Conventional and Polarized Dermoscopy Features of Dermatofibroma

Journal of Medical Case Reports

Background: The usual stereotypical dermoscopic pattern associated with dermatofibromas is a pigment network and central white patch. However, this pattern may be difficult to diagnose in some variant cases. We aimed to describe dermoscopic patterns of dermatofibroma according to its histopathological subtypes, with special emphasis on new and rare dermoscopic features. Methods: This prospective study, which was conducted between September 2015 and May 2016 in the

Journal of the American Academy of Dermatology, 2005

Journal of the European Academy of Dermatology and Venereology : JEADV, 2015

Dermatology literature lacks a study investigating both histopathological and dermatoscopic features of dermatofibroma. To analyse histopathological, dermatoscopic and digital microscopic features of dermatofibromas. Two hundred dermatofibromas and 190 patients were included and retrospectively evaluated. Nine histopathological and ten dermatoscopic patterns were used to classify the lesions. We identified four different types of dermatofibroma in digital microscopy. The mean age of the patients was 42.18 ± 13.72 years. Dermatofibroma was more common in females (67%) and the male to female ratio was 1 : 1.97. The most common location was leg (41%). The most frequent histopathological variant was fibrocollagenous type (49%). Grenz zone was the most common histopathological finding (89%). The most frequent digital microscopic type was type 1 (63%). We found that palisading variant displayed only pattern 6 in dermatoscopy and cellular variant showed type 3 significantly in digital micr...

BMC Dermatology, 2012

Dermoscopy is a useful, widely used tool for examining pigmented lesions, especially helpful in cases of an uncertain nature. Nevertheless, doctors may experience diagnostic difficulties while using this method. An example of this may be found in the examination of subcorneal hematoma, dark nevi with black lamella or lesions of acral volar skin. In such cases, a few diagnostic tricks have proven to be helpful in achieving diagnostic accuracy. This paper reviews various methods of performing dermoscopy, suggesting a number of simple, yet helpful tests. These include the adhesive tape test, the skin scraping test and the ink furrow test. The adhesive tape test is helpful in differentiating between dark melanocytic nevi and melanoma. Hematoma may be more easily differentiated with the use of the so-called skin scraping test. The confirmation of benign and melanocytic lesions of acral volar skin, on the other hand, is more accurate when using the ink furrow test. These methods have been discussed here based upon a series of literature reviews, the authors' own experience and, also, iconography. The present article describes novel methods used in dermoscopy, helping to bring about a faster, more accurate diagnostics of those lesions which have proven to be more difficult to recognize. Helpful tricks, such as have been known to professional literature, as well as the authors' own experience (for instance, applying urea cream to hyperkeratotic lesions or using photographs of skin lesions taken with the aid of a mobile phone cameraall prior to surgery) will surely be considered beneficial to the practitioner, be it dermatologist or any other physician.

Journal of Pakistan Association of Dermatology, 2018

Objective To describe predominant dermoscopic patterns in common pigmented skin lesions in skin of colour. Methods It was an observational study carried out at department of dermatology unit-II, Mayo Hospital Lahore. A total of 44 patients (12 males, 32 females) with common pigmented skin lesions were enrolled and interviewed. Their clinical pictures were taken with iPhone 6 & clinical differentials or diagnosis was formulated by three examiners via mutual agreement. Dermoscopic pictures were taken at the same time with Firefly DE350® using both optical and digital magnification. Predominant patterns were described keeping in mind the internationally accepted terminology and criteria. Results Common pigmented skin lesions included seborrheic keratosis (SK), solar lentigo, freckles, blue nevi, melanocytic nevi, dysplastic nevi etc. Melanocytic nevi had pigmented network, aggregated or peripheral globules and various types of pigment. Predominant pattern of SKs was milia like cysts an...

Background: There is a need for better standardization of the dermoscopic terminology in assessing pigmented skin lesions.

Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2016

Dermatofibromas are benign fibrohistiocytic tumors that involve the dermis. They have often a polymorphous clinical aspect, being frequently confused with other lesions varying from vascular tumors to melanoma. An important tool in diagnosis is represented by dermoscopy, which facilitates the recognition of dermatofibromas' characteristic structures such as central white patch and peripheral pigment network. Although dermatofibromas are often solitary lesions, we report the case of a woman who presented two fibrohistiocytary masses, involving the calf and the thigh, the last one with an atypical aspect leading to the confusion with a malignant tumor. Furthermore, the lesions were different at both dermoscopic and histopathological examinations, needing a second histopathological opinion. The aim of our study is to emphasize the role of histopathology, which represents the diagnostic golden standard in suspicious cases and the possible connections between dermatoscopy and histolo...

JAMA dermatology, 2016

Both colors and structures are considered important in the dermoscopic evaluation of skin lesions but their relative significance is unknown. To determine if diagnostic accuracy for common skin lesions differs between gray-scale and color dermoscopic images. A convenience sample of 40 skin lesions (8 nevi, 8 seborrheic keratoses, 7 basal cell carcinomas, 7 melanomas, 4 hemangiomas, 4 dermatofibromas, 2 squamous cell carcinomas [SCCs]) was selected and shown to attendees of a dermoscopy course (2014 Memorial Sloan Kettering Cancer Center dermoscopy course). Twenty lesions were shown only once, either in gray-scale (n = 10) or color (n = 10) (nonpaired). Twenty lesions were shown twice, once in gray-scale (n = 20) and once in color (n = 20) (paired). Participants provided their diagnosis and confidence level for each of the 60 images. Of the 261 attendees, 158 participated (60.5%) in the study. Most were attending physicians (n = 76 [48.1%]). Most participants were practicing or train...

