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Dermatology and Therapy Feb 2020An increased incidence of tinea capitis has been observed over the last few decades. Trichoscopy is a non-invasive, in-office method helpful in establishing the correct... (Review)
Review
INTRODUCTION
An increased incidence of tinea capitis has been observed over the last few decades. Trichoscopy is a non-invasive, in-office method helpful in establishing the correct diagnosis in patients with hair loss and inflammatory hair disorders. The objective was to review and analyze current data on the trichoscopy of tinea capitis.
METHODS
A systematic review of the literature was conducted using the PubMed, EBSCO and Scopus databases. The search terms included 'tinea capitis' combined with 'trichoscopy', 'dermatoscopy', 'dermoscopy', 'videodermatoscopy' or 'videodermoscopy'.
RESULTS
Of 326 articles, 37 were considered eligible for the quantitative analysis. The most characteristic (with a high predictive value) trichoscopic findings of tinea capitis included comma hairs (51%), corkscrew hairs (32%), Morse code-like hairs (22%), zigzag hairs (21%), bent hairs (27%), block hairs (10%) and i-hairs (10%). Other common, but not characteristic, trichoscopic features were broken hairs (57%), black dots (34%), perifollicular scaling (59%) and diffuse scaling (89%). Morse code-like hairs, zigzag hairs, bent hairs and diffuse scaling were only observed in Microsporum tinea capitis (8/29, 28%; 6/29, 21%; 4/29, 14% and 4/29, 14%, respectively). In Trichophyton tinea capitis, corkscrew hairs were more commonly detected compared to Microsporum tinea capitis (21/38, 55% vs 3/29, 10%).
CONCLUSION
The presence of characteristic trichoscopic features of tinea capitis is sufficient to establish the initial diagnosis and introduce treatment before culture results are available. Trichoscopy may be useful in distinguishing between Microsporum and Trichophyton tinea capitis.
PubMed: 31907867
DOI: 10.1007/s13555-019-00350-1 -
The Journal of Dermatology Jan 2022Trichoscopy represents a non-invasive diagnostic modality widely used in daily practice. Despite the common perception that this technique has been fairly established,... (Review)
Review
Trichoscopy represents a non-invasive diagnostic modality widely used in daily practice. Despite the common perception that this technique has been fairly established, some key issues remain to be addressed. Complexity and inconsistency in terminology in past literature are likely to confuse investigators when they are recording, reporting, and retrieving the findings. In addition, a diagnostic algorithm adopting sufficiently integrated and updated findings is not readily available. By adopting a systematic review approach, this review attempted to redefine major trichoscopic findings and integrate their synonyms individually into the most frequently used terms besides identifying and discussing terms which potentially cause confusion. The findings are categorized into five subgroups: hair shaft, follicular, perifollicular, scalp findings, and hair distribution pattern abnormalities. The calculation of sensitivities and positive predictive values of such redefined findings was conducted by reviewing the descriptions in the past literature on major hair diseases, including alopecia areata, androgenetic alopecia/female pattern hair loss, telogen effluvium, trichotillomania, lichen planopilaris, frontal fibrosing alopecia, central centrifugal cicatricial alopecia, discoid lupus erythematosus, folliculitis decalvans, tinea capitis, and dissecting cellulitis, to confirm the diagnostically meaningful findings for representative diseases. This attempt redefined, for instance, yellow dots, short vellus hairs, exclamation mark hairs, black dots, and broken hairs as the findings of diagnostic significance for alopecia areata and hair diameter diversity, peripilar sign, and focal atrichia for androgenetic alopecia/female pattern hair loss. An updated diagnostic flowchart is proposed with the instructions to maximize its usefulness. Current limitations and future perspectives of trichoscopy as well as other emerging non-invasive diagnostic modalities for hair diseases are also discussed.
Topics: Alopecia; Alopecia Areata; Dermoscopy; Female; Hair; Hair Diseases; Humans; Software Design
PubMed: 34806223
DOI: 10.1111/1346-8138.16233 -
Journal of the American Academy of... Sep 2021Multiple studies have reported on dermoscopic structures in basal cell carcinoma (BCC) and its subtypes, with varying results.
