Search

Xanthelasma palpebrarum (XP) is a benign cosmetic condition. Although the role of CO2 laser is well described, there are only a few studies on Erbium: YAG in XP. Similarly, trichloroacetic acid (TCA) is commonly used in XP. However, there are only a few studies comparing these modalities in the treatment of XP. Aim: To evaluate the effectiveness and safety of Erbium: YAG laser and 50% TCA in the treatment of XP with the role of dermoscope in the evaluation of lesions. Materials and Methods: A total of 20 subjects were randomly allocated into two groups: group A (TCA) and group B (laser). All patients were subcategorized into three grades viz. I (mild), II (moderate), and III (severe) using a self-devised scoring system. Results: About 25% and 70% of patients achieved complete clearance in groups A and B, respectively (P = 0.017). The rate of recurrence was 40% and 15% in groups A and B. Dyspigmentation and erythema were the most common side effects. Pretreatment dermoscopic evaluation of the lesion showed a network of brown streaks on a background of a yellowish structureless area and was used to assess the area and margins of the lesion where the adipose tissue was found during the procedure and serial assessment of the lesion. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Diagnosis & Therapy on Dermato-venereology is the property of Dermatology Hospital of Southern Medical University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Diagnosis & Therapy on Dermato-venereology is the property of Dermatology Hospital of Southern Medical University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Melasma is a type of hyperpigmentation typically found on sun-exposed areas, particularly on the face but occasionally on the neck and forearms as well. Despite ongoing research, the exact cause of melasma is still unknown, although it is believed that both genetic factors and exposure to ultraviolet light may contribute to its development. There is a scarcity of studies that assessed the relationship between Wood's lamp and dermoscopic findings in relation to melasma. The current study was conducted to find a correlation and comparison between the observations of Wood's lamp and dermoscopy for melasma. A cross sectional study was carried out among patients with clinical features of melasma attending the outpatient department at multispecialty hospital with a sample size of 200. It was observed that out of 200 cases, mean age group was around 32 years, housewives constituted the majority 72(36%) patients followed by farmers 32(16%); 162(81%) were literate and 38(19%) were illiterate; and 127(63.5%) were using cosmetics and 73(36.5%) were not using any cosmetics; 69 (34.5%) centro-facial melasma, 130(65%) malar and 1(0.5%) with irregular melasma; 137(68.5%) were reticulo-globular, 54(27%) reticular and 9(4.5%) were globular; 10(5%) contrast enhancement, 107(53.5%) only enhancement and 83(41.5%) no enhancement. Facial hypermelanosis has long been a source of distress for patients, with the current trend of valuing physical appearance and fairness in the population only exacerbating this concern. The use of Wood's lamp and subsequently confirmed by dermoscopy has undergone significant development. [ABSTRACT FROM AUTHOR]

