Dermoscopy in general Dermatology
This chapter describes the dermoscopy criteria for many conditions in general dermatology
It has the following subchapters:
Dermoscopy, also known as dermatoscopy or epiluminescence microscopy, is a non-invasive diagnostic tool used in dermatology to examine skin lesions in greater detail. While it is commonly associated with the diagnosis of pigmented skin lesions, dermoscopy has also proven to be a valuable technique in the evaluation of inflammatory skin disorders and infections. This article will explore the clinical applications of dermoscopy in these specific dermatological areas.
Inflammatory skin disorders
Inflammatory skin disorders encompass a wide range of conditions, including psoriasis, eczema (atopic dermatitis), lichen planus, pityriasis rosea, and many others. Dermoscopy plays a crucial role in differentiating between these disorders, guiding treatment decisions, and assessing disease activity. Some key applications of dermoscopy in inflammatory skin disorders include:
Psoriasis: Dermoscopy in psoriasis reveals characteristic features like "dotted" or "regular vascular" patterns and "white scales," which help distinguish it from other inflammatory conditions and guide targeted therapies.
Eczema (Atopic Dermatitis): Dermoscopy aids in identifying fine superficial scaling and dotted vessels in eczematous lesions, assisting in differentiating it from psoriasis and other similar-looking conditions.
Lichen Planus: The characteristic "Wickham striae" (fine white lines and dots) seen on dermoscopy help in diagnosing lichen planus and distinguishing it from other papulosquamous disorders.
Pityriasis Rosea: Dermoscopy can reveal "collarette scales" and "crown vessels" on the periphery of pityriasis rosea patches, aiding in diagnosis.
Seborrheic Dermatitis: Dermoscopy can demonstrate "yellowish scales" and "comma vessels," which are typical findings in seborrheic dermatitis.
Dermoscopy not only aids in differentiating between various inflammatory skin disorders but also allows for monitoring treatment response and assessing disease progression.
Dermoscopy in Infections
Dermoscopy is an invaluable tool in diagnosing and managing various infectious skin conditions caused by bacteria, fungi, viruses, and parasites. Some notable applications include:
Fungal Infections: Dermoscopy assists in diagnosing superficial fungal infections, such as tinea corporis (ringworm), tinea capitis (scalp ringworm), and tinea pedis (athlete's foot). Characteristic findings include "corkscrew hairs," "comma hairs," and "zigzag-shaped vessels."
Viral Infections: In viral skin infections like herpes zoster (shingles), dermoscopy can reveal "clustered vessels" and "white scales" within the vesicular lesions.
Parasitic Infections: Dermoscopy can aid in the diagnosis of scabies, showing "burrows" as linear structures and "scattered dark dots" representing mites or their feces.
Bacterial Infections: In bacterial skin infections like cellulitis, dermoscopy can reveal "corkscrew vessels" and "white scales" in the affected areas.
Viral Warts: Dermoscopy helps differentiate common warts from other skin lesions and assesses the treatment response, showing "hairpin vessels," "black dots," and "mosaic pattern."
By providing rapid and accurate diagnosis, dermoscopy allows for timely initiation of appropriate treatments, reducing the risk of complications and improving patient outcomes.
Dermoscopy is a valuable and versatile tool in dermatology, extending beyond the diagnosis of pigmented skin lesions. In the context of inflammatory skin disorders and infections, dermoscopy plays a vital role in accurate diagnosis, differentiation between various conditions, and monitoring treatment response. Its non-invasive nature, combined with its ability to provide additional information beyond naked-eye examination, makes dermoscopy an essential technique in the management of inflammatory skin disorders and infectious skin conditions. As technology continues to advance and dermatologists gain more experience, the applications of dermoscopy in these areas are expected to expand, further enhancing patient care and outcomes.
