Rinni R Patel, Hita H Mehta, Manal D Dave

Abstract

Introduction: Follicular dermatoses are conditions characterized by localization around hair follicles, often presenting as small papular lesions. These dermatoses can be challenging to diagnose with the naked eye, making dermoscopy an important adjunctive diagnostic tool. However, the literature on the dermoscopic features of follicular dermatoses remains limited.

Objectives: To evaluate dermoscopic findings in follicular dermatoses.

Methods: This cross-sectional study was conducted from November 2022 to January 2024 at the dermatology department of a tertiary hospital. Patients were categorized into inflammatory and keratinization follicular dermatosis. A fully developed lesion was dermoscopically examined using a DermLite DL-5 dermoscope. The data were statistically analyzed.

Results: We studied 147 patients. Most follicular dermatoses on dermoscopy showed classical findings such as keratotic plugs, perifollicular white halo, or brown halo. However, they also exhibited characteristic features unique to each dermatoses. Keratosis pilaris exhibited coiled hair (77.41%). Reactive perforating collagenosis presented a central yellowish plug (100%), whitish rim (100%), and peripheral erythematous halo (87.5%). Follicular LP showed reduced follicular ostia (45.45%) and blue-gray globules (40.90%), with newer findings like radial white stria and rosette. Follicular psoriasis displayed regular red dots (100%), while follicular eczema showed red globules (50%) and irregular red dots (16.7%). Acne keloidalis nuchae exhibited radial white streaks (62.5%), perifollicular white globules (50%), V-shaped hair (50%), and radial linear vessels (18.75%). Darier disease showed central hyperpigmented and white keratotic plugs, comedo-like openings, and interfollicular exaggerated pseudo-pigment areas.

Conclusion: Our study highlights that each follicular dermatosis presents specific dermoscopic patterns, supporting dermoscopy as a useful, noninvasive tool for differentiation that can complement histopathology.

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The DermLite DL5 Plus dermatoscope is a premium handheld dermatoscope built for modern dermoscopy workflows. With a 32 mm premium lens delivering true 10× magnification, variable polarisation, you can scroll from deeper cross-polarisation to very superficial parallel polarisation, and substantially brighter illumination across modes, the DL5 Plus helps clinicians visualise pigmentation contrasts, vascular structures and subtle dermoscopic features more clearly.

Designed for dermatologists, skin cancer clinics and GPs performing skin checks, DL5 Plus also adds smart connectivity via the DermLite App, enabling streamlined capture and documentation.

For further information on the DermLite DL5 Plus please click here.

Alexandre Ladet, Sandra Lawton, Michael J Boffa

ABSTRACT

Introduction: In many Western countries, access to a dermatologist can be difficult, while the incidence of skin cancer has risen steadily over the past 50 years.

Objective: We reviewed the published literature to determine whether training primary care practitioners (PCPs) in dermoscopy through brief interventions based on diagnostic algorithms could improve patient care by improving their diagnostic accuracy of suspect lesions.

Methods: A scoping review of the literature was conducted, focusing on studies published in the period 2003–2023 that assessed the ability of low-experienced PCPs to triage suspicious dermatological lesions using dermoscopic diagnostic algorithms. Regarding outcomes, we focused on quantitative variables relevant to screening practice in general practice, including sensitivity, specificity, referrals to specialists, and unnecessary lesion excisions.

Results: Of the 926 studies initially identified, 13 were eventually selected: 10 cross-sectional observational studies and three randomized controlled trials. The studies were carried out in North America (N=6), Western Europe (N=4), and Australia (N=3). There was heterogeneity in the training interventions and the criteria used to assess diagnostic accuracy of PCPs after training; however, all studies showed an improvement in this parameter. The preferred algorithms for training PCPs were the 3-point checklist, the 7-point checklist, and the Triage Amalgamated Dermoscopy Algorithm.

Key Points

Question  Does a lower-cost, ambient-light, nonpolarized dermatoscope provide similar clinical utility as a higher-cost, illuminated, polarized dermatoscope for patient-performed teledermoscopy?

