupus erythematosus: report of two cases. J Dermatol. 2014;41(8):756–7.PubMedGoogle Scholar
  15. 15.
    Lacarrubba F, Musumeci ML, Ferraro S, Stinco G, Verzì AE, Micali G. A three-cohort comparison with videodermatoscopic evidence of the distinct homogeneous bushy capillary microvascular pattern in psoriasis vs atopic dermatitis and contact dermatitis. J Eur Acad Dermatol Venereol. 2016;30(4):701–3.PubMedGoogle Scholar
  16. 16.
    Lallas A, Kyrgidis A, Tzellos TG, Apalla Z, Karakyriou E, Karatolias A, et al. Accuracy of dermoscopic criteria for the diagnosis of psoriasis, dermatitis, lichen planus and pityriasis rosea. Br J Dermatol. 2012;166:1198–205.PubMedGoogle Scholar
  17. 17.
    Errichetti E, Stinco G. Dermoscopy in differential diagnosis of palmar psoriasis and chronic hand eczema. J Dermatol. 2016;43(4):423–5.PubMedGoogle Scholar
  18. 18.
    Suh KS, Park JB, Yang MH, Choi SY, Hwangbo H, Jang MS. Diagnostic usefulness of dermoscopy in differentiating lichen aureus from nummular eczema. J Dermatol. 2017;44(5):533–7.PubMedGoogle Scholar
  19. 19.
    Lallas A, Argenziano G, Apalla Z, Gourhant JY, Zaballos P, Di Lernia V, Moscarella E, Longo C, Zalaudek I. Dermoscopic patterns of common facial inflammatory skin diseases. J Eur Acad Dermatol Venereol. 2014;28:609–14.PubMedGoogle Scholar
  20. 20.
    Lallas A, Argenziano G, Longo C, Moscarella E, Apalla Z, Koteli C, Zalaudek I. Polygonal vessels of rosacea are highlighted by dermoscopy. Int J Dermatol. 2014;53:e325–7.PubMedGoogle Scholar
  21. 21.
    Rosina P, Zamperetti MR, Giovannini A, Chieregato C, Girolomoni G. Videocapillaroscopic alterations in erythematotelangiectatic rosacea. J Am Acad Dermatol. 2006;54:100–4.PubMedGoogle Scholar
  22. 22.
    Micali G, Gerber PA, Lacarrubba F, Schäfer G. Improving treatment of erythematotelangiectatic rosacea with laser and/or topical therapy through enhanced discrimination of its clinical features. J Clin Aesthet Dermatol. 2016;9(7):30–9.PubMedPubMedCentralGoogle Scholar
  23. 23.
    Micali G, Dall’Oglio F, Verzì AE, Luppino I, Bhatt K, Lacarrubba F. Treatment of erythemato-telangiectatic rosacea with brimonidine alone or combined with vascular laser based on preliminary instrumental evaluation of the vascular component. Lasers Med Sci. 2018;33(6):1397–400.PubMedGoogle Scholar
  24. 24.
    Balestri R, La Placa M, Bardazzi F, Rech G. Dermoscopic subpatterns of granulomatous skin diseases. J Am Acad Dermatol. 2013;69(5):e217–8.PubMedGoogle Scholar
  25. 25.
    Bombonato C, Argenziano G, Lallas A, Moscarella E, Ragazzi M, Longo C. Orange color: a dermoscopic clue for the diagnosis of granulomatous skin diseases. J Am Acad Dermatol. 2015;72:S60–3.PubMedGoogle Scholar
  26. 26.
    Lallas A, Zaballos P, Zalaudek I, Apalla Z, Gourhant JY, Longo C, et al. Dermoscopic patterns of granuloma annulare and necrobiosis lipoidica. Clin Exp Dermatol. 2013;38(4):425–7.PubMedGoogle Scholar
  27. 27.
