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Drummond MVMS, Borges JR, Ribeiro AMQ, Ximenes BAS. Dermoscopy as an auxiliary tool for the diagnosis of acral squamous diseases: palmoplantar psoriasis, tinea pedis/manuum and eczema. An Bras Dermatol 2024:S0365-0596(24)00060-6. [PMID: 38658237 DOI: 10.1016/j.abd.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 04/26/2024] Open
Affiliation(s)
| | - Jules Rimet Borges
- Service of Dermatology, Hospital das Clínicas de Goiânia, Goiânia, GO, Brazil
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2
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Wu Y, Sun L. Clinical value of dermoscopy in psoriasis. J Cosmet Dermatol 2024; 23:370-381. [PMID: 37710414 DOI: 10.1111/jocd.15926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/25/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Dermoscopy is a noninvasive technique that has attracted increasing attention in the field of inflammatory skin diseases (such as psoriasis) in recent years. OBJECTIVE This study aimed to provide an up-to-date overview of the role of dermoscopy in the diagnosis and extra-diagnosis of psoriasis. METHODS This study sought to review the published literature regarding use of dermoscopy in the evaluation of psoriasis. RESULTS The diagnostic value of dermoscopy in psoriasis vulgaris, nail psoriasis, and other types of psoriasis was summarized from the aspects of vascular pattern, scale pattern, and other features. Meanwhile, the application value of dermoscopy in the differential diagnosis, efficacy and severity assessment, prediction and monitoring of psoriasis was discussed. CONCLUSION Dermoscopy has good clinical value in the diagnosis and differential diagnosis of psoriasis and shows great prospects for severity assessment and efficacy prediction monitoring.
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Affiliation(s)
- Yifeng Wu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Liyun Sun
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
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3
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Tancredi V, Buononato D, Caccavale S, Di Brizzi EV, Di Caprio R, Argenziano G, Balato A. New Perspectives in the Management of Chronic Hand Eczema: Lessons from Pathogenesis. Int J Mol Sci 2023; 25:362. [PMID: 38203533 PMCID: PMC10778876 DOI: 10.3390/ijms25010362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/19/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
Chronic hand eczema (CHE) is a common inflammatory skin condition that significantly impacts the quality of life. From work-related disabilities to social embarrassment, pain, and financial costs, the burden on society is substantial. Managing this condition presents challenges such as long-term treatment, poor patient compliance, therapy side effects, and economic feasibility. As a result, significant efforts have been made in this field in recent years. Specifically, the broader understanding of CHE pathogenesis has led to the development of new drugs, both topical and systemic. The aim of this narrative review is to summarize the current available data on hand eczema pathophysiology and explore the resulting developments in drugs for its treatment. A comprehensive search on PubMed and the other main scientific databases was conducted using keywords related to CHE and its pathogenesis. The most relevant pathways targeted by therapies include the JAK-STAT cascade, IL-4, and IL-13 axis, phosphodiesterase 4 enzyme, and chemo-attractant cytokines. In the near future, physicians will have a plethora of therapeutic alternatives. Consequently, they should be well-trained not only in how to use these alternatives but also how to combine these treatments to address the ongoing challenges related to efficacy, tolerability, and safety.
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Affiliation(s)
| | | | | | | | | | | | - Anna Balato
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (D.B.)
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4
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Chatterjee M, Rajput G, Hemdani R. Review article: Dermoscopy in pediatric dermatosis. APOLLO MEDICINE 2023. [DOI: 10.4103/am.am_178_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
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5
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Avcı EB, Erdemir VA, Erdem O, Işık R, Aksu AEK. Evaluation of serum vascular endothelial growth factor level and findings of nailfold capillaroscopy by dermatoscope in the differential diagnosis of palmoplantar psoriasis and palmoplantar eczema. Microvasc Res 2023; 145:104441. [PMID: 36195239 DOI: 10.1016/j.mvr.2022.104441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 09/09/2022] [Accepted: 09/23/2022] [Indexed: 02/03/2023]
Abstract
OBJECT This study aimed to evaluate VEGF level, capillaroscopic findings, and these features for differential diagnosis of palmoplantar psoriasis and eczema patients. METHODS This comparative cross-sectional study included 40 patients clinical and histopathologically diagnosed with eczema or psoriasis (20 psoriasis and 20 eczema) and 30 patients of similar age and gender without inflammatory disease in the control group. Serum samples of patients were collected and analyzed for VEGF by enzyme-linked immunosorbent assay (ELISA) and at the same time, we applied capillaroscopy with computerized dermatoscopy qualitatively and semiquantitatively. RESULTS In the qualitative evaluation, a decrease in capillary density and a significant increase of the avascular area was in palmoplantar plaque psoriasis (PPP) and palmoplantar eczema (PPE) patients compared to the control group. In the semiquantitative evaluation, the mean score decreased capillary density was significantly higher in PPE than in the PPP and control groups (p < 0.001). Minor morphological change (tortuous, crossed and enlarged capillary) scores were significantly higher in patients with PPE compared to PPP and control groups (p = 0.011). Major morphological change (mega, meandering, branching, bushy, bizarre, and disorganized polymorphic capillary) score was significantly higher in patients with PPP than PPE and the control group (p < 0.001). Major morphological change and m-PPPASI scores were correlated in PPP patients (p < 0.05). Disorganized capillaries in PPP patients were significantly higher than in the PPE and control groups (p < 0.001). There was no significant correlation between serum VEGF value and clinical severity and capillaroscopy findings of the patients. CONCLUSION Significant morphological changes were detected between PPP, PPE, and control groups in the qualitative and semi-quantitative evaluation of capillaroscopic findings. In the differential diagnosis of PPP and PPE, major morphological change, especially the presence of disorganized polymorphic capillaries, was considered an important finding in the capillaroscopic evaluation. These capillaroscopic findings may be helpful to discriminate eczema and psoriasis. However, there was no significant relationship between serum VEGF level and the patients' capillaroscopic findings and clinical severity.