Clinics in Dermatology, 2002

Background Epiluminescence microscopy (ELM) (dermoscopy, dermatoscopy) is a technique for non-invasive diagnosis of pigmented skin lesions that improves the diagnostic performance of dermatologists. Little is known about the possible influence of associated clinical features on the reliability of dermoscopic diagnosis during in vivo examination. Objective To compare diagnostic performance of in vivo dermoscopy (combined clinical and dermoscopic examination) with that of dermoscopy performed on photographic slides (pure dermoscopy). Design This case series comprised 256 pigmented skin lesions consecutively identified as suspicious or equivocal during examination in a general dermatological clinic. Clinical examination and in vivo dermos-copy were performed before excision by two trained dermatologists. The same observers carried out dermoscopy on photographic slides at a later time, and these three diagnostic classifications were reviewed together with the histological findings for the individual lesions. This was carried out in a university hospital. Results In vivo dermoscopy performed better than dermoscopy on photographic slides for classification of pigmented skin lesions compared with histological diagnosis, and both performed better than general clinical diagnosis. In vivo dermoscopic diagnosis of melanoma showed 98.1% sensitivity, 95.5% specificity and 96.1% diagnostic accuracy while dermoscopic diagnosis of melanoma on photographic slides was less reliable with 81.5% sensitivity, 86.7% specificity and 85.2% diagnostic accuracy. In particular, diagnosis of melanoma based on photographic slides led to nine false negative cases (three in situ , six invasive; thickness ranges 0.2–1.5 mm). Conclusions In vivo dermoscopy, i.e. combined clinical and dermoscopic examination, is more reliable than dermoscopy on photographic slides. In clinical practice, therefore, in vivo dermoscopy cannot be considered independent from associated clinical characteristics of the lesions, which help the trained observer to reach a more precise classification. This may have implications on the reliability of ELM diagnosis made by an observer not fully trained in the clinical diagnosis of pigmented skin lesions or by a remote observer during digital ELM teleconsultation.

Journal of pharmaceutical research international, 2022

This work was carried out in collaboration among all authors. Author SBK, SB and HBA were involved in conception of idea and study design. Author EE did data collection and performed bench work. HBA performed the statistical analysis. Authors HM and HS managed the literature searches. All authors read and approved the final manuscript.

Dermatologic Surgery, 2008

Objective: To evaluate whether the differences in colors and structures observed in dermoscopic images from non-polarized dermoscopes (NPD) and polarized dermoscopes (PD) can impact physicians' diagnostic ability and their confidence levels. Participants: 100 dermatologists who attended a one-day course on the fundamental of dermoscopy course at Memorial Sloan-Kettering Cancer Center. Design: Twenty five pigmented lesions were chosen, which consisted of 7 seborrheic keratoses, 3 basal cell carcinomas, 2 atypical nevi, 5 melanomas, 3 dermatofibromas, 3 blue nevi and 2 hemangiomas. Two images of each lesion (one NPD and one PD) for a total of 50 lesions were included in the image presentation. Participants were not informed of the study design and were not told that they would be viewing the same lesions under 2 different imaging modalities. Statistical analysis examining the participants' responses was performed using the McNemar's test and Paired t test. Main Outcome Measures: The main outcomes included the assessment of the diagnostic accuracy and confidence level for clinicians viewing lesions via NPD and PD. Results: Ninty-one participants completed the study. Statistically significant differences in the diagnoses were observed in the seborrheic keratosis, atypical nevus and melanoma groups. For seborrehic keratosis, 75% and 59% of the final participants correctly diagnosed SK when presented with the NPD and PD images, respectively. For atypical nevi, 19% and 33% had the correct diagnoses when presented with NPD and PD images, respectively. For melanomas, 23% and 34% had correct diagnoses with the NPD and PD images, respectively. For the categories of seborrehic keratosis and atypical nevus, participants were statistically more confident in their diagnoses when presented with the NPD images than with the PD images. For the category of basal cell carcinoma, participants were more confident in their diagnosis when viewing the PD images compared to the NPD images. Conclusion: There are observed differences between NPD and PD in term of the color and structure visualized. In some cases, physicians diagnostic accuracy and confidence are affected by the differences seen with the different dermoscopes. NPD and PD appears to provide different but complementary information.

ISRN Dermatology, 2013

Four types of facial pigmented skin lesions (FPSLs) constitute diagnostic challenge to dermatologists; early seborrheic keratosis (SK), pigmented actinic keratosis (AK), lentigo maligna (LM), and solar lentigo (SL). A retrospective analysis of dermoscopic images of histopathologically diagnosed clinically-challenging 64 flat FPSLs was conducted to establish the dermoscopic findings corresponding to each of SK, pigmented AK, LM, and SL. Four main dermoscopic features were evaluated: sharp demarcation, pigment pattern, follicular/epidermal pattern, and vascular pattern. In SK, the most specific dermoscopic features are follicular/epidermal pattern (cerebriform pattern; 100% of lesions, milia-like cysts; 50%, and comedo-like openings; 37.50%), and sharp demarcation (54.17%). AK and LM showed a composite characteristic pattern named "strawberry pattern" in 41.18% and 25% of lesions respectively, characterized by a background erythema and red pseudo-network, associated with prominent follicular openings surrounded by a white halo. However, in LM "strawberry pattern" is widely covered by psewdonetwork (87.5%), homogenous structureless pigmentation (75%) and other vascular patterns. In SL, structureless homogenous pigmentation was recognized in all lesions (100%). From the above mentioned data, we developed an algorithm to guide in dermoscopic features of FPSLs.