Background: There are no standards for evaluating skin photoaging. Dermoscopy is a non‐invasive detection method that might be useful for evaluating photoaging. Objective: To assess the correlation between the dermoscopic evaluation of photoaging and clinical and pathological evaluations. Methods: The age, clinical evaluation (Fitzpatrick classification, Glogau Photoaging Classification, and Chung's standardized image ruler), histopathology (Masson staining and MMP‐1 immunohistochemistry), and dermoscopy (Hu's and Isik's) of 40 donor skin samples were analyzed statistically, and Spearman rank correlation analysis was performed. Results: There was a robust correlation between the total Hu scores and Isik dermoscopy. The correlation of dermoscopy with histopathology was higher than that of clinical evaluation methods. There is a strong correlation between telangiectases and lentigo. Xerosis, superficial wrinkle, diffuse erythema, telangiectases, and reticular pigmentation were significantly correlated with the three clinical evaluation methods. Superficial wrinkles were correlated with Masson, MMP‐1, various clinical indicators, and other dermoscopic items. Conclusion: There is a good correlation between dermoscopy and clinical and histopathological examination. Dermoscopy might help evaluate skin photoaging. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Diagnosis & Therapy on Dermato-venereology is the property of Dermatology Hospital of Southern Medical University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Diagnosis & Therapy on Dermato-venereology is the property of Dermatology Hospital of Southern Medical University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Unsupervised overuse of topical corticosteroids (TCs) is highly common in dermatological practice, leading to steroid abuse known as topical steroid damaged/dependent face (TSDF). Dermoscopy aids in the early detection of TSDF. Aims: The aim of this study was to evaluate the clinical and dermoscopic findings in patients with TSDF. Materials and Methods: The study was conducted on eighty patients presenting with clinical features suggestive of TSDF. Detailed history taking, clinical examination, and dermoscopic evaluation with a DermLite dermoscope were performed. Results: Out of the eighty patients included in the study, 64 (80%) were females and 16 (20%) were males. The most common age group affected was 18-30 years (52; 65%). Sixty-six were literate. Melasma was a common underlying condition for which a steroid was used by the patients (44; 55%). Betamethasone (34; 47.5%) was the most commonly used, followed by clobetasol (18; 22.5%). Relatives and friends were the common sources of recommendation (46; 57.5%). Most of the patients applied these for one year. Redness was the predominant presenting complaint, seen in sixty patients (75%). The common clinical findings were erythema (75%), hyperpigmentation (44; 55%), and hypertrichosis (50; 62.5%). The common findings observed on dermoscopy were telangiectasia (90%), red, diffuse areas (75%), brown globules (55%), and hypertrichosis (62.5%). In telangiectasia, the linear (60%), polygonal (30%), Y-shaped (25%), and serpentine (15%) types were seen. The other findings observed were white, structureless areas (37.5%), Demodex tails (25%), scaling (15%), pustules (10%), comedones (20%), and the breaking of the pseudo-reticular network (22.5%). Limitations: The limitation of this study was the lack of histopathological correlation. Conclusion: Dermoscopy aids in the early diagnosis of TSDF. [ABSTRACT FROM AUTHOR]

Background: Alopecia areata is an autoimmune condition that causes non‐scarring hair loss. To date, there is no single cure and treatment remains challenging. Objectives: To evaluate the efficacy of Jessener solution versus intralesional steroid in treatment of Alopecia Areata. Methods: This study included 40 patients who presented with multifocal patchy alopecia areata (AA). For each patient, three patches were randomly selected to be treated one with intralesional steroid, another with topical Jessner solution and the third with normal saline. Three sessions were done 3 weeks apart and were followed up for 3 months. Response was assessed clinically and by trichoscope. Results: Fifteen percent of patches coated with Jessner or injected with steroids showed an excellent response while 20% of patches coated with Jessner and 32.5% patches injected with steroids showed a good response. A significant difference was observed between the three modalities of treatment regarding the prognostic score for response (p < 0.001) as patches coated with Jessner and those steroid injected showed a significant higher response rate than patches injected with saline (p < 0.001) while no significant difference was reported between patches either treated with Jessner or steroids (p > 0.05). Conclusion: Jessners solution can be a novel and feasible and well tolerated modality of treatment for patients suffering from alopecia areata. [ABSTRACT FROM AUTHOR]

Background: Follicular unit extraction (FUE) is a minimally invasive surgery that is becoming popular in hair restoration in cicatricial alopecia (CA). Aim: Evaluation of FUE with or without platelet rich plasma (PRP) in scarring alopecia. Patients and methods: Twenty patients with CA were randomized into two groups. Group A (10 patients) underwent FUE, group B (10 patients) underwent FUE + PRP. PRP was injected 1 week before surgery, then monthly after surgery for 3 months. Follow up was done after 3, 6 and 12 months by calculating the density of surviving follicular units and the survival rate. Results: In group A, there was statistically significant increase in mean survival rate which was 30.30%. At 3 months, 67.26% at 6 months and 78.15% at 12 months. In group B, there was a significant increase in mean survival rate being 30.14% at 3 months, 58.75% at 6 months and 69.74% at 12 months. There was no significant difference between both groups at anytime during follow up period. Conclusion: Follicular unit extraction is a preferred procedure for hair restoration in CA with few side effects. The role of PRP in HT is controversial. In the present study, PRP does not significantly affect the survival rate of hair grafts. [ABSTRACT FROM AUTHOR]

