1
|
Alorainy M, Buchanan K, Nussinow T, Rabinowitz JB, Cyr P, Seiverling EV. A Systematic Review of Diagnoses with Rosettes Under Dermoscopy. Dermatol Pract Concept 2024; 14:dpc.1402a125. [PMID: 38810026 PMCID: PMC11135967 DOI: 10.5826/dpc.1402a125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION Rosettes are a cluster of shiny white dots in the shape of a four-leaf clover seen under polarized dermoscopic light. Historically, rosettes were primarily reported in actinic keratoses and squamous cell carcinoma. However, rosettes have also been reported in other conditions. OBJECTIVES The objective of this systematic review to elucidate the breadth of diagnoses exhibiting this unique dermoscopic phenomenon. METHODS A review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Literature searches were performed in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science, as well as a manual search of the reference lists of screened articles. RESULTS A total of 73 articles met the inclusion criteria. Out of these, 47 distinct diagnoses with rosette were identified. Among neoplastic conditions, keratinizing neoplasms had the highest number of articles reported (N = 19). Discoid lupus was the most commonly reported diagnosis within the inflammatory category (N = 6). Molluscum contagiosum was the predominant diagnosis among infectious entities (N = 3), while acroangiodermatitis was the sole diagnosis reported in the vascular category (N = 1). CONCLUSIONS These findings confirm rosettes are not specific to keratinocytic growths and are observed in a wide range of conditions. Knowledge of the breadth of conditions with rosettes may aid clinicians when developing a differential diagnosis of a growth or an eruption with rosettes under dermoscopy.
Collapse
Affiliation(s)
- May Alorainy
- Tufts University School of Medicine, Department of Dermatology, Boston, Massachusetts, USA
| | - Kendall Buchanan
- Medical College of Georgia at Augusta University, Department of Dermatology, Augusta, Georgia, USA
| | - Tyler Nussinow
- University of New England College of Osteopathic Medicine, Biddeford, Maine, USA
| | - Judy B. Rabinowitz
- Hirsh Health Science Library, Tufts University, Boston, Massachusetts, USA
| | - Peggy Cyr
- Maine Medical Center, Department of Family Medicine, Boston, Massachusetts, USA
- Tufts University School of Medicine, Department of Family Medicine, Boston, Massachusetts, USA
| | | |
Collapse
|
2
|
Batra J, Gulati S, Sarangal R, Chopra D, Puri S, Kaur R. Utility of Dermoscopy in the Diagnosis of Erythroderma: A Cross-Sectional Study. Indian Dermatol Online J 2023; 14:821-828. [PMID: 38099018 PMCID: PMC10718095 DOI: 10.4103/idoj.idoj_678_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/05/2023] [Accepted: 06/17/2023] [Indexed: 12/17/2023] Open
Abstract
Background It is difficult to diagnose the underlying cause of erythroderma on mere clinical presentation. The role of dermoscopy in diagnosing erythroderma secondary to various etiologies is evolving. Aim and Objectives This study aimed to observe the dermoscopic features of erythroderma secondary to different cutaneous disorders and compare them with clinical features and histopathology. Materials and Methods Twenty-nine consecutive patients of erythroderma were enrolled in the study. Dermoscopy was performed on every case using a Heine Delta II Dermatoscope with 10x magnification in polarized mode. A histopathological examination was conducted to confirm the diagnosis. Results Eight patients were diagnosed with psoriasis, five with endogenous eczema, four with pityriasis rubra pilaris (PRP), three with pustular psoriasis, two with drug rash secondary to antitubercular therapy, two with dermatophytic infection, one patient each of atopic dermatitis, crusted scabies, pemphigus foliaceous, drug reaction with eosinophilia and systemic symptoms, and mycosis fungoides. Characteristic dermoscopic features were observed in erythroderma due to psoriasis, PRP, pustular psoriasis, endogenous eczema, scabies, and dermatophytosis. Differentiation of other disorders based on dermoscopy alone was difficult, and clinico-histopathological correlation was crucial to reach a diagnosis. Conclusion Dermoscopic features of classical patterns of skin disorders are preserved even in the corresponding erythrodermic or unstable stage. Dermoscopic features of erythroderma secondary to psoriasis, pustular psoriasis, PRP, endogenous eczema, scabies, and dermatophytosis are clearly differentiating, whereas the dermoscopic features in other causes of erythroderma are overlapping. Thus, dermoscopy can be a good screening tool in the clinical assessment of erythroderma.
