Perifollicular and interfollicular skin surface

From dermoscopedia

Main PageTrichoscopyTrichoscopic structures and patternsPerifollicular and interfollicular skin surface
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 Editor: Anna Waskiel Burnat

 Author(s): Anna Waskiel Burnat     ·  Lidia Rudnicka
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Description This chapter describes the perifollicular and interfollicular criteriameasure of how well one variable or set of variables predicts an outcome as seen in trichoscopyThis glossary term has not yet been described. (dermoscopyThe examination of [skin lesions] with a 'dermatoscope'. This traditionally consists of a magnifier (typically x10), a non-polarised light source, a transparent plate and a liquid medium between the instrument and the skin, and allows inspection of skin lesions unobstructed by skin surface reflections. Modern dermatoscopes dispense with the use of liquid medium and instead use polarised light to cancel out skin surface reflections. of hair and scalpThis glossary term has not yet been described.)
Author(s) Anna Waskiel Burnat · Lidia Rudnicka
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Status update January 21, 2019
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In trichoscopy, following perifollicular and interfollicular skin surface abnormalities may be observed: scaling, discoloration, discharge and surface structure.

Scaling

Epidermal scaling can be divided into perifollicular and diffuse [13].

Mild diffuse scaling may be observed in healthy persons with dry skinThis glossary term has not yet been described.. White moderate to severe diffuse scaling is detected in psoriasisThis glossary term has not yet been described., discoid lupus erythematosusis a chronic skin condition of sores with inflammation and scarring favouring the face, ears, and scalp and at times on other body areas. These lesions develop as a red, inflamed patch with a scaling and crusty appearance. The centre areas may appear lighter in colour with a rim darker than the normal skin. and contact dermatitisalso known as eczema is a group of diseases that results in inflammation of the skin.. Yellowish moderate to severe diffuse scaling is presented in seborrheic dermatitisThis glossary term has not yet been described., discoid lupus erythematosus and ichthyosis [13].

White perifillicular, tubular scaling is characteristic for lichen planopilarisThis glossary term has not yet been described.. In folliculitis decalvans, yellowish, tubular with collar formation is observed [13]. It needs to be emphasized, that diffuse “scaling” with formation of white perifollicular clusters may be present in monoclonal gammopathy [13].



Discoloration

Brown areas in trichoscopy may occur in three different patternsThis glossary term has not yet been described..
Honeycomb pattern comprises a homogenous, mosaic or contiguous brown rings. It may be observed in chronically sun-exposed areas of thinning or complete hair loss and the scalp of dark-skinned patients [17]. Perifollicular brown coloration results from perifollicular lymphocytic infiltration [14] and is commonly detected in androgenetic alopeciaThis glossary term has not yet been described., telogen effluviumThis glossary term has not yet been described.. It may be presented in up to 10% of hair follicle openingsThis glossary term has not yet been described. in healthy persons [14, 18]. Scattered brown discoloration is typical feature of discoid lupus erythematosus [5].

Pink, “strawberry ice cream” areas are characteristic trichoscopic findings of cicatricial alopeciaThis glossary term has not yet been described. and correspond to early fibrosis [5].

Red areas may be observed in case of inflammationThis glossary term has not yet been described., extravasation, epidermal detachment and vascular abnormalities [13].

White areas are common feature of cicatricial alopecia and correspond to late fibrosing process [5]. They may be also observed in epidermal detachment and edema [13].

Yellow areas are detected in dissecting cellulitis, follicular pustules, dissecting cellulitis and bacterial infections [13].



Discharge

Yellow or yellow-red discharge is detected in folliculitis decalvans, bacterial infections, dissecting cellulitis or tinea capitisThis glossary term has not yet been described. [13].



Surface structure

Starburst patternThis pattern consists of peripheral globules, pseudopods or streaks (or a combination of them), located around the entire perimeter of the lesion hyperplasia results from fibrosis and is characteristic trichoscopic findings of folliculitis decalvans [5].