Background: Dermatosis neglecta (DN) is an underdiagnosed localized pigmentary disorder, characterized by asymptomatic hyperpigmented patches and plaques with adherent scales in an inadequately cleansed area. It is a diagnostic challenge leading to unnecessary interventions and burden to patients. Dermoscopy is a noninvasive handy diagnostic tool, though its utility in the diagnosis of DN is unexplored. Objective: To describe the various clinical and dermoscopic patterns in patients with DN. Materials and Methods: An observational study in 10 admitted patients of a tertiary hospital with DN was done, who consulted in department of dermatology in view of hyperpigmented lesions. After a thorough history and clinical examination, dermoscopy was done over the lesions. Results: In 10 patients, DN was confirmed with a resolution of part of lesion on the application of water-soaked gauze. On dermoscopy, dark-brown polygonal, cornflake-like scales are seen arranged in a mosaic pattern with intervening normal skin, sometimes over an erythematous background. On further probing, most patients gave the history of unintentional neglect of the affected part related to their primary illness. Limitations: Small sample size. Conclusions: DN is an underreported localized hyperpigmented disorder, mimicking other dermatoses. It should always be kept in mind in patients with morbidities that lead to the inability to maintain hygiene in the relevant areas, which may not be the classically described sites of DN. Dermoscopy helps to differentiate it from other hyperpigmented lesions, especially in its milder forms, avoiding the act of wiping the lesions especially in areas associated with hyperesthesia and helps in reinforcing the diagnosis. However, the criteria to diagnose DN based on dermoscopy is not definite. [ABSTRACT FROM AUTHOR]

Context: Repeated trauma involving extremities (in the setting of peripheral neuropathy) and poor vascularity that impairs wound healing are important causes of disability and deformity in leprosy patients. Nail changes can serve as indicators of trophic changes due to leprosy. Aims: To describe the onychoscopy findings in leprosy cases and to identify any specific findings in leprosy patients in comparison to controls. Settings and Design: The first 30 leprosy patients and 30 age and sex-matched controls who attended our tertiary care center from 1 August 2018 were included in this cross-sectional study. Materials and Methods: Onychoscopy examination of all fingernails was performed at 50× magnification using dinolite dermoscope AM4113ZT under non-polarizing light to document surface changes and under polarizing light to document pigmentation and vascular changes. Statistical Analysis: The observed nail changes in cases and controls were compared using Pearson's Chi-square test. Results: Statistically significant association with leprosy was found for pitting, onycholysis, melanonychia, transverse lines, nail pallor, and onychauxis. Nail pallor was unique to leprosy patients. Limitations: Small sample size and not evaluating toenails were the major limitations of the study. Conclusions: Studies with large sample size are needed to assess the significance of nail pallor as a specific onychoscopy finding in leprosy. [ABSTRACT FROM AUTHOR]

Background and Aims: Melanonychia can be a manifestation of benign or malignant pathology and often poses a diagnostic challenge on clinical examination. Even with distinguishing dermoscopic features (nail plate), it can be quite difficult to determine the nature of pigmentation as complete assessment of nail bed and matrix is still not possible. Intraoperative dermoscopy (IOD) can serve as a useful tool to appreciate the bed and matrix changes. The aim here is to study the intraoperative dermoscopic features in patients with melanonychia and correlate with histopathology. Methods: 20 consecutive patients with melanonychia were recruited. Inclusion criteria was melanonychia of sudden onset, progressive nature, irregular width/color/symmetry on dermoscopy, positive Hutchinson sign, solitary nail involvement or associated nail dystrophy. Preoperative dermoscopy was performed and recorded. Patients were planned for nail matrix biopsy, during which IOD was performed over nail matrix and bed after removal of the nail plate. Images were recorded and analyzed and correlated with the histopathology. Results: Out of 20 patients, 12 were females and 8 males. On IOD‑histopathological correlation, 2 patients were found to have melanoma of the nail unit, 5had nail lichen planus, 9 had benign melanocytic nevi, and 4 had fungal melanonychia. IOD revealed fine, parallel and regular lines of pigmentation localized to proximal nail bed and matrix in all patients with benign melanonychia, while dark thick bands with irregular borders, dots, globules, streaks and structureless areas in the two patients with melanoma. Fungal melanonychia revealed an unremarkable nail bed and matrix on IOD. Conclusion: Intraoperative dermoscopycan help in determining the nature of melanonychia and obviate the need to perform biopsy in certain cases. It can also aid in delineating the most suitable site for biopsy, along with grossly assessing the extent of involvement in case of malignancy. [ABSTRACT FROM AUTHOR]

