Dermatoscopy of Cutaneous Granulomatous Disorders

Abstract

Cutaneous granulomatous disorders represent diseases with underlying granulomas on histology and are broadly divided into infectious and noninfectious disorders. Although histology is sine qua non in diagnosis of granulomatous disorders, lately dermoscopy has come up as a useful tool assisting in diagnosis of granulomatous disorder. Dermoscopy of granulomatous disorder is characterized by localized or diffuse, structureless yellowish-orange areas, along with vessels. Dermoscopic features of granulomatous disorders can be overlapping among various disorders, but detailed accurate assessment of various findings and their pattern may be useful in differentiating among them. In addition to this, peculiar dermatoscopic findings seen can also prove useful in distinguishing between various disorders. Hereby, we discuss dermatoscopic findings of various granulomatous disorders.

Keywords: Cutaneous granulomatous disorders; dermoscopy; granulomatous disorder.

Figure 1

Dermoscopy of sarcoidosis showing transculent yellowish-orange structureless areas (black star) with well-focussed vessles (blue box). Scar-like depigmentation is also seen (black arrow). [In set: Clinical image]

Figure 2

Well-focused, sharp network shaped, and serpentine vessels over a yellowish-orange background (black star). [In set: Clinical image]

Figure 3

Dermoscopy of granuloma annulare showing pale-white structureless areas all along the annulus (black stars). [In set: Clinical image]

Figure 4

Dermoscopy of annular elastolytic giant cell granuloma showing diffuse yellowish orange structureless areas (black star) in the periphery with vessels over a pinkish background more prominent in the center. Pigmentation structures and shiny white lines (black arrow) also appreciated. [In set: Clinical image]

Figure 5

Dermoscopy of rheumatoid nodule displaying a subtle, diffuse dull orange structureless area. [In set: Clinical image]

Figure 6

Vascular polygons (black arrow) over a yellowish-orange background (black star) seen in dermoscopy of granulomatous rosacea. [In set: Clinical image]

Figure 7

Dermoscopy of lupus milaris disseminates faciei shows perifollicular structureless yellowish-orange areas (black star), with follicular keratotic plugs (black boxes), perifollicular scales, and vessels (black arrow). [In set: Clinical image]

Figure 8

Dermoscopy of granulomatous cheilitis showing yellow-white structureless areas (black star), white structureless area (red star), and linear (blue arrow) and dotted (red arrow) vessels. [In set: Clinical image]

Figure 9

Dermoscopy of borderline tuberculoid leprosy showing yellow-white structureless areas (black stars). Note the conspicuous scarcity of eccrine openings and empty hair follicles (black arrow). [In set: Clinical image]

Figure 10

Dermoscopy of borderline lepromatous leprosy showing yellow-white structureless areas (black stars), widened skin furrows (blue arrow), and distorted pigment network (black arrow). [In set: Clinical image]

Figure 11

Dermoscopy of lupus vulgaris showing yellow-orange structureless areas (black stars), white structureless areas (blue stars) and white scales (red arrow) on a pink structureless background. [In set: Clinical image]

Figure 12

Dermoscopy of cutaneous leishmaniasis showing generalized erythema, polymorphic vessels (black arrows), and yellow to white tear drops (black circle). Erosions, crusts, and scaling can also be appreciated. [In set: Clinical image]

Figure 13

Dermoscopy of chromoblastomycosis showing yellow-orange globules (black arrows), reddish-black dots (black circles) over pink and white areas, and yellowish white scales. [In set: Clinical image]

Figure 14

Dermoscopy of sporotrichosis showing diffuse erythema, yellowish-orangish areas (blue stars), yellow tears (black circle), white fibrotic areas (black star), scales, and unfocussed vessels (black arrow). [In set: Clinical image]

Figure 15

Dermoscopy of mycetoma showing a central serosanguineous crust (yellow star) surrounded by white halo (blue arrow) indicative a discharging sinus, yellow-orange structureless areas (black stars) on a pinkish background. [In set: Clinical image]

Figure 16

Dermoscopy of xanthogranuloma showing yellow-orange and yellow-white structureless areas (black stars) with linear marginal vessels extending towards but without crossing the center (blue arrows). [In set: Clinical image]

Figure 17

Dermoscopy of nevus lipomatosus cutaneous superficialis showing a global lobulated aspect of the lesion with cerebriform surface, yellow-white structureless areas (black stars) and comedo-like structures (black arrow). [In set: Clinical image]

Figure 18

Dermoscopy of nevus sebaceous (verrucous plaque lesion) showing bright yellow-white structureless areas and papillary excrescences (blue arrow) indicative of overlying epidermal hyperplasia. [In set: Clinical image]

Figure 19

Dermoscopy of benign sebaceous hyperplasia showing multiple yellow-white globules with central umbilications (black arrows) and linear and branching vessels (red arrows). [In set: Clinical image]