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Dermatology Practical & Conceptual Apr 2024
PubMed: 38810049
DOI: 10.5826/dpc.1402a122 -
Dermatology Practical & Conceptual Apr 2024Dermoscopy has evolved over the years beyond distinguishing benign pigmented lesions from melanoma to diagnosing virtually all diseases in dermatology. Overwhelming...
INTRODUCTION
Dermoscopy has evolved over the years beyond distinguishing benign pigmented lesions from melanoma to diagnosing virtually all diseases in dermatology. Overwhelming evidence demonstrates its utility in improving diagnostic accuracy, reducing unnecessary biopsies and lesion monitoring. Dermoscopy is widely used in Western nations, hence most descriptions of lesions in literature are predominantly on Fitzpatrick skin types I-III. Current evidence shows that there are unique dermoscopic features in the dark skin as a result of pigment and pathological reactions. Nationwide surveys and reports have been conducted across several continents to highlight prevalence and factors influencing dermoscopy use with the hope of maximizing its apparent benefits. There are currently no such reports from Africa.
OBJECTIVES
To evaluate dermoscopy use and its determinants among dermatologists in Africa.
METHODS
A cross-sectional study. Online forms were e-mailed to individual practicing dermatologists and members of the African Society of Dermatologists and Venereologists.
RESULTS
There were 196 respondents from 24 African countries. Half of them used dermoscopy. Training, practice settings and location, provision of dermatoscopes by institutions and knowledge of criteria were notable significant determinants. Multiple training exposures, knowledge of criteria, availability of dermatoscopes, use of both hand-held and videodermatoscopes, average number of patients seen per day, and a positive outlook towards dermoscopy were significant determinants of frequency of use. Leading impediments were lack of training and inadequate dermatoscopes in practice.
CONCLUSIONS
Dermoscopy use in Africa is relatively low. Incorporating dermoscopy training into the curriculum with provision of dermatoscopes by training institutions will promote wider usage.
PubMed: 38810048
DOI: 10.5826/dpc.1402a98 -
Dermatology Practical & Conceptual Apr 2024
PubMed: 38810040
DOI: 10.5826/dpc.1402a143 -
Dermatology Practical & Conceptual Apr 2024Studies focused on dermoscopic aspects of pigmented Bowen disease (pBD) in Latin American population are scarce and limited to only case reports or small series.
INTRODUCTION
Studies focused on dermoscopic aspects of pigmented Bowen disease (pBD) in Latin American population are scarce and limited to only case reports or small series.
OBJECTIVES
To report dermoscopic findings in a large series of 147 pBD diagnosed in Ibero-Latin American population.
METHODS
We conducted a multicentric, retrospective study on 147 histologically proven pBD under the auspices of the Dermoscopy Chapter of the Ibero-Latin American College of Dermatology.
RESULTS
The study population consisted of 77 females (52%) and 70 males (48%) with a mean age of 68.6 years. 70.1% of patients had skin phototype 3, 15.6% to skin phototype 2, and 14.3% to skin phototype 4. On clinical examination, near 60% of pBD were flat, 70% presented with scales, and 90% were asymmetric. Under dermoscopy, structureless hypopigmented areas, dots brown and pink color were the most frequently observed. Regarding specific dermoscopic clues to pBD, the most prevalent were structureless hypopigmented areas, vessels arranged in linear fashion at the periphery, and pigmented lines or pigmented dots distributed in a linear fashion. Clustered, coiled, and dotted vessels were observed in 55.8%, 45.6%, and 45.6% of the cases, respectively.
CONCLUSIONS
We report a large series of cases of pBD in Latin American patients, with most patients being skin phototype 3 and 4. Distinctively in our study, the pigmented structures and the clues derived from the presence of melanin were much more frequent than in previous reports in fair skin.
PubMed: 38810038
DOI: 10.5826/dpc.1402a86 -
Dermatology Practical & Conceptual Apr 2024Actinic Lichen Planus (ALP) is a rare photosensitive variant of lichen planus. Four subtypes can be distinguished: pigmented, annular (AALP), plaque-like and dyschromic...
INTRODUCTION
Actinic Lichen Planus (ALP) is a rare photosensitive variant of lichen planus. Four subtypes can be distinguished: pigmented, annular (AALP), plaque-like and dyschromic ALP.
METHODS
This is a retrospective; descriptive and analytical study investigating the dermoscopic patterns of different subtypes of ALP in skin of color.
RESULTS
Sixteen adult patients were included in this study; the majority of them were young females, while five patients with the pigmented subtype of ALP were more than 50 years old. This subtype was more prevalent in patients with phototype IV. AALP was described in men with a very dark phototype.In pigmented melasma-like ALP, dermoscopy showed an annular granular pattern, white reticular and circular Wickham striae (WS) with hypopigmentation lacking skin creases, dots inside circles and an eccentric pigmentation on circles. In ALP, annular, circular WS; and perifollicular white halos with follicular plugs were described. The black hole pattern with dotted vessels was seen in the dyschromic ALP. White-yellow-bluish WS were noticed in plaque-type ALP with circumferential radial lines at the periphery.
CONCLUSIONS
This descriptive study of dermoscopic patterns of various subtypes of ALP in skin of color highlighted new dermoscopic descriptions that vary according to the clinical variant or the morphology; lesions distribution; and phototype. Also, many epidemiological differences were found between our results and the literature concerning the older age of onset in melasma-like pigmented ALP, and the male predominance in annular ALP.
PubMed: 38810036
DOI: 10.5826/dpc.1402a101 -
Dermatology Practical & Conceptual Apr 2024Pilomatricoma is a benign adnexal dermal or subcutaneous tumor derived from immature hair matrix cells. (Review)
Review
INTRODUCTION
Pilomatricoma is a benign adnexal dermal or subcutaneous tumor derived from immature hair matrix cells.
