Many articles on dermoscopy of bacterial, viral, and fungal dermatoses have been published over the last two decades, yet information is sparse and lacks an analytical approach. |
This systematic literature review summarizes published data on dermoscopy of bacterial, viral, and fungal dermatoses and provides a homogeneous terminology of reported dermoscopic features according to a standardized methodology. |
Introduction
Methods
Results
Dermatoses | Total number of studies | Total number of patients | Dermoscopic findings |
---|---|---|---|
Leprosy | 11 | 178 | |
Borderline tuberculoid (BT) | 4 | 63 | White areas, decreased density of hairs/paucity of appendageal structures, yellow dots and globules, decreased/absent white dots, branching vessels, structureless yellowish-orange areas, diminished/loss of pigment network, lack of blood vessels, and violaceous to erythematous background |
Tuberculoid (TL) | 2 | 6 | Central yellowish-white structureless areas, surrounding zone of erythema, linear branching vessels, broken pigmentary network, lesional loss of hair follicles and eccrine gland openings, and orange yellow areas |
Borderline lepromatous (BL) | 2 | 27 | Broken and loss of pigmentary network, linear chrysalis-like structures, relative paucity of appendages/hair follicles, focal areas of hyperpigmentation, and relative sparing of appendages |
Lepromatous (LL) | 5 | 35 | Yellowish-orange structureless areas, dilated branching/arborizing vessels, sparse appendages/diminished hair follicles with preserved eccrine ducts, diffuse yellow coloration/reddish-brown background, discrete brownish halo in the center, scarring nacreous center/whitish streaks, heteromorphic telangiectasias more concentrated peripherally, yellowish/orange-brown globules, patchy xerosis, shiny skin, white scaling, hypotrichosis, and accentuation of normal reticular pigment |
Type 1 reaction | 4 | 34 (10 with BT spectrum) | Scales (grayish-white, semi-adherent, triangular, and/or star shaped silvery white) prominent keratinous plugs, yellowish-orange/reddish-orange areas, vessels, diffuse erythematous background, sparse hair follicles, white globules, accentuation of normal skin markings, and violaceous to brown perifollicular and periappendageal pigmentation |
Type 2 reaction | 3 | 22 (12 with LL spectrum) | Blanching/increased erythema, vascular dilation/vessels, hyperpigmentation, scales, xerosis, and red dots + BL and LL dermoscopic features |
Histoid leprosy | 6 | 13 | Structureless white areas/shiny white area/crystalline lines/rosettes, rim of brownish hyperpigmentation, linear branching/crown/hairpin vessels, well circumscribed dome shaped yellowish brown nodules, yellowish-brown to pink background, orange yellow areas, scaling, and follicular plugs |
Syphilis | 6 | 6 | |
Condyloma lata | 1 | 1 | Red to milky red globules at periphery with glomerular vessels in the center, whitish-pink network on the raised border, and yellowish structureless areas at the periphery with multiple, white, small, round structures in the center |
Palmoplantar syphiloderm | 2 | 2 | Yellowish-red/orangish background, circular scaling edge progressing outward with erythematous halo, and vessels |
Penile annular syphiloderm | 2 | 2 | White scales, vessels (dotted, short linear, linear irregular, and/or hairpin), central clear area, and whitish/yellowish background |
Secondary syphilis | 1 | 1 | Scaling within furrows and peripheral scaling, relatively clear central area, central ill-defined paler area fading toward periphery, and orange color |
Lupus vulgaris | 4 | 40 | Orange-yellowish areas, vessels (linear branching, dotted, and/or linear), white reticular streaks, milia-like cysts/follicular plugs, white/yellow scales, pigmentation structures, yellowish-white/reddish globules, pinkish-red background, ulceration, white structureless areas, patulous follicles, and bluish hue |