Findings  In this randomized study within a trial including 251 adults treated for early-stage melanoma, 92 (71.9%) who used the polarized device and 83 (67.5%) who used the ambient-light device received a teledermatologist management recommendation for baseline images (the difference was not significant). The polarized device resulted in more images that were reportable (95.0% vs 91.1%; difference: 3.9%; 95% CI, 1.5%-6.3%) and fewer image quality issues.

Meaning  The study results suggest that both dermatoscopes supported patient-performed teledermoscopy; the modest image quality advantages of the polarized device must be weighed against its substantially higher cost.

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Meryem Soughi, Oumaima Bouraqqadi, Zakia Douhi, Sara Elloudi, Hanane Baybay, Fatimazahra Mernissi

ABSTRACT

Introduction: Palmoplantar nevi (PPN) are common and sometimes difficult to diagnose because
of their unusual clinical, dermoscopic, and histological features, often mistaken for acral lentiginous
melanoma.

Objective: This study aimed to investigate the different dermoscopic patterns of palmoplantar nevi
and their correlation with age and location.

Methods: This was a retrospective-prospective cohort study of a sample of the Moroccan population
collected over 2 years. The diagnosis was based mainly on clinical and dermoscopic evaluation, and a
biopsy performed in a single patient.

Results: A total of 140 patients with 144 PPNs were included in this study. PPNs were more frequently
located on the palms (64%) than on the soles (36%). The parallel furrow pattern (PFP) was the most
frequent in 44% of patients, followed by the lattice pattern (17,4%), then the homogeneous pattern
(16.7%), the fibrillar pattern (10,4%), the compound pattern (7%), the globular pattern (2 %), the
dotted pattern (2 %), and finally, the atypical pattern (0.7%). We found a correlation between fibrillar
and globular patterns with younger patients (P <0.05) lattice pattern with pressure-free regions such
as the arch and palmar region. In contrast, the fibrillar pattern was associated with heels and PFP with
digital location.

Conclusion: Recognition of these patterns is crucial for accurate diagnosis and to avoid unnecessary
excisions.

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Abstract

Introduction: Conjunctival nevi (CN) represent the majority of benign conjunctival melanocytic lesions (CML), followed by complexion-associated melanosis (CAM). Noninvasive methods like dermoscopy could be of importance to increase diagnostic accuracy in this biopsy-sensitive area. Because of the unique anatomy of the conjunctiva, dermoscopic findings differ significantly compared to the skin or other mucosae.

Objective: Our objective was to analyze epidemiological, clinical, and dermoscopic characteristics of benign conjunctival melanocytic lesions and to explore their correlation to total body nevus count (TBNC).

Methods: This retrospective study involved the collection and analysis of demographic data, patient information, and clinical and dermoscopic images from individuals with long-standing, stable, pigmented conjunctival lesions.

Results: A total of 30 benign conjunctival melanocytic lesions in 28 patients (female/male :18/10) with a median age of 32 (range 16–68) years were evaluated. The prevalent dermoscopic pattern was a mixed, globular, homogeneous pattern (36.6%). Clear cysts were identified via dermoscopy in 60% of the lesions, and a reticular pattern was observed in all cases involving cysts (P<0.05). The presence of benign CML was associated with a low TBNC (<10) in 64.3%.

Conclusions: The present study provides a detailed overview of the clinical and dermoscopic characteristics of benign CML. It highlights consistent patterns such as cyst-associated reticular features and a low TBNC among affected individuals. These findings support the clinical utility of dermoscopy as a noninvasive tool for differentiating between benign and suspicious conjunctival lesions. The observed association with low TBNC may warrant increased vigilance during ocular examination in patients with few cutaneous nevi. Prospective studies with larger cohorts are needed to confirm and extend these observations.

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Julien Anriot, Nadia Ikhlef, Gérard Duru, Sophie Darnis, Pauline Scouarnec, Younes Tamarat, Mona Amini-Adle, Luc Thomas