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Affiliation(s)
- Elif Bal Avcı
- Department of Dermatology, Taksim Training and Research Hospital, Istanbul, Turkey.
| | - Vefa Aslı Erdemir
- Department of Dermatology, Göztepe Prof Dr Süleyman Yalçın City Hospital, Medeniyet University, Istanbul, Turkey
| | - Ozan Erdem
- Department of Dermatology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Reyhan Işık
- Department of Medical Biochemistry, Istanbul Training and Research Hospital, Health Science University, Istanbul, Turkey
| | - Ayşe Esra Koku Aksu
- Department of Dermatology, Istanbul Training and Research Hospital, Health Science University, Istanbul, Turkey
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6
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Wang L, Zheng Y, Zhou R, Liu W. Three-Dimensional Skin CT Based on Intelligent Algorithm in the Analysis of Skin Lesion Sites Features in Children with Psoriasis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8195243. [PMID: 35126635 PMCID: PMC8816560 DOI: 10.1155/2022/8195243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/11/2021] [Accepted: 12/22/2021] [Indexed: 11/22/2022]
Abstract
This research was to explore the application value of three-dimensional computed tomography (CT) based on artificial intelligent algorithm in analyzing the characteristics of skin lesions in children with psoriasis. In this study, 15 children with psoriasis were selected as the observation group, and 15 children with other skin diseases were selected as the control group. The CT images were optimized, and the feature selection was carried out based on artificial intelligent algorithm. Firstly, the results were compared with the results of simple skin three-dimensional CT to determine the effectiveness. Then, the two groups of three-dimensional skin CT image features of skin psoriasis-like hyperplasia, Munro microabscess, dermal papillary vascular dilation, and squamous epithelium based on intelligent algorithms were compared. After comparison, the detection rate of psoriasis-like hyperplasia, Munro microabscess, dermal papillary vascular dilation, and squamous epithelium in the observation group was higher than that in the control group, with significant difference and statistical significance (P < 0.05). In addition, the sensitivity of psoriasis-like hyperplasia, Munro microabscess, dermal papilla vascular dilatation, and squamous epithelium in children with psoriasis was 80.0%, 86.7%, 80.0%, and 93.3%, respectively. The specificity of psoriasis-like hyperplasia, Munro microabscess, dermal papilla vascular dilatation, and squamous epithelium in children with psoriasis was 86.7%, 93.3%, 60.0%, and 73.3%, respectively. The results showed that Munro microabscess and psoriasis-like hyperplasia had high sensitivity and specificity in all diagnostic items, which could be used as important features of skin lesion sites in the diagnosis of psoriasis in children. The research provides a basis for the clinical diagnosis of psoriasis in children, which is worthy of clinical promotion.
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Affiliation(s)
- Lina Wang
- Department of Dermatology, Hanzhong People's Hospital, Hanzhong, 723000 Shaanxi, China
| | - Youning Zheng
- Department of Pediatrics, Hebei General Hospital, Shijiazhuang, 050051 Hebei, China
| | - Ran Zhou
- Department of Pediatrics, Hebei General Hospital, Shijiazhuang, 050051 Hebei, China
| | - Wenfang Liu
- Surgery Teaching and Research Office, Cangzhou Medical College, Cangzhou, 061001 Hebei, China
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7
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Doshi B, Adabala S, Manjunathswamy BS. A cross-sectional study to assess the role of dermoscopy in differentiating palmar psoriasis, chronic hand eczema, and eczema in psoriatico. Indian Dermatol Online J 2022; 13:78-85. [PMID: 35198472 PMCID: PMC8809167 DOI: 10.4103/idoj.idoj_782_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 04/11/2021] [Accepted: 09/05/2021] [Indexed: 11/28/2022] Open
Abstract
Background: Overlapping clinical features often make the differentiation between palmar psoriasis, hand eczema, and eczema in psoriatico a difficult task. In such cases, history and biopsy often aid in the diagnosis. Dermoscopy acts as a link between clinical dermatology and dermatopathology. Aim: To study the dermoscopic features in biopsy-proven cases of palmar psoriasis, hand eczema, and eczema in psoriatico. Methods: A 1-year cross-sectional study was conducted using a video dermatoscope, Dinolite premier AM4113ZT, on 60 patients having clinical diagnosis of either of palmar psoriasis, hand eczema, and eczema in psoriatico. Statistical analysis was performed using R i386 3.6.3 software. Results: Among 60 patients, 38 were psoriatics followed by 14 of eczema and 8 of eczema in psoriatico. On dermoscopy, characteristic features of psoriasis lesions were diffuse scaling in 76.3% (29/38), white scales in 60.5% (23/38), and dotted vessels in 76.3% (29/38) along with regular distribution of vessels in 71% (27/38); in hand eczema lesions, diffuse scaling in 78.5% (11/14), white and yellow scales in 57.1% (8/14), and dotted vessels in 78.5% (11/14) along with a patchy distribution of vessels in 57.1% (8/14); in eczema in psoriatico, diffuse scaling in 75% (6/8), white and yellow scales in 62.5% (5/8), and dotted vessels in 87.5% (7/8) along with regular distribution of vessels in 50% (4/8). Conclusion: The various patterns and combinations reflecting specific features give an insight into the cases of palmar psoriasis, hand eczema, and eczema in psoriatico on dermoscopy. However, a study with larger sample size is required to validate the findings of our study. Limitations: Inability to perform a patch test for eczema due to unavailability.
