Dermoscopy in General Dermatology

Aimilios Lallas, Enzo Errichetti, Dimitrios Ioannides, Aimilios Lallas, Enzo Errichetti, Dimitrios Ioannides

• Publisher: CRC Press
• Year: 2018
• Print ISBN: 9780367341343
• eBook ISBN: 9781351782883
• Edition: 1
• Topic: Medicine
• Subtopic: Dermatology

This lavishly illustrated guide from experts will enable practitioners to get the most out of dermoscopy for investigations and treatments in general dermatology.

Part IInflammatory Diseases

1Papulosquamous disorders

Aimilios Lallas and Enzo Errichetti

1.1Psoriasis

1.1.1Introduction

Psoriasis is a common, chronic, and recurrent inflammatory disease characterized by heritability, phenotypic variability, and possible association to psoriatic arthritis and metabolic syndrome. Psoriasis is considered as a hyperproliferative disorder, but this increased proliferation of keratinocytes is the result of a cascade of immunologic reactions driven by inflammatory mediator cells and cytokines.1–3

1.1.2Clinical presentation

Psoriasis is typified by the presence of well-­demarcated, scaly erythematous plaques of various sizes, typically covered by adherent silvery scales (Figure 1.1). The most frequent sites of involvement are the scalp, elbows, and knees, followed by lower back, buttocks, nails, umbilical region, trunk, palms, and soles. However, psoriatic lesions might develop on any body site. The severity of manifestations varies from very few small plaques to involvement of the largest part of the skin (erythroderma).1–3 The main clinical types of psoriasis are the following:

Figure 1.1The typical psoriatic lesion: demarcated erythematous plaque with stuck-on white-silvery scales.

1.1.2.1Plaque Psoriasis

Plaque psoriasis, also known as psoriasis vulgaris, is the most frequent clinical variant of the disease, typified by lesions as described earlier. Initially, the psoriatic lesions appear as red scaling papules that grow and coalesce to form round-oval plaques covered by thick silvery scales (Figure 1.2). The intensity of hyperkeratosis depends on the anatomic body site, being heavy on the scalp or palms and soles and absent in intertriginous areas (Figure 1.3). The scales are typically adherent in the center and looser at the periphery. When removed, small bleeding points appear (Auspitz sign). The most frequent anatomic sites of involvement have been mentioned previously. Psoriatic lesions may also develop on sites of physical trauma (Koebner’s phenomenon). In general, the disease is asymptomatic. However, pruritus might be present in a considerable proportion of patients.1–3

Figure 1.2Psoriatic lesions often coalesce to form larger plaques.

Figure 1.3Palmar psoriatic lesion characterized by intense hyperkeratosis (A). Psoriatic lesion on the intergluteal fold lacks hyperkeratosis (B).

1.1.2.2Guttate Psoriasis

Guttate psoriasis is characterized by the acute onset of multiple small, red, scaly papules, often following an acute infection, such as streptococcal pharyngitis (Figure 1.4). Guttate psoriasis might represent the first manifestation of psoriasis or may occur as an acute exacerbation of preexisting plaque psoriasis.1–3

Figure 1.4Guttate psoriasis is typified by small papules/plaques of recent onset located mainly on the trunk.

1.1.2.3Inverse Psoriasis...

Table of contents

• Cover
• Half Title Page
• Dedication
• Title Page
• Copyright Page
• Contents
• Preface
• Contributors
• Introduction
• Part IInflammatory Diseases
• Part IIInfiltrative Diseases
• Part IIIInfectious Diseases
• Part IVHair and Nail Diseases
• Part VSkin of Color
• Appendix I: Differential diagnosis of erythematosquamous macules/papules on the trunk and/or extremities
• Appendix II: Differential diagnosis of erythematous macules/plaques on the face
• Appendix III: Differential diagnosis of palmar/plantar keratoderma
• Appendix IV: Differential diagnosis of sclero- atrophic patches on the trunk and/or extremities
• Appendix V: Differential diagnosis of hyperpigmented macules/papules on the trunk and/or extremities
• Appendix VI: Differential diagnosis of hypopigmented macules on the trunk and/or extremities
• Appendix VII: Differential diagnosis of itchy papules/nodules on the trunk and/or extremities
• Appendix VIII: Differential diagnosis of inflammatory papules along Blaschko’s lines
• Appendix IX: Differential diagnosis of purpuric macules/patches
• Appendix X: Differential diagnosis of nonscarring alopecia
• Appendix XI: Differential diagnosis of scarring alopecia
• Appendix XII: Differential diagnosis of hair casts
• Appendix XIII: Differential diagnosis of onycholysis
• Appendix XIV: Differential diagnosis of pitting of the nail plate
• Index