The dermoscopic findings of common papulo-squamous skin diseases: A descriptive comparative study

Dermoscopy for papulosquamous diseases

Abstract

Objective To describe and compare the dermoscopic features of various papulosquamous skin disorders.   Methods This study is an observational, descriptive-comparative study performed on 169 patients with papulosquamous skin diseases including psoriasis, lichen planus, eczema, pityriasis rosea and pityriasis lichenoides chronica at the outpatient clinic at the dermatology department of AL-Sader teaching hospital in Basra during the period between April 2021 to September 2022. A detailed history was taken from each patient with a complete physical examination and all relevant investigations were done. The dermoscopic examination was done using a hand-held dermoscope (x10) and photos were taken with a mobile phone camera attached to the Dermlight DL200 dermoscope then this data was collected and statistically analyzed.   Results Dermoscopic examination of psoriasis showed that light red background, regularly dotted vessels and diffuse white scales were the most common findings. The most characteristic dermoscopic features of lichen planus was Wickham striae which was seen as radial streaming followed by a reticular pattern, the lesion was purple in color, non-scaly and non-vascular lesions, the scales if present were mainly peripheral white scales, while the vascular lesions of lichen planus were usually dotted peripheral blood vessels. Patchy dotted blood vessels on a dull red background covered by yellow-white scales in patchy distribution were the common findings seen in eczema. According to a study of patients with pityriasis rosea, the most significant dermoscopic features observed in patients were yellow background color, peripheral white scales, and an avascular pattern. Pityriasis lichenoides chronica was found to be associated with peripheral dotted vessels on orange- yellow background covered by white scales on a peripheral or diffuse pattern.   Conclusion Dermoscopy is a simple non-invasive safe bedside tool that provides important information to help in diagnosis or narrowing differential diagnosis of many papulosquamous skin diseases.