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8
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Nair PA, Bhavsar N, Patel D. A Pilot Study to Evaluate Dermoscopic Patterns in Eczema at Rural Based Tertiary Care Centre. Indian J Dermatol 2021; 66:421-424. [PMID: 34759408 PMCID: PMC8530058 DOI: 10.4103/ijd.ijd_223_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Pragya A Nair
- Department of Dermatology and Venereology, Pramukhswami Medical College, Karamsad, Gujarat, India E-mail:
| | - Namrata Bhavsar
- Department of Dermatology and Venereology, Pramukhswami Medical College, Karamsad, Gujarat, India E-mail:
| | - Dhruv Patel
- Department of Dermatology and Venereology, Pramukhswami Medical College, Karamsad, Gujarat, India E-mail:
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9
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Nakanishi T, Kokubu H, Fujimoto N, Tanaka T. Detection rate of pustules in palmoplantar pustulosis with dermoscopy. J Dermatol 2021; 49:299-302. [PMID: 34723401 DOI: 10.1111/1346-8138.16222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/21/2021] [Indexed: 11/29/2022]
Abstract
In this study, dermoscopy was applied to determine the site of skin biopsy in cases of palmoplantar pustulosis (PPP) with invisible tiny pustules or vesicles. Fifty-two clinically diagnosed PPP patients (11 men and 41 women) were observed by a dermoscope and underwent skin biopsy. Nineteen patients had visible pustules, whereas 33 had no visible pustules. Pustules were detected by a dermoscope on palmoplantar lesions in 17 of the 33 PPP patients. In contrast, 16 patients showed no presence of pustules or vesicles observed by a dermoscope. In this group, biopsy specimens were taken from scaly lesions. Out of the 16 patients, 10 histologically showed pustules in the epidermis. We finally detected pustules for 46 patients among 52 who were clinically diagnosed with PPP. As a result, we detected pustules in PPP for 19 patients on "inspection", and 36 patients on "inspection and dermoscopy", and 46 patients on "inspection, dermoscopy, and biopsy". Dermoscopy is significantly useful comparing the detection rate (inspection, 0.41; inspection and dermoscopy, 0.78; p = 0.0003; using χ2 -test). In addition, we also should learn from the results that the detection rate goes down to 0.78 without a biopsy. Thus, dermoscopy is certainly a useful tool for invisible pustules and also undetectable pustules to detect pustules in PPP. Moreover, we objectively showed that "inspection, dermoscopy, and biopsy" are the best way to make a PPP diagnosis.
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Affiliation(s)
- Takeshi Nakanishi
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
| | - Hiraku Kokubu
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
| | - Noriki Fujimoto
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
| | - Toshihiro Tanaka
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
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10
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Yu X, Wei G, Shao C, Zhu M, Sun S, Zhang X. Analysis of dermoscopic characteristic for the differential diagnosis of palmoplantar psoriasis and palmoplantar eczema. Medicine (Baltimore) 2021; 100:e23828. [PMID: 33592839 PMCID: PMC7870165 DOI: 10.1097/md.0000000000023828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 11/20/2020] [Indexed: 01/05/2023] Open
Abstract
Dermoscopy is a noninvasive diagnostic technique that is of great value for the differential diagnosis of palmoplantar psoriasis and palmoplantar eczema. Considering the particularity of palmoplantar anatomy, the dermoscopic features of psoriasis and eczema in palm region show fewer differences, compared with those in other parts of the body. Only a few studies have examined the palmoplantar region of psoriasis and eczema patients under a dermoscope.A total of 26 patients with palmoplantar psoriasis and 31 patients with palmoplantar eczema were enrolled in our study. Target palmoplantar areas were observed through general observation and under dermoscope.We found that the presence of white scales and a regular arrangement of dots and globular vessels were significantly indicative of palmoplantar psoriasis, while yellowish scales and an irregular arrangement of atypical vessels were significantly indicative of palmoplantar eczema.
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Affiliation(s)
- Xiaoping Yu
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine
| | - Guo Wei
- Department of Dermatology, The Second Hospital of Shandong University
| | - Chunchun Shao
- Center of Evidence-based Medicine, Institute of Medical Sciences, the Second Hospital of Shandong University, Jinan, Shandong, China
| | - Mingjie Zhu
- Colorado School of Public Health, University of Colorado, Colorado, United States
| | - Shuna Sun
- Department of Dermatology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Xiaojie Zhang
- Department of Dermatology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
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11
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Ye C, Yi J, Lai W, Zheng Y. Skin barrier damaging and repairing process: A new application field of dermoscopy. J Cosmet Dermatol 2020; 20:897-905. [PMID: 32892490 DOI: 10.1111/jocd.13643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/18/2020] [Accepted: 07/21/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although more and more noninvasive detection technologies have been used in assessing skin barrier integrity and functions, more accurate, intuitive, and convenient detective methods still needed to be explored and developed. AIMS To investigate the characteristic image changes under the dermoscopy and to explore the relationship with skin physiological indexes in skin barrier damaging and repairing process. PATIENTS/METHODS 25 healthy subjects with normal skin in forearm were included and divided into different groups according to the operated strips numbers (30, 35, and 40 times). Before tape stripping, and immediately, 3, 7, 14, and 21 days after tape stripping, dermoscopic examination and skin transepidermal water loss (TEWL), surface hydration, and L*a*b* value were simultaneously tested in the same region. RESULTS Immediately after different times tape stripping, the amount of cuticle cells residues and the microvascular images were different. In skin barrier repairing process, the scab forming time observed under dermoscopy was day 14, day 7, and day 3 on 30 times, 35 times, and 40 times stripped skin, respectively. A small amount of cuticle cells and blurry vessels could be identified in hydration value <40 group, while there was no cuticle cell residue, and the branching vessels were obvious in hydration value >40 group. CONCLUSIONS Unique manifestations could be observed under dermoscopy in different time points of skin barrier with various degree of injury and in skin barrier repairing process. By combining dermoscopy and skin indexes assessing technologies, the skin barrier integrity and function could be observed and evaluated more accurately and precisely.