Collapse
Affiliation(s)
- Jayati Batra
- Government Medical College, Patiala, Punjab, India
| | | | | | | | - Sulabh Puri
- Government Medical College, Patiala, Punjab, India
| | - Ravneet Kaur
- Government Medical College, Patiala, Punjab, India
| |
Collapse
|
3
|
Żychowska M, Kołt-Kamińska M, Kijowski R, Reich A. Hailey-Hailey disease exacerbated by scabies: the role of dermatoscopy in preventing misdiagnosis. Postepy Dermatol Alergol 2023; 40:567-570. [PMID: 37692273 PMCID: PMC10485762 DOI: 10.5114/ada.2023.130477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/26/2023] [Indexed: 09/12/2023] Open
Affiliation(s)
- Magdalena Żychowska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszow, Poland
| | - Marta Kołt-Kamińska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszow, Poland
| | - Robert Kijowski
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszow, Poland
| | - Adam Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszow, Poland
| |
Collapse
|
4
|
Bazzacco G, Conforti C, Toffoli L, Zelin E, Zalaudek I, di Meo N. Dermoscopic Features of Herpes Zoster: Case Series and Review of the Literature. Dermatol Pract Concept 2023; 13:e2023149. [PMID: 37557161 PMCID: PMC10412062 DOI: 10.5826/dpc.1303a149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2023] [Indexed: 08/11/2023] Open
Affiliation(s)
- Giulia Bazzacco
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Claudio Conforti
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Ludovica Toffoli
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Enrico Zelin
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Iris Zalaudek
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Nicola di Meo
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, Trieste, Italy
| |
Collapse
|
5
|
Maronese CA, Errichetti E, Avallone G, Beretta A, Marzano AV. Dermoscopy as a supportive diagnostic tool in human monkeypox. J Eur Acad Dermatol Venereol 2023; 37:e412-e414. [PMID: 36152029 DOI: 10.1111/jdv.18597] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/13/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Carlo A Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Enzo Errichetti
- Department of Medicine, Institute of Dermatology, University of Udine, Udine, Italy
| | - Gianluca Avallone
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.,Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
| | - Andrea Beretta
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Angelo V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
6
|
Ramos-Rodríguez D, Mercader-Salvans J, Algarra-Sahuquillo J, Aleman-Valls MR, Pestana-Eliche MM, Hernandez-Leon N. Dermoscopy of monkeypox: Histopathology and clinical correlation. J Eur Acad Dermatol Venereol 2023; 37:e312-e313. [PMID: 36153690 DOI: 10.1111/jdv.18596] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/13/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Daniel Ramos-Rodríguez
- Dermatology Department, University Hospital of Canary Islands, San Cristóbal de La Laguna, Spain
| | - Julia Mercader-Salvans
- Dermatology Department, University Hospital of Canary Islands, San Cristóbal de La Laguna, Spain
| | - Judit Algarra-Sahuquillo
- Dermatology Department, University Hospital of Canary Islands, San Cristóbal de La Laguna, Spain
| | | | - Maria M Pestana-Eliche
- Dermatology Department, University Hospital of Canary Islands, San Cristóbal de La Laguna, Spain
| | - Nieves Hernandez-Leon
- Pathology Department, University Hospital of Canary Islands, San Cristóbal de La Laguna, Spain
| |
Collapse
|
7
|
Proietti I, Santoro PE, Skroza N, Tieghi T, Bernardini N, Tolino E, Dybala AE, Di Guardo A, Rallo A, Di Fraia M, Rossi MF, Vitiello M, Moscato U, Pellacani G, Lichtner M, Potenza C. A Case Report of Monkeypox in an Adult Patient from Italy: Clinical and Dermoscopic Manifestations, Diagnosis and Management. Vaccines (Basel) 2022; 10:1903. [PMID: 36366410 PMCID: PMC9694441 DOI: 10.3390/vaccines10111903] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/27/2022] [Accepted: 11/07/2022] [Indexed: 01/16/2024] Open
Abstract
Monkeypox infection is an emerging problem and a new challenge for modern medicine. With an increasing number of new cases worldwide, new data regarding the clinical manifestations, characteristics of the patients, risk factors and treatment options are coming to light. Knowing more about the disease will allow to elaborate new helpful methods to facilitate its diagnosis. Special attention should be paid to the careful dermatologic and dermoscopic examination of the patient. The analysis of available data also suggests possible strategies for the prevention of Monkeypox virus spread; the vaccine against Smallpox seems to be an effective solution. This case report describes the diagnostic approach and management of a non-vaccinated adult patient with several risk factors and a history of sexually transmitted disease. The patient had no history of travel abroad. Even though a clinical diagnose of Monkeypox can be challenging due to its similarities with skin rashes caused by other Orthopoxviral infections, there are fine differences between the rashes which can be helpful in their differentiation, although laboratory analysis is required for a definitive identification. A careful study of the characteristics of the rash, such as diameter, its presence on palms and soles and its evolution in time, provided important clues for the diagnosis of Monkeypox infection. The lack of vaccinations in the history of the patient was another crucial finding in the diagnostic process.
