Dermoscopy in Leprosy: A Clinical and Histopathological Correlation Study

Background: Leprosy, an insidious infectious granulomatous disease, is diagnosed traditionally through clinical examination coupled with skin smears and histopathology. It has myriad clinical presentations that pose diagnostic challenges. Lately, dermoscopy has emerged as a rapid, noninvasive diagn...

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Autores principales:	Alpana Mohta, Suresh Kumar Jain, Aditi Agrawal, Ramesh Kumar Kushwaha, Pritee Sharma, Khusbhoo Sethia, Manish Jain
Formato:	article
Lenguaje:	EN
Publicado:	Mattioli1885 2021
Materias:	leprosy dermoscopy histopathology clofazimine-induced pigmentation Dermatology RL1-803
Acceso en línea:	https://doaj.org/article/939a3c8d40f24060a16dfc9e658a7652
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spelling	oai:doaj.org-article:939a3c8d40f24060a16dfc9e658a76522021-11-17T08:27:59ZDermoscopy in Leprosy: A Clinical and Histopathological Correlation Study10.5826/dpc.1102a322160-9381https://doaj.org/article/939a3c8d40f24060a16dfc9e658a76522021-04-01T00:00:00Zhttp://dpcj.org/index.php/dpc/article/view/1511https://doaj.org/toc/2160-9381 Background: Leprosy, an insidious infectious granulomatous disease, is diagnosed traditionally through clinical examination coupled with skin smears and histopathology. It has myriad clinical presentations that pose diagnostic challenges. Lately, dermoscopy has emerged as a rapid, noninvasive diagnostic modality for many dermatoses. Objectives: We evaluated the dermoscopic findings of various manifestations of leprosy and correlated them with clinical and histopathological features. Methods: This prospective, cross-sectional study was conducted in our skin outpatient department for a period of 1 year. Patients newly diagnosed as having leprosy or those undergoing leprosy treatment for less than 6 months were included. The most representative lesion was dermoscopically evaluated and later biopsied. Results: We included 73 patients in the study. Results indicated an obvious correlation between dermoscopic findings and histopathology. We noted orangish yellow and white structureless areas, steadily throughout the spectrum, depicting dermal granuloma. Additionally, we observed focal vascular structures such as branching, linear, and crown vessels that result from the pressure of granuloma pushing the dilated vessels upwards. The relative absence of skin appendages aided in differentiating leprosy from other granulomatous disorders. Novel findings of our study were the detection of a branch-like pattern of clofazimine-induced pigmentation on dermoscopy and orange globules on onychoscopy. Other unique findings included violaceous structureless areas, characteristic large telangiectatic vessels, follicular plugging, star-shaped silvery-white scaling, and white globules in type 1 reaction; white shiny steaks were observed in patients with borderline lepromatous leprosy, and central white dots and keratotic plugs were observed in patients with histoid leprosy. Conclusions: Dermoscopy, as a noninvasive modality, could aid in the quick diagnosis of leprosy and should be used as a handy tool to complement other investigative tools for this disease. Alpana MohtaSuresh Kumar JainAditi AgrawalRamesh Kumar KushwahaPritee SharmaKhusbhoo SethiaManish JainMattioli1885articleleprosydermoscopyhistopathologyclofazimine-induced pigmentationDermatologyRL1-803ENDermatology Practical & Conceptual, Vol 11, Iss 2 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	leprosy dermoscopy histopathology clofazimine-induced pigmentation Dermatology RL1-803
spellingShingle	leprosy dermoscopy histopathology clofazimine-induced pigmentation Dermatology RL1-803 Alpana Mohta Suresh Kumar Jain Aditi Agrawal Ramesh Kumar Kushwaha Pritee Sharma Khusbhoo Sethia Manish Jain Dermoscopy in Leprosy: A Clinical and Histopathological Correlation Study
description	Background: Leprosy, an insidious infectious granulomatous disease, is diagnosed traditionally through clinical examination coupled with skin smears and histopathology. It has myriad clinical presentations that pose diagnostic challenges. Lately, dermoscopy has emerged as a rapid, noninvasive diagnostic modality for many dermatoses. Objectives: We evaluated the dermoscopic findings of various manifestations of leprosy and correlated them with clinical and histopathological features. Methods: This prospective, cross-sectional study was conducted in our skin outpatient department for a period of 1 year. Patients newly diagnosed as having leprosy or those undergoing leprosy treatment for less than 6 months were included. The most representative lesion was dermoscopically evaluated and later biopsied. Results: We included 73 patients in the study. Results indicated an obvious correlation between dermoscopic findings and histopathology. We noted orangish yellow and white structureless areas, steadily throughout the spectrum, depicting dermal granuloma. Additionally, we observed focal vascular structures such as branching, linear, and crown vessels that result from the pressure of granuloma pushing the dilated vessels upwards. The relative absence of skin appendages aided in differentiating leprosy from other granulomatous disorders. Novel findings of our study were the detection of a branch-like pattern of clofazimine-induced pigmentation on dermoscopy and orange globules on onychoscopy. Other unique findings included violaceous structureless areas, characteristic large telangiectatic vessels, follicular plugging, star-shaped silvery-white scaling, and white globules in type 1 reaction; white shiny steaks were observed in patients with borderline lepromatous leprosy, and central white dots and keratotic plugs were observed in patients with histoid leprosy. Conclusions: Dermoscopy, as a noninvasive modality, could aid in the quick diagnosis of leprosy and should be used as a handy tool to complement other investigative tools for this disease.
format	article
author	Alpana Mohta Suresh Kumar Jain Aditi Agrawal Ramesh Kumar Kushwaha Pritee Sharma Khusbhoo Sethia Manish Jain
author_facet	Alpana Mohta Suresh Kumar Jain Aditi Agrawal Ramesh Kumar Kushwaha Pritee Sharma Khusbhoo Sethia Manish Jain
author_sort	Alpana Mohta
title	Dermoscopy in Leprosy: A Clinical and Histopathological Correlation Study
title_short	Dermoscopy in Leprosy: A Clinical and Histopathological Correlation Study
title_full	Dermoscopy in Leprosy: A Clinical and Histopathological Correlation Study
title_fullStr	Dermoscopy in Leprosy: A Clinical and Histopathological Correlation Study
title_full_unstemmed	Dermoscopy in Leprosy: A Clinical and Histopathological Correlation Study
title_sort	dermoscopy in leprosy: a clinical and histopathological correlation study
publisher	Mattioli1885
publishDate	2021
url	https://doaj.org/article/939a3c8d40f24060a16dfc9e658a7652
work_keys_str_mv	AT alpanamohta dermoscopyinleprosyaclinicalandhistopathologicalcorrelationstudy AT sureshkumarjain dermoscopyinleprosyaclinicalandhistopathologicalcorrelationstudy AT aditiagrawal dermoscopyinleprosyaclinicalandhistopathologicalcorrelationstudy AT rameshkumarkushwaha dermoscopyinleprosyaclinicalandhistopathologicalcorrelationstudy AT priteesharma dermoscopyinleprosyaclinicalandhistopathologicalcorrelationstudy AT khusbhoosethia dermoscopyinleprosyaclinicalandhistopathologicalcorrelationstudy AT manishjain dermoscopyinleprosyaclinicalandhistopathologicalcorrelationstudy
_version_	1718425811041648640

Dermoscopy in Leprosy: A Clinical and Histopathological Correlation Study

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