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Affiliation(s)
- CongXiu Ye
- Department of Dermato-Venereology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - JinLing Yi
- Department of Dermato-Venereology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wei Lai
- Department of Dermato-Venereology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yue Zheng
- Department of Dermato-Venereology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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12
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Çetinarslan T, Türel Ermertcan A, Temiz P. Dermoscopic clues of palmoplantar hyperkeratotic eczema and palmoplantar psoriasis: A prospective, comparative study of 90 patients. J Dermatol 2020; 47:1157-1165. [PMID: 32691449 DOI: 10.1111/1346-8138.15487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 06/03/2020] [Indexed: 11/30/2022]
Abstract
Diagnosis can be difficult in isolated palmar and plantar lesions in patients with psoriasis and eczema. The purpose of our study is to compare the dermoscopic findings in patients with palmoplantar psoriasis and palmoplantar hyperkeratotic eczema. This prospective, comparative study included 90 patients histopathologically diagnosed with eczema or psoriasis (35 psoriasis and 55 eczema). The age range was 18-75 years. The most common vessel type was dot vessel in psoriasis. Red globular ring vessels were seen in five patients with psoriasis, but not in any with eczema (P = 0.007). The most common vascular distribution pattern was regular in psoriasis (40%). Patchy vascular pattern was significant in eczema. The most common background color was light red in psoriasis (48.6%) (P < 0.001). Brownish-orange globules were observed in 25.7% of patients with eczema and 5.7% in patients with psoriasis (P = 0.02). There is only one study in the published work about dermoscopy of palmoplantar psoriasis and eczema. In our study, yellow crusts, patchy scale distribution, patchy vascular pattern, yellow scale color, dull red background color and brownish-orange globules were significant in patients with palmoplantar eczema. On the other hand, patients with psoriasis had light red background color, regular vascular distribution pattern and white scale color. We observed globule structures with a pale center and dark peripheral rim only in patients with eczema, which was not identified in previous studies. This globule structure may be a new finding in eczema.
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Affiliation(s)
| | - Aylin Türel Ermertcan
- Departments of, Department of, Dermatology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Peyker Temiz
- Department of, Pathology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
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13
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Politiek K, Loman L, Pas HH, Diercks GFH, Lemmink HH, Jan SZ, van den Akker PC, Bolling MC, Schuttelaar MLA. Hyperkeratotic hand eczema: Eczema or not? Contact Dermatitis 2020; 83:196-205. [PMID: 32333380 PMCID: PMC7496397 DOI: 10.1111/cod.13572] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 03/25/2020] [Accepted: 04/23/2020] [Indexed: 12/12/2022]
Abstract
Background Hyperkeratotic hand eczema (HHE) is a typical clinical hand eczema subtype with a largely unknown pathophysiology. Objective To investigate histopathology, expression of keratins (K), epidermal barrier proteins, and adhesion molecules in HHE. Methods Palmar skin biopsies (lesional and perilesional) were obtained from seven HHE patients and two healthy controls. Moreover, 135 candidate genes associated with palmoplantar keratoderma were screened for mutations. Results Immunofluorescence staining showed a significant reduction of K9 and K14 in lesional skin. Upregulation was found for K5, K6, K16, and K17 in lesional skin compared with perilesional and healthy palmar skin. Further, upregulation of involucrin and alternating loricrin staining, both in an extracellular staining pattern, was found. Filaggrin expression was similar in lesional, perilesional, and control skin. No monogenetic mutations were found. Conclusion Currently, the phenotype of HHE is included in the hand eczema classification system; however, it can be argued whether this is justified. The evident expression of filaggrin and involucrin in lesional skin does not support a pathogenesis of atopic eczema. The upregulation of K6, K16, and K17 and reduction of K9 and K14 might contribute to the underlying pathogenesis. Unfortunately, comparison with hand eczema studies is not possible yet, because similar protein expression studies are lacking.
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Affiliation(s)
- Klaziena Politiek
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Laura Loman
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hendri H Pas
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gilles F H Diercks
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henny H Lemmink
- Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Sabrina Z Jan
- Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Peter C van den Akker
- Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Maria C Bolling
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marie L A Schuttelaar
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Abstract
BACKGROUND Using current diagnostic tools for hand eczema, namely clinical picture and histology, differential diagnoses such as psoriasis palmaris usually cannot be ruled out. OBJECTIVES Discussion of current diagnostic possibilities for hand eczema; presentation and critical evaluation of proposed biomarkers for molecular diagnostics and outlook how diagnostics in dermatology will change in the near future. MATERIALS AND METHODS In this article, we discuss basic research and provide a review of the literature. RESULTS Molecular diagnostics has the potential to substantially improve diagnosis of hand eczema; prerequisites are prospective validation of proposed markers and availability of valid and cost-effective diagnostics. CONCLUSIONS In the near future, the diagnosis of hand eczema will be complemented by software algorithms and artificial intelligence on the one hand and simple, precise, and economic molecular diagnostic devices on the other.
