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. 2019 Sep-Oct;64(5):341-345.
doi: 10.4103/ijd.IJD_123_18.

Role of Dermoscopy in the Diagnosis of Hypertrophic Lichen Planus and Prurigo Nodularis

Bangaru Hanumaiah  1 , Joice Maria Joseph  1
Affiliations

Role of Dermoscopy in the Diagnosis of Hypertrophic Lichen Planus and Prurigo Nodularis

Bangaru Hanumaiah et al. Indian J Dermatol. 2019 Sep-Oct.

Abstract

Background: A dermoscope is an office tool used in the diagnosis of various disorders. At present, studies on hypertrophic lichen planus (HLP) and prurigo nodularis (PN) are limited.

Aims and objectives: The aim of this study was to compare the dermoscopic features of HLP and PN and to determine the role of dermoscopy in the differential diagnosis of both the conditions.

Materials and methods: A cross-sectional study was undertaken. After clinical assessment and relevant investigations, dermoscopy was performed using DermLite DL3 dermoscope (×10) followed by histopathology. Dermoscopic findings in cases of HLP and PN were evaluated.

Results: Thirty patients each with HLP and PN were included in the study. On dermoscopy, peripheral striations were the most common findings in both the conditions. Statistically significant features on intergroup comparison included blue-gray globules (P<0.001), comedo-like openings (P<0.001), and follicular plugging (P<0.001) in HLP and pearly white areas with white starburst pattern (P=0.028), red dots and globules (P<0.001), glomerular vessels (P=0.003), crusting (P=0.002), and erosions (P<0.001) in PN.

Conclusion: Dermoscopy is useful in differentiating HLP and PN. Blue-gray globules, comedo-like openings, and follicular plugging were specific for HLP. Pearly white areas with white starburst pattern and red dots and globules were the specific findings in PN.

Keywords: Dermoscopy; hypertrophic lichen planus; prurigo nodularis.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Clinical picture of hypertrophic lichen planus showing hyperkeratotic plaques on legs
Figure 2
Figure 2
Clinical image of prurigo nodularis showing hyperkeratotic plaques and nodules with excoriations
Figure 3
Figure 3
(a) Histopathology of hypertrophic lichen planus showing hyperkeratosis, acanthosis, hypergranulosis, and basal cell damage confined to the tips of rete ridges. (b) Histopathology of prurigo nodularis showing orthokeratosis and hyperkeratosis, irregular acanthosis, elongated rete ridges, and vertically arranged collagen fibers in the dermis (H and E, ×40)
Figure 4
Figure 4
Dermoscopy of hypertrophic lichen planus showing peripheral striations (white arrows), brownish-black globules (circle)
Figure 5
Figure 5
Dermoscopy of hypertrophic lichen planus showing peripheral striations (white arrows), bluish-gray globules (circle), comedo-like openings (red arrow), and yellowish structures (rectangle)
Figure 6
Figure 6
Dermoscopy of prurigo nodularis showing white starburst pattern with peripheral striations (white arrows), pearly white areas (star), red dots and globules (circle), and scales (black arrows)
Figure 7
Figure 7
Dermoscopy of prurigo nodularis showing pearly white areas (star) with peripheral striations (black arrows), red dots and globules (rectangle), and scales (white arrows)
See this image and copyright information in PMC

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