Collapse
Affiliation(s)
- Ilaria Proietti
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Paolo Emilio Santoro
- Department of Health Science and Public Health, Catholic University of the Sacred Heart, 00168 Roma, Italy
| | - Nevena Skroza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Tiziana Tieghi
- Department of Neurosciences Public Health and Organs of Sense, Infectious Diseases Unit, Sapienza University of Rome, Santa Maria Goretti Hospital, 04100 Latina, Italy
| | - Nicoletta Bernardini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Ersilia Tolino
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Agnieszka Ewa Dybala
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Antonio Di Guardo
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Alessandra Rallo
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Marco Di Fraia
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Maria Francesca Rossi
- Department of Health Science and Public Health, Catholic University of the Sacred Heart, 00168 Roma, Italy
| | - Martina Vitiello
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Umberto Moscato
- Department of Health Science and Public Health, Catholic University of the Sacred Heart, 00168 Roma, Italy
| | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Miriam Lichtner
- Department of Neurosciences Public Health and Organs of Sense, Infectious Diseases Unit, Sapienza University of Rome, Santa Maria Goretti Hospital, 04100 Latina, Italy
| | - Concetta Potenza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| |
Collapse
|
8
|
Ankad BS, Koti VR, Lallas A. Dermoscopic Differentiation of Blister Beetle Dermatitis and Herpes Zoster: an Observational Study. Dermatol Pract Concept 2022; 12:e2022180. [PMID: 36534553 PMCID: PMC9681307 DOI: 10.5826/dpc.1204a180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2022] [Indexed: 06/17/2023] Open
Abstract
INTRODUCTION Blister beetle dermatitis (BBD) and herpes zoster (HZ) manifest suddenly with vesicular lesions mimicking each other and progress rapidly. But a lack of definite differentiating criteria yearns the need for better investigating modality. Though histopathology persuades the need, is an invasive procedure, commonly deferred. Thus, dermoscopy, a non-invasive rapid diagnostic tool, can help in differentiating. OBJECTIVES To evaluate different dermoscopic patterns of BBD and HZ to differentiate both and to study dermoscopic features in early and late stages of lesions. METHODS An observational cross-section study conducted in southern India. Nine patients with clinical features suggestive of BBD and HZ were recruited. Lesions were divided arbitrarily into early and late. Dermoscopic examination was performed with handheld dermoscope. Diagnosis was confirmed by skin biopsy and Tzanck smear wherever necessary. Statistical analysis performed using data in terms of frequencies and percentages. RESULTS Dermoscopy of early BBD lesions showed multiple discrete and confluent yellowish-white structures, brown dots, roundish white globules, gray structures, 'targetoid pattern', brown areas over intense reddish pink background. Late BBD lesions revealed pinkish-white area, reduced gray structures and, dotted and globular vessels. Early HZ lesions showed poly-lobular gray and brown globules, bright pink background, gray globules covered by grayish veil-like structure with gray rim. Late HZ lesions revealed 'solar eclipse' pattern and 'crumpled fabric' patterns. The dermoscopic findings correlated with histopathology. CONCLUSIONS Dermoscopic patterns show peculiar features consistently pertaining to BBD and HZ, thus help in early diagnosis assisting in accurate treatment in both conditions.
Collapse
Affiliation(s)
- Balachandra Suryakant Ankad
- Department of Dermatology, S. Nijalingappa Medical College, Near APMC, Navanagar, Bagalkot, Karnataka, India
| | - Varsha R. Koti
- Department of Dermatology, S. Nijalingappa Medical College, Near APMC, Navanagar, Bagalkot, Karnataka, India
| | - Aimilios Lallas
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| |
Collapse
|
9
|
Tsang DA, Tang PY, Oh CC. Dermatoscopic features of acute granulomatous ulceronecrotic herpes zoster of the face. JAAD Case Rep 2022; 25:107-110. [PMID: 35799685 PMCID: PMC9253830 DOI: 10.1016/j.jdcr.2022.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Denise A Tsang
- Department of Dermatology, Singapore General Hospital, Singapore
| | - Po Y Tang
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Choon C Oh
- Department of Dermatology, Singapore General Hospital, Singapore
| |
Collapse
|