Dermoscopy in the Diagnosis of Cutaneous Leishmaniasis
Keywords:
dermoscopy, leishmaniasis, vascular, cutaneousAbstract
Background: Cutaneous leishmaniasis (CL) is a protozoan infectious disease. Dermoscopy is a noninvasive diagnostic tool that has been applied to several skin diseases, including infestations.
Objectives: To determine the dermoscopic patterns of CL lesions and to investigate whether a relationship exists between dermoscopic characteristics and the disease duration, localization, and type of CL lesions.
Methods: Seventy-nine patients (48 male, 31 female) from Hatay, Turkey, were enrolled in the study and a dermoscopic evaluation was performed on 139 lesions. Images of CL lesions were taken via polarized light contact dermoscopy. Chi-square and Fisher exact tests were used for statistical analyses and P values <0.05 were considered significant.
Results: Generalized erythema was seen in all CL lesions. Vascular structures (94.2%), yellow tears (75.5%), and a white starburst-like pattern (58.3%) were the other most common dermoscopic features. Hyperkeratosis (P = 0.001) and white starburst-like pattern (P < 0.001) were more prevalent in the extremities than elsewhere. Among vascular structures, linear irregular (45.8%), hairpin (43.5%), and comma-shaped (25.9%) patterns were the most common dermoscopic findings. Linear irregular (P = 0.023) and arborizing vessels (P = 0.001) were observed in the head-neck region. Dotted (P = 0.009), hairpin (P < 0.001), and glomerular-like (P = 0.016) morphological findings were more prevalent in the extremities. Statistical significances in disease duration were detected in microarborizing (P = 0.027) and arborizing (P = 0.004) vessels and were most prevalent with a disease duration of >6 months. Hairpin vessels were prevalent in the plaque and nodulo-ulcerative type of lesions. Dotted vessels were most commonly seen in the plaque type (47.4%) of lesions.
Conclusions: Generalized erythema, yellow tears, and starburst-like patterns, as well as linear irregular, hairpin, comma-shaped, and arborizing vessels, were the most commonly detected dermoscopic features of CL lesions. We suggest that the presence of these features can be helpful when diagnosing CL lesions by dermoscopy.
References
Uz OK, Balcıoğlu IC, Taylan Özkan A, Ozensoy S, Ozbel Y. Leishmaniasis in Turkey. Acta Trop. 2002;84(1):43-48.
WHO. Leishmaniasis in high-burden countries: an epidemiological update based on data reported in 2014. Wkly Epidemiol Rec. 2016;91(22):287-296.
Lallas A, Kyrgidis A, Tzellos TG, et al. Accuracy of dermoscopic criteria for the diagnosis of psoriasis, dermatitis, lichen planus and pityriasis rosea. Br J Dermatol. 2012;166(6):1198–1205.
Ayhan E, Ucmak D, Baykara SN, Akkurt ZM, Arica M. Clinical and dermoscopic evaluation of cutaneous leishmaniasis. Int J Dermatol. 2015;54(2):193–201.
Yücel A, Günasti S, Denli Y, Uzun S. Cutaneous leishmaniasis: new dermoscopic findings. Int J Dermatol. 2013;52(7):831–837.
Taheri AR, Pishgooei N, Maleki M, et al. Dermoscopic features of cutaneous leishmaniasis. Int J Dermatol. 2013;52(11):1361–1366.
Argenziano G, Zalaudek I, Corona R, et al. Vascular structures in skin tumors. Arch Dermatol. 2004;140(12):1485-1489.
Zalaudek I, Kreusch J, Giacomel J, Ferrara G, Catriacala C, Argenziano G. How to diagnose nonpigmented skin tumors: a review of vascular structures seen with dermoscopy, part I: melanocytic skin tumors. J Am Acad Dermatol. 2010;63(3):361-374.
Llambrich A, Zaballos P, Terrasa F, Torne I, Puig S, Malvehy L. Dermoscopy of cutaneous leishmaniasis. Br J Dermatol. 2009;160(4):756–761.
Errichetti E, Stinco G. Dermoscopy of granulomatous disorders. Dermatol Clin. 2018;36(4):369-375.
Piccolo V, Russo T, Agozzino M, et al. Dermoscopy of cutaneous lymphoproliferative disorders: where are we now? Dermatology. 2018;234(3-4):131-136.
Piccolo V, Mascolo M, Russo T, Staibano S, Argenziano G. Dermoscopy of primary cutaneous B-cell lymphoma (PCBCL). J Am Acad Dermatol. 2016;75(4):e137-e139.
Mascolo M, Piccolo V, Argenziano G, et al. Dermoscopy pattern, histopathology and immunophenotype of primary cutaneous B-cell lymphoma presenting as a solitary skin nodule. Dermatology. 2016;232(2):203-207.
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