BACKGROUND
Multiple studies have reported on dermoscopic structures in basal cell carcinoma (BCC) and its subtypes, with varying results.
OBJECTIVE
To systematically review the prevalence of dermoscopic structures in BCC and its subtypes.
METHODS
Databases and reference lists were searched for relevant trials according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were assessed for the relative proportion of BCC dermoscopic features. Random-effects models were used to estimate summary effect sizes.
RESULTS
Included were 31 studies consisting of 5950 BCCs. The most common dermoscopic features seen in BCC were arborizing vessels (59%), shiny white structures (49%), and large blue-grey ovoid nests (34%). Arborizing vessels, ulceration, and blue-grey ovoid nests and globules were most common in nodular BCC; short-fine telangiectasia, multiple small erosions, and leaf-like, spoke wheel and concentric structures in superficial BCC; porcelain white areas and arborizing vessels in morpheaform BCC; and arborizing vessels and ulceration in infiltrative BCC.
LIMITATIONS
Studies had significant heterogeneity. Studies reporting BCC histopathologic subtypes did not provide clinical data on pigmentation of lesions.
CONCLUSION
In addition to arborizing vessels, shiny white structures are a common feature of BCC. A constellation of dermoscopic features may aid in differentiating between BCC histopathologic subtypes.
Topics: Carcinoma, Basal Cell; Dermoscopy; Humans; Pigmentation; Pigmentation Disorders; Skin Neoplasms
PubMed: 31706938
DOI: 10.1016/j.jaad.2019.11.008 -
International Journal of Dermatology Aug 2021Terra firma-forme dermatosis (TFFD) is an acquired pigmentation disorder that promptly regresses after applying isopropyl alcohol 70%. The clinical presentation ranges... (Review)
Review
Terra firma-forme dermatosis (TFFD) is an acquired pigmentation disorder that promptly regresses after applying isopropyl alcohol 70%. The clinical presentation ranges from patches of brownish discoloration to velvety hyperkeratotic plaques. Critical analyses of current data are lacking, so etiologies, pathogenesis, and disease associations are still debated in the literature. A literature search was done in the PubMed and Google Scholar databases to identify the published papers reporting clinical cases of TFFD. Of 102 papers screened, 64 met the including criteria. Overall, the records of 256 patients presenting a mean age of 18.34 years and a female:male ratio of 1:37 were reviewed. The present article aims to provide a key point-summary regarding the clinical outcome, associated comorbidities, pathogenesis, histopathology, dermoscopy, and therapeutic modalities of TFFD.
Topics: Adolescent; Databases, Factual; Female; Humans; Hyperpigmentation; Male
PubMed: 33280096
DOI: 10.1111/ijd.15301 -
Journal of Clinical Medicine Mar 2022Noninvasive imaging techniques have recently outlined precise microscopic features of acne elementary lesions and accurate quantifications for disease severity staging... (Review)
Review
Noninvasive imaging techniques have recently outlined precise microscopic features of acne elementary lesions and accurate quantifications for disease severity staging and therapeutical efficacy follow-up. The aim of this review is to systematically describe current applications of dermoscopy, reflectance confocal microscopy (RCM), and optical coherence tomography (OCT) in acne vulgaris assessment and management. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We included studies conducted on human subjects with elementary lesions of acne vulgaris, reporting assessment of the lesions with dermoscopy, RCM, and/or OCT. At present there are few large studies regarding acne and noninvasive imaging techniques, representing the main limitation of this review. Clinical examination represents the first line in acne diagnosis and treatment. However, dermoscopy, RCM, and OCT are further tools that can improve acne classification, monitoring of treatment, and pathophysiologic characterization. In the near future, dermoscopy, RCM, and OCT could become routinely used for the evaluation of acne vulgaris to provide a deeper knowledge of the disease and to guide the clinician in the prescription of tailored treatment protocols based on each patient's characteristics.
