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Dermoscopic findings in scalp psoriasis and seborrheic dermatitis; two new signs; signet ring vessel and hidden hair.

Kibar M, Aktan Ş, Bilgin M - Indian J Dermatol (2015 Jan-Feb)

Bottom Line: Trichoscopic examinations were performed using a videodermatoscope (MoleMax 3(®)).Trichoscopic findings of scalp psoriasis and seborrheic dermatitis were compared with each other, with 100 healthy individuals and with other noncicatricial alopecias including female androgenetic alopecia (FAGA) (n: 138), male androgenetic alopecia (n: 63), FAGA of male pattern (FAGA.M) (n: 5), alopecia areata (39), TE (n: 22) and trichotillomania (n: 4).In comparison with previous reports, our study yielded two new trichoscopic structures supporting the diagnosis of psoriasis; HH and SRV.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Muş Bulanık Government Hospital, Muş, Turkey.

ABSTRACT

Background: Psoriasis and seborrheic dermatitis are both chronic erythemato-squamous dermatoses that can involve the scalp. It may be difficult to differentiate these two diseases when there is isolated scalp involvement. Recently, trichoscopy is commonly used to differentiate noncicatricial alopecias including psoriasis and seborrheic dermatitis that can lead to telogen effluvium (TE).

Objectives: The objective of this study is to evaluate the trichoscopic figures that may help to differentiate scalp psoriasis and seborrheic dermatitis.

Materials and methods: Thirty one with scalp psoriasis and 112 patients with seborrheic dermatitis were enrolled. Trichoscopic examinations were performed using a videodermatoscope (MoleMax 3(®)). Trichoscopic findings of scalp psoriasis and seborrheic dermatitis were compared with each other, with 100 healthy individuals and with other noncicatricial alopecias including female androgenetic alopecia (FAGA) (n: 138), male androgenetic alopecia (n: 63), FAGA of male pattern (FAGA.M) (n: 5), alopecia areata (39), TE (n: 22) and trichotillomania (n: 4).

Results: Atypical red vessels, red dots and globules (RDG), signet ring vessels (SRV), structureless red areas and hidden hairs (HH) were statistically more common in psoriasis while twisted red loops and comma vessels (CV) in seborrheic dermatitis. RDG were considered as the characteristic videodermatoscopic figure for psoriasis and arborizing red lines and CV for seborrheic dermatitis. In comparison with previous reports, our study yielded two new trichoscopic structures supporting the diagnosis of psoriasis; HH and SRV. Besides, according to our study, CV were described for the first time in seborrheic dermatitis and considered to be specific for seborrheic dermatitis.

Conclusion: This study confirmed that trichoscopy might be useful in differentiating scalp psoriasis and seborrheic dermatitis from each other and from other noncicatricial alopecia with three trichoscopic structures as HH, SRV and CV.

No MeSH data available.


Related in: MedlinePlus

Signet ring vessels in black circles in two different patients with psoriasis in lesional scalps having active diseases (×100 magnification)
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Figure 1: Signet ring vessels in black circles in two different patients with psoriasis in lesional scalps having active diseases (×100 magnification)

Mentions: This trichoscopic figure was described for the first time as a trichoscopic finding in our study[89] [Figure 1]. It is known that the earliest changes in dermal histopathologic findings in psoriasis can be non-specific and is followed by the development of dilated and slightly tortuous blood vessels within dermal papillae. This SRV sign is thought to be the result of these vascular alterations in psoriasis and seborrheic dermatitis.[1234] This signet ring shape is thought to be formed by a slightly tortuous glomerular vessel and its elongated and dilated annular ring shaped vessel. This vascular sign was not observed in other alopecias so this sign was considered as a specific sign for these dermatoses when compared with other alopecias (n: 271) and healthy individuals (n: 100). Besides when psoriasis and seborrheic dermatitis was compared SRV sign was detected to be more common in psoriasis (P < 0.05).