Introduction: Alopecia areata is a common chronic autoimmune inflammatory disease that involves hair follicles, characterized by hair loss on the scalp and/or body without scarring. Clinically, the disease presents as smooth, patchy hair loss with various patterns - diffuse or reticulate alopecia, ophiasis, ophiasisinversus, alopecia totalis (loss of hair all the scalp), or alopecia universalis (loss of hair all over the body). Clinical diagnosis of AA is made based on typical pattern of hair loss and the presence of characteristic exclamation mark hair in microscopy. Invasive (punch biopsy) techniques are often required in some cases where the clinical diagnosis is not straight forward. Biopsy shows peribulbar lymphocytic infiltrates in a "swarm of bee pattern" which is characteristic of the acute stage of the disease. Dermoscopy is an imaging instrument that immensely magnifies surface features of skin lesions. It works on the principle of illumination and transillumination of skin with different light sources and studying it with a high magnification lens. Dry dermoscopy was done with heine delta 20 dermoscope which was followed by wet dermoscopy. Liquid paraffin was used as the immersion media. It is a noninvasive, repeatable, recordable bedside investigation. Materials and Method Study Design: Cross sectional study Study Area: Skin Outpatient Despartment SreeBalaji Medical College and Hospital Study Population: All patients with hair loss, attending skin OPD, who are clinically diagnosed as Alopecia Areata Study Method: Observational study Sample Size: 30 Result: Clinically, the disease presents as smooth, patchy hair loss with various patterns. Dermoscopy is useful for diagnosis of AA clinically by the presence of cadaverized hairs (black dots), circle hair, coudablity hair, exclamation mark hairs (tapering hairs), broken hairs, yellow dots and clustered short vellus hairs in the hair loss areas. The results wear tabulated. [ABSTRACT FROM AUTHOR]

Objective: To find the concordance of Dermoscopic and Wood's lamp findings in melasma patients. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital, Kharian Pakistan, from Nov 2020 to Sep 2021. Methodology: A total of sixty patients clinically classified as melasma were enrolled in the study. Clinical assessment was done, and patients were examined with Wood's lamp and Dermoscope, and findings were recorded. Results: The results of concordance of Wood's lamp findings and Dermoscopic findings were significant as analysed by Kappa Statistics where value of k was 0.597 and p-value was <0.001. Conclusion: Dermoscopy is a newer and more advanced tool. It should be used as a screening and diagnostic tool for melasma and other pigmentation disorders in our Outpatient Departments for earlier subtyping of melasma, deciding the treatment choice and predicting prognosis. [ABSTRACT FROM AUTHOR]