PubMed: 35407391
DOI: 10.3390/jcm11071783 -
Dermatology Practical & Conceptual Jan 2023Onychomycosis represents a global burden accounting for about 50% of nail consultations. Several studies have tried to assess the dermoscopic features of onychomycosis.... (Review)
Review
INTRODUCTION
Onychomycosis represents a global burden accounting for about 50% of nail consultations. Several studies have tried to assess the dermoscopic features of onychomycosis. With the multiplication of papers, several "new" dermoscopic signs keep being added leading to some inconsistency in onychoscopic terminology.
OBJECTIVE
This study aimed to summarize the existing literature on the dermoscopic features of onychomycosis and propose a unified onychoscopic terminology.
METHODS
The literature search was performed using PubMed and Scopus databases up to October 30, 2021 to identify eligible contributions. In total, 33 records (2111 patients) were included.
RESULTS
The main dermoscopic signs of onychomycosis are "ruin appearance", "longitudinal striae" and "spikes" on the proximal margin of onycholytic areas, with a specificity of 99.38%, 83.78%, and 85.64% respectively. The "aurora borealis" sign had the highest sensitivity and specificity.
CONCLUSIONS
The current review provides a framework for issues related to the onychoscopic terminology of onychomycosis and is intended to serve as an aid for students, teachers, and researchers. We proposed a unifying terminology to describe dermoscopic signs of onychomycosis. Dermoscopic signs of onychomycosis show good specificity and are useful in distinguishing nail psoriasis, trauma, and onychomycosis. It helps differentiate fungal melanonychia from nail melanoma, nevi, and melanocytic activation.
PubMed: 36892372
DOI: 10.5826/dpc.1301a72 -
Journal of the American Board of Family... Feb 2023This issue's teasers: A broad scope of care by family physicians could be incentivized and has positive outcomes. Family physicians could do more dermoscopy-a mixed...
This issue's teasers: A broad scope of care by family physicians could be incentivized and has positive outcomes. Family physicians could do more dermoscopy-a mixed specialty group of experts provide information on diagnosis with associated features and proficiency standards for primary care clinicians. Clinicians could trust more, and do less, such as adult measles-mumps-rubella boosters. Family physicians differ from pediatricians on how to deliver vitamin D to newborns. Practice scope varies by location. Is monetary incentive a key to incentivize COVID vaccination? A new, useful, easy functional status questionnaire. This issue also includes articles on both adult and pediatric obesity, a systematic review of social determinants of health and documentation thereof, plus more.
Topics: Infant, Newborn; Child; Adult; Humans; Rubella; Physicians, Family; Mumps; COVID-19; Measles; Vaccination; Measles-Mumps-Rubella Vaccine
PubMed: 36759131
DOI: 10.3122/jabfm.2022.220413R0 -
Journal of Clinical Medicine Mar 2024: The umbilicus is a fibrous remnant located in the centre of the abdomen. Various entities may be encountered in this special anatomical location; however, little is... (Review)
Review
: The umbilicus is a fibrous remnant located in the centre of the abdomen. Various entities may be encountered in this special anatomical location; however, little is known about their dermoscopic presentation. The aim of this study was to provide a comprehensive summary of existing evidence on dermoscopic features of umbilical lesions. : Studies assessing dermoscopic images of umbilical lesions were included in this study. No age, ethnicity or skin phototype restrictions were applied. Papers assessing lesions outside of the umbilical area, lacking dermoscopic images and/or dermoscopic description and not related to the topic were excluded. Embase, Medline and Cochrane Library were searched from inception to the end of May 2023. The Joanna Briggs Institute critical appraisal tools were used to evaluate the risk of bias of the selected studies. The quality and the level of evidence of included studies were assessed according to the Oxford 2011 Levels of Evidence. Thirty-four studies reporting a total of 39 lesions met the inclusion criteria and were included in qualitative analysis. : A qualitative synthesis of the following entities was performed: melanoma, nevi, basal cell carcinoma, fibroepithelioma of Pinkus, Sister Mary Joseph nodule, mycosis fungoides, dermatofibroma, endometriosis, epidermal cyst, granuloma, intravascular papillary endothelial hyperplasia, lichen planus, omphalolith, seborrheic keratosis, and syringoma. : Dermoscopy is a non-invasive technique that may be useful in the differential diagnosis of umbilical lesions. The main limitations of this study were lack of a high level of evidence in the studies and the lack of uniformity in applied dermoscopic terminology between included studies.