    Pellicano R, Caldarola G, Filabozzi P, Zalaudek I. Dermoscopy of necrobiosis lipoidica and granuloma annulare. Dermatology. 2013;226(4):319–23.PubMedGoogle Scholar
  28. 28.
    Ramadan S, Hossam D, Saleh MA. Dermoscopy could be useful in differentiating sarcoidosis from necrobiotic granulomas even after treatment with systemic steroids. Dermatol Pract Concept. 2016;6(3):17–22.PubMedPubMedCentralGoogle Scholar
  29. 29.
    Vázquez-López F, Manjón-Haces JA, Maldonado-Seral C, Raya-Aguado C, Pérez-Oliva N, Marghoob AA. Dermoscopic features of plaque psoriasis and lichen planus: new observations. Dermatology. 2003;207:151–6.PubMedGoogle Scholar
  30. 30.
    Zalaudek I, Argenziano G. Dermoscopy subpatterns of inflammatory skin disorders. Arch Dermatol. 2006;142:808.PubMedGoogle Scholar
  31. 31.
    Vázquez-López F, Maldonado-Seral C, López-Escobar M, Pérez-Oliva N. Dermoscopy of pigmented lichen planus lesions. Clin Exp Dermatol. 2003;28:554–64.PubMedGoogle Scholar
  32. 32.
    Lacarrubba F, Dinotta F, Nasca MR, Fabbrocini G, Micali G. Localized vascular lesions of the glans in patients with lichen sclerosus diagnosed by dermatoscopy. G Ital Dermatol Venereol. 2012;147:510–1.PubMedGoogle Scholar
  33. 33.
    Shim WH, Jwa SW, Song M, Kim HS, Ko HC, Kim MB, Kim BS. Diagnostic usefulness of dermatoscopy in differentiating lichen sclerous et atrophicus from morphea. J Am Acad Dermatol. 2012;66:690–1.PubMedGoogle Scholar
  34. 34.
    Larre Borges A, Tiodorovic-Zivkovic D, Lallas A, Moscarella E, Gurgitano S, et al. Clinical, dermoscopic and histopathologic features of genital and extragenital lichen sclerosus. J Eur Acad Dermatol Venereol. 2013;27:1433–9.PubMedGoogle Scholar
  35. 35.
    Borghi A, Corazza M, Minghetti S, Bianchini E, Virgili A. Dermoscopic features of vulvar lichen sclerosus in the setting of a prospective cohort of patients: new observations. Dermatology. 2016;232(1):71–7.PubMedGoogle Scholar
  36. 36.
    Lacarrubba F, Verzì AE, Ardigò M, Micali G. Handheld reflectance confocal microscopy, dermatoscopy and histopathological correlation of common inflammatory balanitis. Skin Res Technol. 2018;24(3):499–503.PubMedGoogle Scholar
  37. 37.
    Garrido-Ríos AA, Alvarez-Garrido H, Sanz-Muñoz C, Aragoneses-Fraile H, Manchado-López P, Miranda-Romero A. Dermoscopy of extragenital lichen sclerosus. Arch Dermatol. 2009;145:1468.PubMedGoogle Scholar
  38. 38.
    Horcajada-Reales C, Campos-Domínguez M, Conde-Montero E, Parra-Blanco V, Suárez-Fernández R. Comedo-like openings in dermoscopy: an essential diagnostic clue for lichen sclerosus, even in children. J Am Acad Dermatol. 2015;72:S4–5.PubMedGoogle Scholar
  39. 39.
    Lacarrubba F, Pellacani G, Verzì AE, Pippione M, Micali G. Extragenital lichen sclerosus: clinical, dermoscopic, confocal microscopy and histologic correlations. J Am Acad Dermatol. 2015;72:S50–2.PubMedGoogle Scholar
  40. 40.
    Lacarrubba F, Ardigò M, Di Stefani A, Verzì AE, Micali G. Dermatoscopy and reflectance confocal microscopy correlations in nonmelanocytic disorders. Dermatol Clin. 2018;36(4):487–501.PubMedGoogle Scholar
  41. 41.