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Errichetti E. Dermoscopy of Inflammatory Dermatoses (Inflammoscopy): An Up-to-Date Overview. Dermatol Pract Concept 2019; 9:169-180. [PMID: 31384489 DOI: 10.5826/dpc.0903a01] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2019] [Indexed: 10/31/2022] Open
Abstract
In addition to its use in pigmented and nonpigmented skin tumors, dermoscopy is gaining appreciation in assisting the diagnosis of nonneoplastic diseases, especially inflammatory dermatoses (inflammoscopy). In this field, dermoscopic examination should be considered as the second step of a "2-step procedure," always preceded by the establishment of a differential diagnosis on the basis of clinical examination. In this paper, we sought to provide an up-to-date overview on the use of dermoscopy in common inflammatory dermatoses based on the available literature data. For practical purposes, the analyzed dermatoses are grouped according to the clinical presentation pattern, in line with the 2-step procedure principle: erythematous-desquamative and papulosquamous dermatoses, papulokeratotic dermatoses, erythematous facial dermatoses, sclero-atrophic dermatoses, and miscellaneous.
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Affiliation(s)
- Enzo Errichetti
- Institute of Dermatology, Santa Maria della Misericordia University Hospital, Udine, Italy
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Errichetti E, Zalaudek I, Kittler H, Apalla Z, Argenziano G, Bakos R, Blum A, Braun RP, Ioannides D, Lacarrubba F, Lazaridou E, Longo C, Micali G, Moscarella E, Paoli J, Papageorgiou C, Russo T, Scope A, Stinco G, Thomas L, Toncic RJ, Tschandl P, Cabo H, Hallpern A, Hofmann-Wellenhof R, Malvehy J, Marghoob A, Menzies S, Pellacani G, Puig S, Rabinovitz H, Rudnicka L, Vakirlis E, Soyer P, Stolz W, Tanaka M, Lallas A. Standardization of dermoscopic terminology and basic dermoscopic parameters to evaluate in general dermatology (non-neoplastic dermatoses): an expert consensus on behalf of the International Dermoscopy Society. Br J Dermatol 2019; 182:454-467. [PMID: 31077336 DOI: 10.1111/bjd.18125] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Over the last few years, several articles on dermoscopy of non-neoplastic dermatoses have been published, yet there is poor consistency in the terminology among different studies. OBJECTIVES We aimed to standardize the dermoscopic terminology and identify basic parameters to evaluate in non-neoplastic dermatoses through an expert consensus. METHODS The modified Delphi method was followed, with two phases: (i) identification of a list of possible items based on a systematic literature review and (ii) selection of parameters by a panel of experts through a three-step iterative procedure (blinded e-mail interaction in rounds 1 and 3 and a face-to-face meeting in round 2). Initial panellists were recruited via e-mail from all over the world based on their expertise on dermoscopy of non-neoplastic dermatoses. RESULTS Twenty-four international experts took part in all rounds of the consensus and 13 further international participants were also involved in round 2. Five standardized basic parameters were identified: (i) vessels (including morphology and distribution); (ii) scales (including colour and distribution); (iii) follicular findings; (iv) 'other structures' (including colour and morphology); and (v) 'specific clues'. For each of them, possible variables were selected, with a total of 31 different subitems reaching agreement at the end of the consensus (all of the 29 proposed initially plus two more added in the course of the consensus procedure). CONCLUSIONS This expert consensus provides a set of standardized basic dermoscopic parameters to follow when evaluating inflammatory, infiltrative and infectious dermatoses. This tool, if adopted by clinicians and researchers in this field, is likely to enhance the reproducibility and comparability of existing and future research findings and uniformly expand the universal knowledge on dermoscopy in general dermatology. What's already known about this topic? Over the last few years, several papers have been published attempting to describe the dermoscopic features of non-neoplastic dermatoses, yet there is poor consistency in the terminology among different studies. What does this study add? The present expert consensus provides a set of standardized basic dermoscopic parameters to follow when evaluating inflammatory, infiltrative and infectious dermatoses. This consensus should enhance the reproducibility and comparability of existing and future research findings and uniformly expand the universal knowledge on dermoscopy in general dermatology.
