Journal of Clinical and Aesthetic Dermatology

APR 2018

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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41 JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY April 2018 • Volume 11 • Number 4 R E V I E W D Dermoscopy is a noninvasive technique used to magnify and visualize structures on and beneath the skin surface. Multiple studies have shown the use of dermoscopy increases diagnostic accuracy when analyzing skin growths. 1,2 More recently, the use of dermoscopy has expanded to include the evaluation of rashes and skin infections. 3 The purpose of this research was to review the published literature regarding the use of dermoscopy in the evaluation of inflammatory skin conditions. METHODS Two reviewers (LC and CH) searched Ovid MEDLINE separately. The search terms included the names of 146 inflammatory dermatoses compiled from the table of contents of Dermatology by Bolognia et al 4 and Inflammatory Skin Disorders by Plaza and Prieto. 5 Each inflammatory dermatosis was separately paired with the ancillary search terms dermoscopy, dermatoscopy, and epiluminescence microscopy, respectively. Articles published between 1996 and 2016 were reviewed. Only articles written in the English language were included. We did not include articles that focused solely on confocal microscopy. Duplicates were removed. Titles and abstracts were evaluated, and articles that did not mention dermoscopy of any inflammatory dermatoses were excluded. Any discrepancy on whether to include an article was determined by a third reviewer (EVS). RESULTS The initial search yielded 316 articles. After exclusions, 201 papers were included in the review. The top three inflammatory dermatoses reported were psoriasis (31 articles), cutaneous lupus (26 articles), and lichen planus (23 articles). Of these 54 articles, the majority were case reports (32 articles), followed by cross- sectional studies (14 articles), and case series (8 articles). The most commonly reported dermoscopic findings of psoriasis were red dots, red globules, glomerular vessels (also known as twisted capillary loops), red globular rings, and white scale (Figure 1). Of the 26 articles discussing the dermoscopy of lupus, most focused on discoid lupus of the scalp. Common dermoscopic findings of discoid lupus were yellow follicular keratotic plugs, follicular red dots, blue-gray dots, and peri-follicular scale (Figure 2). Common dermoscopic findings of lichen planus were polymorphic pearly white structures (rounded, arboriform, reticular, annular), radial capillaries, and blue-gray granules (Figure 3). In addition, peri-follicular scale was seen in lichen planopilaris. A B S T R A C T Background: Dermoscopy is well established as a tool to improve the detection of cancerous skin growths. Published data suggest that dermoscopy might be useful in evaluating inflammatory dermatoses and in distinguishing between rashes and skin cancer. Objective: The authors sought to review the published literature regarding use of dermoscopy in the evaluation of inflammatory skin conditions. Methods: Using a systematic approach, the authors performed a literature search using the names of 146 inflammatory dermatoses and pairing each one separately with the search terms dermoscopy, dermatoscopy, and epiluminescence microscopy. Results: After eliminating those papers that did not meet inclusion requirements, the authors identified 201 studies for their review, with the majority consisting of case reports. The most commonly studied inflammatory conditions were psoriasis, lupus, and lichen planus. There was congruence among the studies identified in terms of the most common dermoscopic findings for each of these diseases. Conclusions: The use of dermoscopy in the evaluation of inflammatory dermatoses is a promising option. However, more rigorous studies are needed to determine the sensitivity and specificity of the dermoscopic findings for many inflammatory skin conditions. KEYWORDS: Dermoscopy, inflammatory dermatoses, psoriasis, lupus, lichen planus Dermoscopy in the Diagnosis of Inflammatory Dermatoses: Systematic Review Findings Reported for Psoriasis, Lupus, and Lichen Planus by LAUREN C. COOK, MD; COURTNEY HANNA, MPH; GALEN T. FOULKE, MD; and ELIZABETH V. SEIVERLING, MD Drs. Cook, Foulke, and Seiverling are with the Department of Dermatology, Dr. Seiverling is also with the Department of Family and Community Medicine, and Ms. Hanna is with the Penn State College of Medicine — all with the Penn State Milton S. Hershey Medical Center in Hershey, Pennsylvania. J Clin Aesthet Dermatol. 2018;11(4):41–42 FUNDING: No funding was provided for this article. DISCLOSURES: The authors have no conflicts of interest relevant to the content of this article. CORRESPONDENCE: Lauren C. Cook, MD; Email: lcook1@pennstatehealth.psu.edu

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