    Zaballos P, Puig S, Malvehy J. Dermoscopy of pigmented purpuric dermatoses (lichen aureus): a useful tool for clinical diagnosis. Arch Dermatol. 2004;140:1290–1.PubMedGoogle Scholar
  42. 42.
    Vázquez-López F, Fueyo A, Sánchez-Martín J, Pérez-Oliva N. Dermoscopy for the screening of common urticaria and urticaria vasculitis. Arch Dermatol. 2008;144:568.PubMedGoogle Scholar
  43. 43.
    Errichetti E, Lacarrubba F, Micali G, Piccirillo A, Stinco G. Differentiation of pityriasis lichenoides chronica from guttate psoriasis by dermoscopy. Clin Exp Dermatol. 2015;40(7):804–6.PubMedGoogle Scholar
  44. 44.
    Lacarrubba F, Micali G. Dermoscopy of pityriasis lichenoides et varioliformis acuta. Arch Dermatol. 2010;146:1322.PubMedGoogle Scholar
  45. 45.
    Thomas M, Yadav T, Khopkar U. The role of dermoscopy using a triple light source in the diagnosis of pityriasis rosea: an observational pilot study. Int J Dermatol. 2017;56(7):e147–8.PubMedGoogle Scholar
  46. 46.
    Delfino M, Argenziano G, Nino M. Dermoscopy for the diagnosis of porokeratosis. J Eur Acad Dermatol Venereol. 2004;18:194–5.PubMedGoogle Scholar
  47. 47.
    Panasiti V, Rossi M, Curzio M, Bruni F, Calvieri S. Disseminated superficial actinic porokeratosis diagnosed by dermoscopy. Int J Dermatol. 2008;47:308–10.PubMedGoogle Scholar
  48. 48.
    Zaballos P, Puig S, Malvehy J. Dermoscopy of disseminated superficial actinic porokeratosis. Arch Dermatol. 2004;140:1410.PubMedGoogle Scholar
  49. 49.
    Jha AK, Sonthalia S, Lallas A. Dermoscopy of porokeratosis of mibelli. Indian Dermatol Online J. 2017;8(4):304–5.PubMedPubMedCentralGoogle Scholar
  50. 50.
    Kim GW, Jung HJ, Ko HC, Kim MB, Lee WJ, Lee SJ, Kim DW, Kim BS. Dermoscopy can be useful in differentiating scalp psoriasis from seborrhoeic dermatitis. Br J Dermatol. 2011;164:652–6.PubMedGoogle Scholar
  51. 51.
    Micali G, Lacarrubba F, Musumeci ML, Massimino D, Nasca MR. Cutaneous vascular patterns in psoriasis. Int J Dermatol. 2010;49:249–56.PubMedGoogle Scholar
  52. 52.
    Lacarrubba F, Pellacani G, Gurgone S, Verzì AE, Micali G. Advances in non-invasive techniques as aids to the diagnosis and monitoring of therapeutic response in plaque psoriasis: a review. Int J Dermatol. 2015;54:626–34.PubMedGoogle Scholar
  53. 53.
    Micali G, Nardone B, Scuderi A, Lacarrubba F. Videodermatoscopy enhances the diagnostic capability of palmar and/or plantar psoriasis. Am J Clin Dermatol. 2008;9:119–22.PubMedGoogle Scholar
  54. 54.
    Lacarrubba F, Nasca MR, Micali G. Videodermatoscopy enhances diagnostic capability in psoriatic balanitis. J Am Acad Dermatol. 2009;61:1084–6.PubMedGoogle Scholar
  55. 55.
    Musumeci ML, Lacarrubba F, Catalfo P, Scilletta B, Micali G. Videodermatoscopy evaluation of the distinct vascular pattern of psoriasis improves diagnostic capability for inverse psoriasis. G Ital Dermatol Venereol. 2017;152(1):88–90.PubMedGoogle Scholar
  56. 56.