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Affiliation(s)
- E Errichetti
- Institute of Dermatology, 'Santa Maria della Misericordia' University Hospital, Udine, Italy
| | - I Zalaudek
- Department of Dermatology, University of Trieste, Trieste, Italy
| | - H Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Z Apalla
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - G Argenziano
- Dermatology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - R Bakos
- Department of Dermatology, Hospital de Clınicas de Porto Alegre, Porto, Alegre, Brazil
| | - A Blum
- Public, Private and Teaching Practice of Dermatology, Konstanz, Germany
| | - R P Braun
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - D Ioannides
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - F Lacarrubba
- Dermatology Clinic, University of Catania, Catania, Italy
| | - E Lazaridou
- Second Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
| | - C Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - G Micali
- Dermatology Clinic, University of Catania, Catania, Italy
| | - E Moscarella
- Dermatology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - J Paoli
- Department of Dermatology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - C Papageorgiou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - T Russo
- Dermatology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - A Scope
- Medical Screening Institute, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - G Stinco
- Institute of Dermatology, 'Santa Maria della Misericordia' University Hospital, Udine, Italy
| | - L Thomas
- Department of Dermatology, Lyon University, Lyon, France
| | - R J Toncic
- Dermoscopy Unit, University of Zagreb, Zagreb, Croatia
| | - P Tschandl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - H Cabo
- Dermatology Institute of Medical Research, University of Buenos Aires, Buenos Aires, Argentina
| | - A Hallpern
- Memorial Sloan Kettering Cancer Center, Hauppauge, NY, U.S.A
| | | | - J Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Universitat de Barcelona IDIBAPS, Barcelona, Spain
| | - A Marghoob
- Memorial Sloan Kettering Cancer Center, Hauppauge, NY, U.S.A
| | - S Menzies
- Discipline of Dermatology, Sydney Medical School, The University of Sydney and Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - S Puig
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Universitat de Barcelona IDIBAPS, Barcelona, Spain
| | - H Rabinovitz
- Skin and Cancer Associates, Plantation, FL, U.S.A
| | - L Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - E Vakirlis
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - P Soyer
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Woolloongabba, QLD, Australia
| | - W Stolz
- Department of Dermatology and Allergology and Environmental Medicine Clinic Thalkirchen, Hospital Munich, Munich, Germany
| | - M Tanaka
- Department of Dermatology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
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Golińska J, Sar‐Pomian M, Rudnicka L. Dermoscopic features of psoriasis of the skin, scalp and nails – a systematic review. J Eur Acad Dermatol Venereol 2019; 33:648-660. [DOI: 10.1111/jdv.15344] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 10/01/2018] [Indexed: 12/11/2022]
Affiliation(s)
- J. Golińska
- Department of Dermatology Medical University of Warsaw Warsaw Poland
| | - M. Sar‐Pomian
- Department of Dermatology Medical University of Warsaw Warsaw Poland
| | - L. Rudnicka
- Department of Dermatology Medical University of Warsaw Warsaw Poland
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Differential efficacy of biologic treatments targeting the TNF-α/IL-23/IL-17 axis in psoriasis and psoriatic arthritis. Cytokine 2018; 111:182-188. [PMID: 30172115 DOI: 10.1016/j.cyto.2018.08.025] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/20/2018] [Accepted: 08/24/2018] [Indexed: 02/08/2023]
Abstract
Psoriasis and psoriatic arthritis cause significant physical and psychological burdens for afflicted individuals. An accelerated TNF-α/IL-23/IL-17 axis is their major pathomechanism; therefore, anti-TNF-α/IL-23/IL-17 biologics are very effective for the treatment of skin and joint lesions in psoriasis and psoriatic arthritis. Given that the IL-17 signature is more upregulated in the skin than in synovium in psoriatic arthritis, anti-IL-23/IL-17 agents seem to be superior to anti-TNF-α remedies in the treatment of skin lesions. In this review, we focus on the differential efficacy of anti-TNF-α/IL-23/IL-17 biologics in psoriasis and psoriatic arthritis.
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19
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Sgouros D, Apalla Z, Ioannides D, Katoulis A, Rigopoulos D, Sotiriou E, Stratigos A, Vakirlis E, Lallas A. Dermoscopy of Common Inflammatory Disorders. Dermatol Clin 2018; 36:359-368. [PMID: 30201145 DOI: 10.1016/j.det.2018.05.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In addition to its "traditional" application for the early diagnosis of melanoma and nonmelanoma skin cancers, dermoscopy gains appreciation in fields beyond dermato-oncology. Nowadays, dermoscopy has been established as a reliable adjunctive tool to the everyday clinical practice of general dermatology. Morphology and distribution of vascular structures, background colors, follicular abnormalities, and the presence of scales are important features that should be evaluated. Clinical examination remains the undoubted mainstay of diagnosis in inflammatory and infectious diseases.
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Affiliation(s)
- Dimitrios Sgouros
- 2nd Department of Dermatology - Venereology, National Kapodistrian University of Athens, ATTIKON University Hospital, 1 Rimini Street, Chaidari, Athens 12462, Greece
| | - Zoe Apalla
- 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece
| | - Dimitrios Ioannides
- 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece
| | - Alexander Katoulis
- 2nd Department of Dermatology - Venereology, National Kapodistrian University of Athens, ATTIKON University Hospital, 1 Rimini Street, Chaidari, Athens 12462, Greece
| | - Dimitrios Rigopoulos
- 1st Department of Dermatology - Venereology, National Kapodistrian University of Athens, A. Syggros Hospital, 5 I.Dragoumi Street, Athens 16121, Greece
| | - Elena Sotiriou
- 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece
| | - Alexander Stratigos
- 1st Department of Dermatology - Venereology, National Kapodistrian University of Athens, A. Syggros Hospital, 5 I.Dragoumi Street, Athens 16121, Greece
| | - Efstratios Vakirlis
- 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece
| | - Aimilios Lallas
- 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece.
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20
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Alternative uses of dermoscopy in daily clinical practice: An update. J Am Acad Dermatol 2018; 79:1117-1132.e1. [PMID: 29920317 DOI: 10.1016/j.jaad.2018.06.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 05/30/2018] [Accepted: 06/11/2018] [Indexed: 01/06/2023]
Abstract
Dermoscopy is a noninvasive diagnostic tool that is currently being used for neoplastic skin lesions, several inflammatory and infectious diseases, and skin appendage disorders. As the clinical applications of dermoscopy beyond pigmented lesions are constantly increasing, the aim of this article is to provide an update on this topic. This comprehensive review substantiates how several diseases may show peculiar dermoscopy features so as to enhance the diagnosis and avoid (in selected cases) unnecessary histologic confirmation. In other cases, dermoscopy features may be shared with other conditions, with the advantage of narrowing down the differential diagnosis by ruling out those dermatoses with similar clinical aspect but different dermoscopic presentation.
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21
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Abstract
Tinea manuum is a dermatophytosis which is often mistaken for other keratodermas, especially palmar psoriasis and chronic hand eczema. We report the use of dermoscopy as a diagnostic aid in a case of tinea manuum. The dermoscopic clue turned out to be the presence of whitish scaling located mainly in the furrows. This aspect has never been seen in other keratodermas and therefore can be considered as a useful finding to assist in the recognition of tinea manuum.