Tuberculosis verrucosa cutis | 1 | 1 | Yellowish to reddish background, papillated surface, dirty white thick scales, yellow orange globular areas, and irregularly dilated vessels |
Lichen scrofulosorum | 2 | 2 | Follicular and perifollicular lesions, pale round monomorphic grouped perifollicular dots, central brown follicular plug/clod, marginal rim of white scales, halo of pallor/hyperpigmentation, and telangiectasias |
Mycobacterium marinum infection | 1 | 1 | Whitish areas with surrounding erythematous background, purplish background, multiple structured orangish rounded areas, fine scaling, and vessels (crown-shaped looped vessels, and/or dotted vessels) |
Peruvian wart | 1 | 1 | Vascular component, circular scale, and vascular component with central depression |
Staphylococcal scalded skin syndrome | 1 | 1 | Skin exfoliation still having an epidermis with less leachate |
Pitted keratolysis | 2 | 43 | Multiple pits having heterogeneous architecture/size/configuration, interrupted dermatoglyphic lines, “bead sign,” and white black or brown opaques |
Folliculitis | 2 | 56 | |
Common folliculitis | 1 | 55 | Central round pustule and peripheral sparse dotted vessels |
Pseudomonal folliculitis | 1 | 1 | Pinkish background, paler center, and central vellus hair |
Trichobacteriosis | 7 | 8 | Waxy and yellowish/yellowish-white/golden yellow adherent nodules and concretions along entire length of hair |
Warts | 30 | 819 | |
Genital warts | 12 | 221 | Exophytic papillary structures/irregular projection (finger-like, knob-like, mosaic, cerebriform, unspecific or mixed), peripheral white halo/white band, vessels (red dots, comma shaped, hairpin, dendritic, curved, annular, polymorphic, glomerular, looped, and/or mixed), pigmentation, keratosis, grayish dots, and blue–white structureless background |
Flat warts | 5 | 113 | Light brown/yellow/red/red–gray/whitish/pale background, vessels (dotted/globular/linear), comedo-like openings, presence of papillae/surrounding halo, and interrupted skin markings |
Palmoplantar warts | 12 | 346 | Waved hyperkeratosis, papilliform surface/frogspawn appearance, vessels (homogeneous black to red dots and globules, dotted vessel, linear, and/or coiled), brown/yellow/pink background, pigmented parallel ridge pattern, surrounding white halo interrupting skin dermatoglyphics (falooda seed appearance), yellow/yellow–grey structureless pattern, and hemorrhages/crusting |
Common warts | 6 | 139 | Exophytic keratotic projection (mosaic, finger-like, filiform, cone, knob, daisy flower pattern, or nonspecific), vessels (dotted, looped, coiled, linear, hairpin, and/or glomerular), shiny white/yellow/brown/pink background, hemorrhagic crust, keratosis, presence of papillae/surrounding halo, interrupted skin markings, and white halo surrounding vessels |
Molluscum contagiosum | 22 | 93 (278 lesions) | White–yellow/pearly-white/pinkish-white polyglobular/rounded/four-leaf clover-like shiny clods/amorphous structures/whitish discoid area (white target pattern) in the center, vessels (crown, red corona, hairpin, linear, fine, blurred, branching, punctiform, radial, serpentine, and/or mixed), orifice/central umbilicated core/depression, white shiny/white–yellow clods, smooth reddish and pink surface, and smooth shiny clods (swimming google appearance) |
Orf nodule | 6 | 6 (26 lesions) | Central crust/erosion/ulceration, white/yellow structureless area, white shiny/orange–yellow/grayish-white streaks, vessels (dotted, hairpin, comma, polymorphic, and/or glomerular), scaling (fine peripheral), blue–gray area, yellow–white globules, yellow–white/erythematous ring, erythema, black/brown/brown-grayish dot, red-brownish branched lines, milky red globules/red–pink clods in a linear arrangement on the white background, lacunas at the periphery and milky red globules in nonlinear arrangement surrounded by white network |
