Dermoscopic Features of Cutaneous Hypopigmented Lesions

Abstract Background Pigmentation disorders are rather common in dark skin. In India, 11% of patients presenting to the dermatology outpatient department in Western India have pigmentary disorders. Recently, dermoscopy has been involved as an important tool in the diagnosis of various dermatological diseases. Aim of the Work The aim of this study was to describe the Dermoscopic features of some hypopigmented skin disorders that may be clinically overlapping in order to facilitate differentiation between these skin disorders. Patients and Methods This Cross section descriptive study included 104 patients who complained of patchy or macular hypopigmented lesions. Results The most common dermoscopic features of progressive vitiligo were; Perifollicular hyperpigmentation, diffuse white glowing areas, white vellus and terminal hairs. The most common dermoscopic features of repigmenting vitiligo were; perifollicular pigmentation, marginal hyperpigmentation and interfollicular pigmentation. The most common dermoscopic features of stable vitiligo were; starburst appearance and altered pigmentation, marginal hyperpigmentation and perifollicular pigmentation. The most common dermoscopic features of idiopathic guttate hypomelanosis were; multiple, shiny and porceilin like macules, most of the lesions were well- defined (amoeboid pattern), few lesions were ill-defined with irregular cloudy whitish pattern (nebuloid pattern) and hyperpigmented networks were seen on the surrounding skin of some lesions giving the appearance of the cloudy-sky pattern. The most common Dermoscopic features of nevus depigmentosus were; hypopigmented patch with irregular and serrated borders, faint reticular network in some patches, borders showed pseudopods pattern protruding into the normal skin, the surrounding skin was scaly on some lesions and hair was pigmented with no peri-follicular hyperpigmentation. The most common dermoscopic features of pityriasis alba were; fairly demarcated hypopigmented macules, fine scales and hair inside patches of normal color. Conclusion Dermoscopy can aid in the diagnosis of hypopigmented skin disorders and can help in assessing the activity of vitiligo, however in sometimes the condition may be challenging and difficult to differentiate even by dermoscopy and in such cases histopathological examination may be helpful.