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Affiliation(s)
- Enzo Errichetti
- Department of Experimental and Clinical Medicine, Institute of
Dermatology, University of Udine, Udine, Italy
| | - Giuseppe Stinco
- Department of Experimental and Clinical Medicine, Institute of
Dermatology, University of Udine, Udine, Italy
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22
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Furue K, Ito T, Tsuji G, Kadono T, Nakahara T, Furue M. Autoimmunity and autoimmune co-morbidities in psoriasis. Immunology 2018; 154:21-27. [PMID: 29315555 PMCID: PMC5904708 DOI: 10.1111/imm.12891] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 12/18/2017] [Accepted: 12/29/2017] [Indexed: 12/12/2022] Open
Abstract
Psoriasis is characterized by widespread scaly erythematous plaques that cause significant physical and psychological burdens for the affected individuals. Accelerated inflammation driven by the tumour necrosis factor-α/interleukin-23/interleukin-17 axis is now known to be the major mechanism in the development of psoriasis. In addition, psoriasis has an autoimmune nature that manifests as autoreactive T cells and is co-morbid with other autoimmune diseases, such as autoimmune bullous diseases, vitiligo, alopecia and thyroiditis. In this article, we review the recent topics on autoimmunity and autoimmune co-morbidities in psoriasis.
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Affiliation(s)
| | - Takamichi Ito
- Department of DermatologyKyushu UniversityFukuokaJapan
| | - Gaku Tsuji
- Department of DermatologyKyushu UniversityFukuokaJapan
| | - Takafumi Kadono
- Department of DermatologySt Marianna University School of MedicineKawasakiJapan
| | - Takeshi Nakahara
- Department of DermatologyKyushu UniversityFukuokaJapan
- Division of Skin Surface SensingDepartment of DermatologyKyushu UniversityFukuokaJapan
| | - Masutaka Furue
- Department of DermatologyKyushu UniversityFukuokaJapan
- Division of Skin Surface SensingDepartment of DermatologyKyushu UniversityFukuokaJapan
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23
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Namiki T, Hashimoto T, Hanafusa T, Miura K, Yokozeki H. Case of dermatomyositis with Gottron papules and mechanic's hand: Dermoscopic features. J Dermatol 2017; 45:e19-e20. [PMID: 28971518 DOI: 10.1111/1346-8138.14072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Takeshi Namiki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Hashimoto
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takaaki Hanafusa
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiko Miura
- Department of Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroo Yokozeki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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24
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Errichetti E, Pizzolitto S, Stinco G. Dermoscopy of Erythromelanosis Follicularis Faciei et Colli. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.ad.2017.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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25
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Errichetti E, Pizzolitto S, Stinco G. Dermoscopy of Erythromelanosis Follicularis Faciei et Colli. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.adengl.2017.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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26
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Errichetti E, Stinco G. Dermoscopy in differentiating palmar syphiloderm from palmar papular psoriasis. Int J STD AIDS 2017; 28:1461-1463. [PMID: 28617213 DOI: 10.1177/0956462417714178] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Palmar syphiloderm is one of the most common presentations of secondary syphilis and its recognition is of utmost importance in order to promptly identify such a disease and initiate appropriate workup/management. However, the differential diagnosis with palmar papular psoriasis often poses some difficulties, with consequent possible diagnostic errors/delays and prescription of improper therapies. In this report, we underline the role of dermoscopy as a supportive tool to facilitate the non-invasive recognition of palmar syphiloderm and its distinction from palmar papular psoriasis.
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Affiliation(s)
- Enzo Errichetti
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
| | - Giuseppe Stinco
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
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27
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Errichetti E, Stinco G. Dermoscopy in General Dermatology: A Practical Overview. Dermatol Ther (Heidelb) 2016; 6:471-507. [PMID: 27613297 PMCID: PMC5120630 DOI: 10.1007/s13555-016-0141-6] [Citation(s) in RCA: 180] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Indexed: 12/15/2022] Open
Abstract
Over the last few years, dermoscopy has been shown to be a useful tool in assisting the noninvasive diagnosis of various general dermatological disorders. In this article, we sought to provide an up-to-date practical overview on the use of dermoscopy in general dermatology by analysing the dermoscopic differential diagnosis of relatively common dermatological disorders grouped according to their clinical presentation, i.e. dermatoses presenting with erythematous-desquamative patches/plaques (plaque psoriasis, eczematous dermatitis, pityriasis rosea, mycosis fungoides and subacute cutaneous lupus erythematosus), papulosquamous/papulokeratotic dermatoses (lichen planus, pityriasis rosea, papulosquamous sarcoidosis, guttate psoriasis, pityriasis lichenoides chronica, classical pityriasis rubra pilaris, porokeratosis, lymphomatoid papulosis, papulosquamous chronic GVHD, parakeratosis variegata, Grover disease, Darier disease and BRAF-inhibitor-induced acantholytic dyskeratosis), facial inflammatory skin diseases (rosacea, seborrheic dermatitis, discoid lupus erythematosus, sarcoidosis, cutaneous leishmaniasis, lupus vulgaris, granuloma faciale and demodicidosis), acquired keratodermas (chronic hand eczema, palmar psoriasis, keratoderma due to mycosis fungoides, keratoderma resulting from pityriasis rubra pilaris, tinea manuum, palmar lichen planus and aquagenic palmar keratoderma), sclero-atrophic dermatoses (necrobiosis lipoidica, morphea and cutaneous lichen sclerosus), hypopigmented macular diseases (extragenital guttate lichen sclerosus, achromic pityriasis versicolor, guttate vitiligo, idiopathic guttate hypomelanosis, progressive macular hypomelanosis and postinflammatory hypopigmentations), hyperpigmented maculopapular diseases (pityriasis versicolor, lichen planus pigmentosus, Gougerot-Carteaud syndrome, Dowling-Degos disease, erythema ab igne, macular amyloidosis, lichen amyloidosus, friction melanosis, terra firma-forme dermatosis, urticaria pigmentosa and telangiectasia macularis eruptiva perstans), itchy papulonodular dermatoses (hypertrophic lichen planus, prurigo nodularis, nodular scabies and acquired perforating dermatosis), erythrodermas (due to psoriasis, atopic dermatitis, mycosis fungoides, pityriasis rubra pilaris and scabies), noninfectious balanitis (Zoon's plasma cell balanitis, psoriatic balanitis, seborrheic dermatitis and non-specific balanitis) and erythroplasia of Queyrat, inflammatory cicatricial alopecias (scalp discoid lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia and folliculitis decalvans), nonscarring alopecias (alopecia areata, trichotillomania, androgenetic alopecia and telogen effluvium) and scaling disorders of the scalp (tinea capitis, scalp psoriasis, seborrheic dermatitis and pityriasis amiantacea).