PubMed: 38542014
DOI: 10.3390/jcm13061790 -
Journal of the European Academy of... Jul 2021Dermoscopy and trichoscopy are non-invasive methods used as auxiliary tools in diagnostics of different dermatoses. To date, no systematic review concerning the utility... (Review)
Review
Dermoscopy and trichoscopy are non-invasive methods used as auxiliary tools in diagnostics of different dermatoses. To date, no systematic review concerning the utility of dermoscopy and trichoscopy in the diagnostics of primary cutaneous lymphomas has been published. The aim of this study was to summarize the current state of knowledge on this topic based on systematic search of PubMed database and related references published before 8th of August 2020. Besides dermoscopic features, type of dermoscope, polarization mode, magnification, number of cases and histopathological correlation were analysed. A total of 34 records were included into the final analysis, evaluating 141 patients diagnosed with primary cutaneous T-cell lymphomas and 70 patients with primary cutaneous B-cell lymphomas. Most of the analysed records evaluated dermoscopic features (n = 206); trichoscopy was analysed in only 5 cases. Structures most commonly observed in classical mycosis fungoides (n = 108) were fine short linear vessels/linear vessels, spermatozoa-like vessels and orange-yellow patchy areas. In folliculotropic mycosis fungoides (n = 12), most frequently observed were comedonal lesions/comedo openings/central keratotic plugs and white halo around hair follicles/perifollicular accentuation. Primary cutaneous marginal zone B-cell lymphoma (n = 42) and primary cutaneous follicle centre lymphoma (n = 20) most commonly presented with salmon-coloured background and fine short/linear irregular/serpentine vessels. For other PCL, with less than 10 cases reported in the analysed records, details have been provided in the article. Most observations analysed in this systematic review rely on findings from case reports/case series (with the level of evidence V) and lack a control group. A few studies provided information concerning technical aspects of dermoscopic/trichoscopic examination. The role of dermoscopy/trichoscopy in diagnostics of cutaneous lymphomas requires further studies, especially in entities where dermoscopic features have been described in only single or a few cases. However, it seems that this practical, accessory tool in future may provide additional clues during clinical assessment.
Topics: Dermoscopy; Humans; Lymphoma, B-Cell; Lymphoma, T-Cell, Cutaneous; Male; Mycosis Fungoides; Skin Neoplasms
PubMed: 33710688
DOI: 10.1111/jdv.17219 -
Journal of the European Academy of... Oct 2022Besides classic applications, dermoscopy has gained significant appreciation also for non-tumoral dermatoses (general dermatology). In this field, skin parasitoses... (Review)
Review
Besides classic applications, dermoscopy has gained significant appreciation also for non-tumoral dermatoses (general dermatology). In this field, skin parasitoses (infestations), bites and stings have been reported among the conditions that may benefit most from dermoscopic examination. However, published data on this topic are sparse and often lack a standardized analytical approach. In this systematic review of the literature, we sought to summarize available data on dermoscopy of cutaneous parasitoses, bites and stings, analysing dermoscopic features and used setting (polarization or not/magnification), pathological correlation and level of evidence of published studies as well as trying to align dermoscopic terminology of reported findings following a standardized methodology. A total of 150 publications addressing 29 different dermatoses and reporting 96 different dermoscopic findings were included in the analysis. Most of them displayed a level of evidence of V (113 single case reports and 36 case series), with only one study featuring a level of evidence of IV (case-control study). Additionally, our analysis also displayed poor uniformity in the terminology used in published articles (even for the same dermatosis). Therefore, albeit promising, dermoscopy of cutaneous parasitoses, bites and stings needs future systematized studies for a better characterization.
Topics: Bites and Stings; Case-Control Studies; Dermoscopy; Humans; Skin Diseases, Parasitic
PubMed: 35735046
DOI: 10.1111/jdv.18352