Viral infections

From dermoscopedia

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 Editor: Aimilios Lallas

 Author(s): Aimilios Lallas
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Description Dermoscopy of viral infections
Author(s) Aimilios Lallas
Responsible author Aimilios Lallas→ send e-mail
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Status update September 11, 2017
Status by Ralph P. Braun


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HPV infections[edit]

Common warts (verruca vulgaris) dermoscopically display multiple densely packed papillae, each containing a central red dot or loop, which is surrounded by a whitish halo. Hemorrhages represent a possible additional feature, appearing as irregularly distributed, small, red to black tiny dots or streaks.[1][2][3] Dermoscopy of plantar warts typically reveals multiple prominent hemorrhages within a well-defined, yellowish papilliform surface, in which skin lines are interrupted. This pattern is particularly useful for their discrimination from callus, which lacks blood spots, but instead displays central reddish to bluish structureless pigmentation.[4][5][6] Dermoscopy of plane warts typically reveals regularly distributed, tiny, red dots on a light brown to yellow background. These findings allow differentiation from acne or folliculitis, which display a central white to yellow pore corresponding to the comedo or pus within the hair follicle opening.[1]

The dermoscopic pattern of genital warts was initially described as a mosaic pattern consisting of a white reticular network surrounding central small islands of unaffected mucosal skin.[1] More recently, the authors of a study including a large number of patients identified 4 different dermoscopic patterns, which may also coexist in a single wart: unspecific, fingerlike, mosaic and knoblike pattern.[7] Concerning vessels morphology, glomerular, hairpin/dotted, and glomerular/dotted vessels were detected.

Molluscum contagiosum[edit]

Molluscum contagiosum is due to a poxvirus infection and has a characteristic dermoscopic pattern that may facilitate its clinical recognition in selected cases. Dermoscopy is especially useful in detecting the infection before the development of numerous lesions, in pediatric dermatology, or in immunosuppressed patients who may display unusual clinical manifestations. A central pore or umbilication in conjunction with polylobular white to yellow amorphous structures, surrounded by linear or branched vessels (‘red corona’), compose the stereotypic dermoscopic pattern of the disease (Fig 9c).[8][9][10]

  1. 1.01.11.2 Zalaudek et al.: Entodermoscopy: a new tool for diagnosing skin infections and infestations. Dermatology (Basel) 2008;216:14-23. PMID: 18032894. DOI.
  2. Tanioka et al.: Pigmented wart due to human papilloma virus type 60 showing parallel ridge pattern in dermoscopy. Eur J Dermatol 2009;19:643-4. PMID: 19709979. DOI.
  3. Yoong et al.: Unusual clinical and dermoscopic presentation of a wart. Australas. J. Dermatol. 2009;50:228-9. PMID: 19659993. DOI.
  4. Lee et al.: The use of dermoscopy for the diagnosis of plantar wart. J Eur Acad Dermatol Venereol 2009;23:726-7. PMID: 19309426. DOI.
  5. Dalmau et al.: Acral melanoma simulating warts: dermoscopic clues to prevent missing a melanoma. Dermatol Surg 2006;32:1072-8. PMID: 16918571. DOI.
  6. Bae et al.: Differential diagnosis of plantar wart from corn, callus and healed wart with the aid of dermoscopy. Br. J. Dermatol. 2009;160:220-2. PMID: 19067694. DOI.
  7. Dong et al.: Dermatoscopy of genital warts. J. Am. Acad. Dermatol. 2011;64:859-64. PMID: 21429619. DOI.
  8. Morales et al.: Dermoscopy of molluscum contagiosum. Arch Dermatol 2005;141:1644. PMID: 16365277. DOI.
  9. Zaballos et al.: Dermoscopy of molluscum contagiosum: a useful tool for clinical diagnosis in adulthood. J Eur Acad Dermatol Venereol 2006;20:482-3. PMID: 16643165. DOI.
  10. Ianhez et al.: Dermoscopic patterns of molluscum contagiosum: a study of 211 lesions confirmed by histopathology. An Bras Dermatol 2011;86:74-9. PMID: 21437525.