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Affiliation(s)
- Enzo Errichetti
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy.
| | - Giuseppe Stinco
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
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28
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Errichetti E, Stinco G. Dermoscopy: a useful tool for assisting the diagnosis of Pseudomonas folliculitis. An Bras Dermatol 2016; 91:835-836. [PMID: 28099614 PMCID: PMC5193203 DOI: 10.1590/abd1806-4841.20165382] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 03/08/2016] [Indexed: 11/21/2022] Open
Abstract
This report describes the usefulness of dermoscopy as a supportive diagnostic tool in a pseudomonas folliculitis case.
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29
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Errichetti E, Piccirillo A, Stinco G. Dermoscopy as an auxiliary tool in the differentiation of the main types of erythroderma due to dermatological disorders. Int J Dermatol 2016; 55:e616-e618. [DOI: 10.1111/ijd.13322] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 01/21/2016] [Accepted: 02/03/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Enzo Errichetti
- Department of Experimental and Clinical Medicine; Institute of Dermatology; University of Udine; Udine Italy
| | | | - Giuseppe Stinco
- Department of Experimental and Clinical Medicine; Institute of Dermatology; University of Udine; Udine Italy
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30
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Errichetti E, Maione V, Pegolo E, Stinco G. Dermoscopy: a useful auxiliary tool in the diagnosis of type 1 segmental Darier's disease. Dermatol Pract Concept 2016; 6:53-5. [PMID: 27222773 PMCID: PMC4866628 DOI: 10.5826/dpc.0602a10] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 03/12/2016] [Indexed: 10/31/2022] Open
Abstract
Type 1 segmental Darier's disease is a blaschkolinear variant of Darier's disease resulting from a postzygotic mosaicism. Since it usually lacks diagnostic clues typical of the generalized form, including positive family history of the disease, nail and mucosal abnormalities, and/or acral involvement, its distinction from other acquired inflammatory blaschkolinear dermatoses may often be quite challenging, thus requiring histopathological examination to reach a definitive diagnosis. We report a case of type 1 segmental Darier's disease with its dermoscopic findings in order to show the usefulness of dermoscopy in assisting the noninvasive identification of this condition.
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Affiliation(s)
- Enzo Errichetti
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Italy
| | - Vincenzo Maione
- Department of Dermatology, "Hôpital Saint Louis", Paris Diderot University, France
| | - Enrico Pegolo
- Department of Medical and Biological Sciences, Institute of Anatomic Pathology, University of Udine, Italy
| | - Giuseppe Stinco
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Italy
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31
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Errichetti E, De Francesco V, Pegolo E, Stinco G. Dermoscopy of Grover's disease: Variability according to histological subtype. J Dermatol 2016; 43:937-9. [PMID: 26892381 DOI: 10.1111/1346-8138.13298] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 12/15/2015] [Indexed: 11/30/2022]
Abstract
Distinguishing Grover's disease from other papular dermatoses is often a troublesome task. According to two relatively recent case reports, dermoscopy may be useful in assisting the diagnosis of such a disorder by showing a peculiar pattern. The aim of this study was to evaluate the dermoscopic features of Grover's disease in a larger series of patients and correlate dermoscopy with histopathological findings. Seven patients with histopathologically confirmed Grover's disease were included in the study, with three of them displaying a Darier-like histology and the remaining four cases having a spongiotic histological pattern. The results of our study suggest that Grover's disease may display different features according to the histological subtype, with a central star-shaped/branched polygonal/roundish-oval brownish area surrounded by a whitish halo being characteristic of the Darier-like histological subtype and whitish scales over a reddish-yellowish background being characteristic of the spongiotic histological subtype.
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Affiliation(s)
- Enzo Errichetti
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
| | - Vincenzo De Francesco
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
| | - Enrico Pegolo
- Department of Medical and Biological Sciences, Institute of Anatomic Pathology, University of Udine, Udine, Italy
| | - Giuseppe Stinco
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
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32
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Errichetti E, Stinco G. Dermoscopy as a supportive instrument in the differentiation of the main types of acquired keratoderma due to dermatological disorders. J Eur Acad Dermatol Venereol 2016; 30:e229-e231. [PMID: 26836980 DOI: 10.1111/jdv.13566] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E Errichetti
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
| | - G Stinco
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
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