    Rosina P, Zamperetti MR, Giovannini A, Girolomoni G. Videocapillaroscopy in the differential diagnosis between psoriasis and seborrheic dermatitis of the scalp. Dermatology. 2007;214:21–4.PubMedGoogle Scholar
  57. 57.
    Rosina P, Giovannini A, Gisondi P, Girolomoni G. Microcirculatory modifications of psoriatic lesions during topical therapy. Skin Res Technol. 2009;15:135–8.PubMedGoogle Scholar
  58. 58.
    Stinco G, Lautieri S, Piccirillo F, Valent F, Patrone P. Response of cutaneous microcirculation to treatment with mometasone furoate in patients with psoriasis. Clin Exp Dermatol. 2009;34:915–9.PubMedGoogle Scholar
  59. 59.
    Musumeci ML, Lacarrubba F, Fusto CM, Micali G. Combined clinical, capillaroscopic and ultrasound evaluation during treatment of plaque psoriasis with oral cyclosporine. Int J Immunopathol Pharmacol. 2013;26:1027–33.PubMedGoogle Scholar
  60. 60.
    Stinco G, Buligan C, Maione V, Valent F, Patrone P. Videocapillaroscopic findings in the microcirculation of the psoriatic plaque during etanercept therapy. Clin Exp Dermatol. 2013;38:633–7.PubMedGoogle Scholar
  61. 61.
    Micali G, Lacarrubba F, Santagati C, Egan CG, Nasca MR, Musumeci ML. Clinical, ultrasound, and videodermatoscopy monitoring of psoriatic patients following biological treatment. Skin Res Technol. 2016;22(3):341–8.PubMedGoogle Scholar
  62. 62.
    Akay BN, Kittler H, Sanli H, Harmankaya K, Anadolu R. Dermatoscopic findings of cutaneous mastocytosis. Dermatology. 2009;218:226–30.PubMedGoogle Scholar
  63. 63.
    Vano-Galvan S, Alvarez-Twose I, De las Heras E, Morgado JM, Matito A, Sánchez-Muñoz L, et al. Dermoscopic features of skin lesions in patients with mastocytosis. Arch Dermatol. 2011;147:932–40.PubMedGoogle Scholar
  64. 64.
    Miller MD, Nery NS, Gripp AC, Maceira JP, Nascimento GM. Dermatoscopic findings of urticaria pigmentosa. An Bras Dermatol. 2013;88(6):986–8.PubMedPubMedCentralGoogle Scholar
  65. 65.
    Micali G, Verzì AE, Quattrocchi E, Ng CY, Lacarrubba F. Dermatoscopy of common lesions in pediatric dermatology. Dermatol Clin. 2018;36(4):463–72.PubMedGoogle Scholar
  66. 66.
    Corazza M, Virgili A, Minghetti S, Toni G, Borghi A. Dermoscopy in plasma cell balanitis: its usefulness in diagnosis and follow-up. J Eur Acad Dermatol Venereol. 2016;30(1):182–4.PubMedGoogle Scholar
  67. 67.
    Errichetti E, Lacarrubba F, Micali G, Stinco G. Dermoscopy of Zoon’s plasma cell balanitis. J Eur Acad Dermatol Venereol. 2016;30(12):e209–10.PubMedGoogle Scholar
  68. 68.
    Corazza M, Toni G, Virgili A, Borghi A. Plasma cell vulvitis: further confirmation of the diagnostic utility of dermoscopy. Int J Dermatol. 2018;57(12):e164–5.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Francesco Lacarrubba
    • 1
  • Anna Elisa Verzì
    • 1
  • Giuseppe Micali
    • 1
  1. 1.Dermatology ClinicUniversity of CataniaCataniaItaly

Personalised recommendations