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Dermoscopy aids in differentiating primary cutaneous amyloidosis and post inflammatory hyperpigmentation: A clinico-dermoscopic-histopathological study

J Cosmet Dermatol. 2022 Aug 26. doi: 10.1111/jocd.15332. Online ahead of print.

ABSTRACT

BACKGROUND: Primary cutaneous amyloidosis (PCA) and post-inflammatory hyperpigmentation (PIH) are common causes of cutaneous hyperpigmentation that are usually diagnosed clinically. However, their presentations are sometimes atypical, and their differentiation is difficult. Dermoscopy is a valuable diagnostic tool for pigmented diseases that might aid in their diagnosis.

OBJECTIVE: To describe the characteristic dermoscopic features of PCA and PIH together with histopathological correlation, and to differentiate between these conditions in a non-invasive way.

METHODS: Fifty-two patients with PCA (n=26) and PIH (n=26) were enrolled. A detailed history, skin examination, dermoscopic examination using handheld and video dermoscopy, and histopathological evaluation were performed.

RESULTS: A statistically significant difference could be detected between PCA and PIH in terms of the duration of the disease (p = 0.027), symmetry (p = 0.044), rippling (p <0.001) and back affection (p = 0.048). On dermoscopic examination, central hubs were seen more in the PCA group (p<0.001) with different patterns of peripheral pigmentation. Histopathologically, the number of melanophages per high-power field was significantly higher in the PCA group (p = 0.013).

CONCLUSION: The results of this study shed the light on the potential of dermoscopy as a non-invasive diagnostic tool in differentiating between doubtful cases of PCA and PIH.

PMID:36017750 | DOI:10.1111/jocd.15332

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