Dermatophytes are capable of infecting the skin and its appendages such as nails and hairs producing a variety of clinical conditions. Hair invasion by dermatophytes is a key feature of tinea capitis and tinea barbae but not of tinea of glabrous skin. In this project, we studied the clinico-mycological aspects of follicular involvement in patients with dermatophytosis of the glabrous skin. In total, 16 patients, eight males and eight females, were included in the study. All were adults except for one girl. The disease durations ranged from one month to more than ten years. Fourteen (78.5%) had multiple lesions, and most of them had undergone treatment with antifungals, antibiotics, or steroids. Dermoscopic examination showed infected hairs in the form of broken stubs, coily, curly, or as black dots on the surface of the lesions. Pathogens were either anthropophilic (seven cases of Trichophyton rubrum) or zoophilic (six cases Microsporum canis, three cases of the T. mentagrophytes). Patients responded well to oral griseofulvin or terbinafine, and topical antifungals. No antifungal resistance developed during the treatment course. Follicular involvement of glabrous skin is not as rare as previously thought and should be considered for systemic antifungal treatments. [ABSTRACT FROM AUTHOR]

Background Postinflammatory hyperpigmentation (PIH) is an acquired hyperpigmentation that involves areas of prior cutaneous inflammation. In addition to prevention, there are a variety of medications and procedures used to treat PIH. Aim of the work The aim of this work was to evaluate the efficacy, tolerability, and safety of salicylic acid peeling in comparison with topical tretinoin in the treatment of PIH. Patients and Methods This study included forty-five patients with PIH lesions. The patients were divided into three groups, group I was treated with salicylic acid peeling 20-30%, group II was treated with topical tretinoin 0.1%, and group III was treated with combination of salicylic acid peel and topical tretinoin. The patients were assessed clinically to evaluate the efficacy, tolerability, and safety of the treatment. Dermoscopy was carried out to the recurrent or nonimproved cases only. Results Combination of salicylic acid peel and topical tretinoin treatment showed significant clinical improvement of PIH than each treatment alone with no complications. There was no significant difference in the recurrence rate between the three groups. There was nonsignificant difference between the efficacy of the treatment and the PIH type in the studied groups. There was nonsignificant difference between the efficacy of the treatment and the duration of the PIH except for group III. Conclusion Combination treatment modality is believed to be preferred in the treatment of PIH due to its higher efficacy than single treatment alone, with well tolerability, less side effects, and low recurrence rate. [ABSTRACT FROM AUTHOR]

We reported an adult female with a clinical diagnosis of erythema nodosum. The patient declined lesional biopsy. We applied epiluminescence dermoscopy, which revealed features compatible with panniculitis. We managed conservatively. The rash remitted four weeks since rash onset, leaving only post-inflammatory hyperpigmentation. Dermoscopic examination cannot replace lesional biopsy for histopathology for a diagnosis of erythema nodosum to be properly confirmed. However, there are patients with clinical diagnoses of erythema nodosum who would not give consent for lesional biopsies, and patients presenting to dermatologists when the rash is already remitting. We thus described the dermoscopic findings of our patient in this report. The applicability of dermoscopy to patients with erythema nodosum and differential diagnoses of such is yet to be evaluated by further studies. [ABSTRACT FROM AUTHOR]

Background Various treatments are currently available for melasma. However, results are often disappointing. Objectives 1 To assess the efficacy and safety of combinations of hydroquinone, glycolic acid, and hyaluronic acid in the treatment of melasma after topical application. 2 To evaluate the dermoscopy as a tool in diagnosis and follow-up of melasma treatment. Patients and Methods One hundred patients with mild, moderate-to-severe melasma were divided into five groups. Group I (twenty patients were treated with cream formula containing 4% hydroquinone), group II (twenty patients were treated with cream formula containing 4% hydroquinone + 10% glycolic acid), group III (twenty patients were treated with cream formula containing 4% hydroquinone + 0.01% hyaluronic acid), group IV (twenty patients were treated with cream formula containing 4% hydroquinone + 10% glycolic acid + 0.01% hyaluronic acid), and group V (twenty patients were treated with placebo cream). All patients were subjected to dermoscopic examination and digital photographs before and after treatment. The response and side effects were evaluated. Results Groups I, III, and IV showed highly significant changes in modified Melasma Area and Severity Index ( mMASI) score after using the treatment. Group II showed significant change in mMASI score after using the treatment. The side effects were more reported in group II, followed by group IV, followed by group I, followed by group III. There was highly significant difference between the dermoscopic color findings before and after treatment. Vascularization was another dermoscopic finding. Conclusion A cream formula containing 4% hydroquinone + 10% glycolic acid + 0.01% hyaluronic acid was very effective in treatment of melasma with tolerable side effects. Dermoscope is a valuable noninvasive tool in the diagnosis and follow-up of melasma treatment. [ABSTRACT FROM AUTHOR]

