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Background: Among the papular-pruriginous dermatoses related to human immunodeficiency (HIV) infection, two entities remain poorly differentiated leading to confusion in their diagnosis: HIV-related pruritic papular eruption (HIV-PPE or prurigo) and eosinophilic folliculitis (HIV-EF)., Objective: To establish histopathological and immunohistochemical parameters to differentiate between two conditions associated with HIV infection, the pruritic papular eruption (HIV-PPE) and eosinophilic folliculitis (HIV-EF)., Methods: Clinically typical HIV-PPE (18 cases) and HIV-EF (10 cases) cases were compared with each other in terms of the following topics: clinical and laboratory features (gender, age, CD4+ cell and eosinophil count), histopathological features (hematoxylin-eosin and toluidine blue staining) and immunohistochemical features (anti-CD1a, anti-CD4, anti-CD7, anti-CD8, anti-CD15, anti-CD20, anti-CD30, anti-CD68/macrophage and anti-S-100 reactions)., Results: Among the HIV-EF patients, we found an intense perivascular and diffuse inflammatory infiltration compared with those patients with HIV-PPE. The tissue mast cell count by toluidine staining was higher in the HIV-EF patients, who also presented higher expression levels of CD15 (for eosinophils), CD4 (T helper), and CD7 (pan-T lymphocytes) than the HIV-PPE patients., Limitations: Only quantitative differences and not qualitative differences were found., Conclusions: These data indicate that HIV-related PPE and EF could possibly be differentiated by histopathological and immunohistochemical findings in addition to clinical characteristics. In fact, these two inflammatory manifestations could be within the spectrum of the same disease because only quantitative, and not qualitative, differences were found., (Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.)

Background: The dermatoscopic examination of the nail plate has been recently introduced for the evaluation of pigmented nail lesions. There is, however, no evidence that this technique improves diagnostic accuracy of in situ melanoma., Objective: To establish and validate patterns for intraoperative dermatoscopy of the nail matrix., Methods: Intraoperative nail matrix dermatoscopy was performed in 100 consecutive bands of longitudinal melanonychia that were excised and submitted to histopathologic examination., Results: We identified 4 dermatoscopic patterns: regular gray pattern (hypermelanosis), regular brown pattern (benign melanocytic hyperplasia), regular brown pattern with globules or blotch (melanocytic nevi), and irregular pattern (melanoma)., Limitations: Nail matrix dermatoscopy is an invasive procedure that can not routinely be performed in all cases of melanonychia., Conclusion: The patterns described present high sensitivity and specificity for intraoperative differential diagnosis of pigmented nail lesions., (Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.)

Melanonychia striata represents a diagnostic dilemma for dermatologists. The use of dermoscopy to assess the nail has advantages over clinical examination. However, when compared to skin lesions, it gives fewer details. We describe two cases of melanonychia striata submitted to dermoscopic examination of the nail bed and matrix. This is a new procedure that enables observing dermoscopic characteristics that are not visualized in the nail plate, thus, providing additional information.