Dermoscopic findings in scalp psoriasis and seborrheic dermatitis; two new signs; signet ring vessel and hidden hair.

Kibar M, Aktan Ş, Bilgin M - Indian J Dermatol (2015 Jan-Feb)

Signet ring vessels in black circles in two different patients with psoriasis in lesional scalps having active diseases (×100 magnification)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318061&req=5

Figure 1: Signet ring vessels in black circles in two different patients with psoriasis in lesional scalps having active diseases (×100 magnification)
Mentions: This trichoscopic figure was described for the first time as a trichoscopic finding in our study[89] [Figure 1]. It is known that the earliest changes in dermal histopathologic findings in psoriasis can be non-specific and is followed by the development of dilated and slightly tortuous blood vessels within dermal papillae. This SRV sign is thought to be the result of these vascular alterations in psoriasis and seborrheic dermatitis.[1234] This signet ring shape is thought to be formed by a slightly tortuous glomerular vessel and its elongated and dilated annular ring shaped vessel. This vascular sign was not observed in other alopecias so this sign was considered as a specific sign for these dermatoses when compared with other alopecias (n: 271) and healthy individuals (n: 100). Besides when psoriasis and seborrheic dermatitis was compared SRV sign was detected to be more common in psoriasis (P < 0.05).

Bottom Line: Trichoscopic examinations were performed using a videodermatoscope (MoleMax 3(®)).Trichoscopic findings of scalp psoriasis and seborrheic dermatitis were compared with each other, with 100 healthy individuals and with other noncicatricial alopecias including female androgenetic alopecia (FAGA) (n: 138), male androgenetic alopecia (n: 63), FAGA of male pattern (FAGA.M) (n: 5), alopecia areata (39), TE (n: 22) and trichotillomania (n: 4).In comparison with previous reports, our study yielded two new trichoscopic structures supporting the diagnosis of psoriasis; HH and SRV.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Muş Bulanık Government Hospital, Muş, Turkey.

ABSTRACT

Background: Psoriasis and seborrheic dermatitis are both chronic erythemato-squamous dermatoses that can involve the scalp. It may be difficult to differentiate these two diseases when there is isolated scalp involvement. Recently, trichoscopy is commonly used to differentiate noncicatricial alopecias including psoriasis and seborrheic dermatitis that can lead to telogen effluvium (TE).

Objectives: The objective of this study is to evaluate the trichoscopic figures that may help to differentiate scalp psoriasis and seborrheic dermatitis.

Materials and methods: Thirty one with scalp psoriasis and 112 patients with seborrheic dermatitis were enrolled. Trichoscopic examinations were performed using a videodermatoscope (MoleMax 3(®)). Trichoscopic findings of scalp psoriasis and seborrheic dermatitis were compared with each other, with 100 healthy individuals and with other noncicatricial alopecias including female androgenetic alopecia (FAGA) (n: 138), male androgenetic alopecia (n: 63), FAGA of male pattern (FAGA.M) (n: 5), alopecia areata (39), TE (n: 22) and trichotillomania (n: 4).

Results: Atypical red vessels, red dots and globules (RDG), signet ring vessels (SRV), structureless red areas and hidden hairs (HH) were statistically more common in psoriasis while twisted red loops and comma vessels (CV) in seborrheic dermatitis. RDG were considered as the characteristic videodermatoscopic figure for psoriasis and arborizing red lines and CV for seborrheic dermatitis. In comparison with previous reports, our study yielded two new trichoscopic structures supporting the diagnosis of psoriasis; HH and SRV. Besides, according to our study, CV were described for the first time in seborrheic dermatitis and considered to be specific for seborrheic dermatitis.

Conclusion: This study confirmed that trichoscopy might be useful in differentiating scalp psoriasis and seborrheic dermatitis from each other and from other noncicatricial alopecia with three trichoscopic structures as HH, SRV and CV.

No MeSH data available.


Related in: MedlinePlus