OBJECTIVES
The aim of our study is to evaluate clinical and dermoscopic features of pilomatricomas, with a specific focus on pediatric lesions, and to provide a concise review of the existing literature.
METHODS
A single-center retrospective study was undertaken on 55 patients with a histopathological diagnosis of pilomatricoma referred to the Dermatology Unit, University of Bologna, Bologna, Italy, between 2005 and 2023. Pilomatricomas were retrospectively evaluated relying on clinical and dermoscopic images. A PubMed search was conducted. All the relevant research up to July 31, 2023, was reviewed. We classified the cases as "typical" or "atypical" based on whether they were suspected of being pilomatricomas or not.
RESULTS
A total of 55 children with pilomatricomas were observed and studied. Two patients presented with 2 pilomatricomas, leading to the identification of 58 pilomatricomas. 'Typical' pilomatricomas were observed in 79% of cases as nodular and pigmented lesions with one or more colors, ranging from blue-gray to red to yellow/white, evident on clinical examination and even better on dermoscopy. In 21% of cases, pilomatricomas presented in an 'atypical' form, which did not allow for a well-founded suspicion, placing them in differential diagnosis with other lesions and therefore requiring histological examination.
CONCLUSIONS
According to our case series and systematic review of the literature, clinical appearance and dermoscopy may be sufficient to diagnose or suspect pilomatricoma in around 80% of cases, while histological examination is necessary to confirm the diagnosis in the remaining 20% of cases.
PubMed: 38810027
DOI: 10.5826/dpc.1402a140 -
Dermatology Practical & Conceptual Apr 2024Rosettes 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... (Review)
Review
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).
CONCLUSIONS
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.
PubMed: 38810026
DOI: 10.5826/dpc.1402a125 -
Skin Research and Technology : Official... Jun 2024
Topics: Humans; Dermoscopy; Sporotrichosis; Microscopy, Electron, Scanning; Male; Sporothrix; Female
PubMed: 38809586
DOI: 10.1111/srt.13775 -
Advanced Biomedical Research 2024Basal cell carcinoma (BCC) manifests different dermoscopic patterns in individuals with dark skin complexion compared to those with fair skin types. This study aimed to...
BACKGROUND
Basal cell carcinoma (BCC) manifests different dermoscopic patterns in individuals with dark skin complexion compared to those with fair skin types. This study aimed to investigate the diagnostic utility of dermoscopy in discerning superficial BCC from other types of BCC, specifically in patients with dark skin complexion.
MATERIALS AND METHODS
This cross-sectional study focuses on patients diagnosed with BCC who were referred for skin biopsy between July 2020 and September 2022. Initially, the demographic characteristics of patients, clinical attributes of lesions, and pathological sub-types of BCC were documented. Subsequently, videodermoscopy was employed to capture comprehensive views and dermoscopic images of the lesions. Univariate logistic regression analysis was then utilized to assess the reliability of dermoscopic structures in distinguishing superficial BCC from other BCC types. Last, the study evaluated the sensitivity, specificity, positive predictive value, and negative predictive value of dermoscopy in the differentiation of superficial BCC from other BCC sub-types.
RESULTS
The study enrolled 49 patients diagnosed with BCC, with a mean age of 66.22 ± 10.41 years. The most prevalent pathological sub-type observed was nodular (53.1%). Dermoscopy exhibited a higher specificity compared to the naked eye in the differentiation of superficial BCC from other types (55% vs. 35%, respectively). Univariate analysis revealed a significant association between spoke-wheel structures and superficial BCC ( = 0.02, odds ratio = 7.2, 95% confidence interval = 1.35-38.32).
CONCLUSION
Dermoscopy exhibited superior specificity compared to the naked eye in differentiating superficial BCC from other BCC types. Notably, the spoke-wheel structure demonstrated the most robust correlation with superficial BCC.
PubMed: 38808321
DOI: 10.4103/abr.abr_315_23 -
Open Veterinary Journal Apr 2024Dermatophytosis is a contagious fungal infection that affects mainly cats. It poses significant challenges in veterinary medicine due to its zoonotic potential and...
BACKGROUND
Dermatophytosis is a contagious fungal infection that affects mainly cats. It poses significant challenges in veterinary medicine due to its zoonotic potential and impact on animal and public health. Rapid and reliable diagnosis is crucial for preventing the spread of the disease, guiding treatment decisions, and monitoring disease control efforts. Although there are several studies on diagnostic methods in feline dermatophytosis, the comparison between them from the same sample lacks data. The absence of a universally accepted gold standard diagnostic method highlights the need for a multifaceted approach to diagnosing feline dermatophytosis.
AIM
This study aims to assess the accuracy and efficacy of different diagnostic techniques comprehensively.
METHODS
For this, 48 samples of cats were analyzed by dermoscopy, direct hair examination, fungal culture using various media (Mycosel, Sabouraud, and Dermatophyte Test Medium), and polymerase chain reaction (PCR).
RESULTS
Direct examination and dermoscopy yielded unsatisfactory results. Mycosel and Sabouraud were suboptimal. DTM demonstrated superior selectivity, making it the most reliable among traditional methods. PCR was the top performer, exhibiting singular sensitivity, specificity, and accuracy.
CONCLUSION
The study suggests that PCR may be the preferred choice for diagnosing feline dermatophytosis in clinical practice, especially when rapid and accurate results are essential.
Topics: Cats; Animals; Cat Diseases; Tinea; Polymerase Chain Reaction; Sensitivity and Specificity; Dermoscopy; Dermatomycoses
PubMed: 38808284
DOI: 10.5455/OVJ.2024.v14.i4.14