Background/purpose: Androgenetic alopecia (AGA) in women is characterized by diffuse thinning in the frontal and parietal areas of the scalp; preservation of the frontal hairline is norm. Hair over the occipital scalp is preserved. The purpose of this work was to investigate the findings of phototrichogram (PTG) of the affected and the spared areas in women with AGA and to compare them with those of healthy subjects. Methods: Twenty-two controls and 60 untreated women with AGA (32 with Ludwig I, 28 with Ludwig II) were included in this study. Hair density, percentages of thin hair, and non-growing hair were estimated both on the midscalp and on the occiput by using PTG with digital camera attached to a dermoscope. Results: In the control group, hair density was higher on the midscalp than the occiput. In AGA groups, hair density was lower on the midscalp than the occiput and percentages of thin hair and non-growing hair were higher on the midscalp than the occiput. These findings were more prominent in Ludwig II group. In the occiput there were findings mimicking the changes seen on the midscalp. These were less striking than those seen on the midscalp yet the difference between the control and Ludwig II group was statistically significant. Conclusion: We concluded that the hair is not equally distributed on the scalp, the occiput may be affected in females with AGA and further studies are necessary to support these findings. [ABSTRACT FROM AUTHOR]

Within the past 15 years, dermoscopy has become a widely used non-invasive technique for physicians to better visualize pigmented lesions. Dermoscopy has helped trained physicians to better diagnose pigmented lesions. Now, the digital revolution is beginning to enhance standard dermoscopic procedures. Using digital dermoscopy, physicians are better able to document pigmented lesions for patient follow-up and to get second opinions, either through teledermoscopy with an expert colleague or by using computer-assisted diagnosis. As the market for digital dermoscopy products begins to grow, so do the number of decisions physicians need to make when choosing a system to fit their needs. The current market for digital dermoscopy includes two varieties of relatively simple and cheap attachments which can convert a consumer digital camera into a digital dermoscope. A coupling adapter acts as a fastener between the camera and an ordinary dermoscope, whereas a dermoscopy attachment includes the dermoscope optics and light source and can be attached directly to the camera. Other options for digital dermoscopy include complete dermoscopy systems that use a hand-held video camera linked directly to a computer. These systems differ from each other in whether or not they are calibrated as well as the quality of the camera and software interface. Another option in digital skin imaging involves spectral analysis rather than dermoscopy. This article serves as a guide to the current systems available and their capabilities. [ABSTRACT FROM AUTHOR]

Background: Trichoscopy is a reliable instrument for diagnosis and for tracking therapy-related changes in female pattern hair loss (FPHL). Videodermoscopic diagnosis of FPHL has been established, which requires fine measurements of hair-related parameters; the method requires an expensive equipment/digital program.Aim: To determine whether a low-cost, simple USB dermoscope can ascertain the hair-related changes in early FPHL.Methods: An age-matched, cross-sectional study was performed over 3 years on subjects with less than 6-month history of hair loss and without an obvious broadening of midline hair parting. Trichoscopic analysis of the frontal and occipital scalp of the study subjects were performed, using a USB-connected dermoscope. The subjects were analyzed for the presence of microscopic hair changes in the form of anisotrichosis, vellus-like hair, single hair follicle unit, peri-pilar sign and yellow dots.Results: A total of 230 cases and 230 controls were analyzed. The dermoscopic hair changes were found to be significantly associated with the frontal scalp zone of cases.Limitations: Histopathological evaluation of the cases was not done.Conclusion: Microscopic changes recorded with the help of a simple USB dermoscope are helpful in establishing a diagnosis of FPHL even in early disease. [ABSTRACT FROM AUTHOR]