Milker’s nodule | 1 | 20 lesions | Blue–gray area, orange–yellow/grayish-white streaks, central yellow–white areas, crust, erosion–ulceration, yellow–white globules, yellow–white/erythematous ring, erythema, black dot, and vessels (dotted, comma, polymorphic, hairpin, glomerular, and/or milky-red globules) |
Sporotrichosis | 2 | 5 | Yellowish-orange areas, generalized erythema, ulceration/crusting, yellow tears, white scar-like areas/radiating white streams, clustered pustules at periphery, and unfocused linear/arborizing vessels |
Cutaneous blastomycosis | 2 | 2 | White to pink overlapping papillomatous structures, white and red structureless areas, blood spots, hemorrhagic crusting, scattered thin plates of scale, and polymorphous vessels (irregular, dotted, coiled, and/or serpentine) |
Tinea nigra | 16 | 33 | Homogeneous, superficial, nonmelanocytic fine, wispy, dark brown/gray–brown pigment with spicule forming filamentous/reticular pattern not following dermatoglyphic lines, brown to gray colored, fine dotted and granule like structure over amorphous dark brown pigmentation, and parallel ridge pattern |
White piedra | 5 | 18 | Creamy yellow/white nodules/concretion/ovular masses distributed along the hair shaft |
Tinea manuum | 3 | 12 | White scales mainly in palmar furrows, brownish scales showing dried vesicles, dotted vessels localized in the furrows, and intense erythema |
Tinea corporis | 6 | 74 | Diffuse erythema/erythematous background, scales (white/yellow/both, diffuse/patchy/central/peripheral/perifollicular, and moth-eaten), micropustules, multiple brown spots some with loss of vellus hair and surrounding white-yellowish halo, scaly broken, wavy hair, peeling with outward direction, vessels (globular/linear), and Morse code of vellus hair |
Tinea incognito | 5 | 55 | Erythematous background, vessels (nonspecific, linear, tortuous, and/or dotted), scaly, broken/bent/deformable weakened transparent hair showing unusual bends, comma, corkscrew, translucent hair/Morse code hair, micropustules, black dots surrounded by white-yellowish halo, scales (white, peripheral, and/or perifollicular) and crusts, tinea of vellus hair, reddish-brown hemorrhagic spots, and concentric areas of erythema separated by scales |
Tinea of vellus hair | 3 | 8 | Erythematous background, follicular pustules, empty follicles, yellow scales, black dots, broken, dystrophic, translucent, corkscrew, Morse code hair, white sheath around hair shaft, and scattered linear vessels |
Majocchi’s granuloma | 2 | 2 | Yellowish/orange/blue structureless areas, central yellowish crust, polymorphic vessels (serpentine, coiled, looped with bulbous endings, or clod vessels of different sizes), and hemorrhages |
Talaromyces marneffei infection | 3 | 3 (63 lesions) | Round or homogeneous whitish background with central keratin plug or hemorrhagic ulcer, molluscum like lesions, folliculitis/acne like lesions, xanthoma-like lesions, and vessels (radial, tufted, hairpin, and/or punctiform) |
Cutaneous cryptococcosis | 1 | 1 | White structureless area, vessels (linear irregular, branching, and/or serpentine), surrounding structureless yellowish halo, pinkish background, and white lines on the periphery |
Chromoblastomycosis | 6 | 6 | Yellow–orange ovoid structures, reddish black–brown dots, white net-like pattern, white and pink areas, scales, crust, and polymorphic vessels |
Mycetoma | 4 | 4 | Yellow/white/blue areas, yellow/brown–black, red/white globules, small black grains and surrounding white halo, white scales, vessels (polymorphic and dotted), and blood spots |
Pityriasis versicolor | 4 | 157 | Background of hypopigmented or hyperpigmented skin, scaling (mostly along furrows, or diffuse, patchy, and/or perifollicular), contrast halo sign, folliculocentricity, and hypopigmentation of hair |
Pityrosporum folliculitis | 2 | 67 | Folliculocentric papules and pustules with surrounding erythema, perilesional dirty white scaling, keratosis pilaris like features, hypopigmentation of hair shaft, and perilesional brownish discoloration in resolving lesions |