Department of Dermatology, Andrology and STDs, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Indian J Dermatol Venereol Leprol. 2022 May-Jun;88(3):360-366. doi: 10.25259/IJDVL_207_19.
Discoid lupus erythematosus (DLE) affects mainly the head and neck and lesions heal with scaring. Early diagnosis of DLE is crucial; dermoscopy may enable early diagnosis and help to assess the prognosis of well-established lesions.
To describe the dermoscopic features of DLE and to correlate them with the histological findings, site and duration of DLE.
This study included 28 patients diagnosed as DLE based on clinical and histopathological examination. We examined the lesions clinically, dermoscopically and histopathologically. Evaluated dermoscopic variables were based on data in the available literature and on our observations.
Whitish scales (89.3%), arborizing blood vessels (85.7%), follicular plugging (82.1%), and pigmentation (82.1%) were the commonest dermoscopic findings. Radial arrangement of arborizing blood vessel in between a radially arranged perifollicular whitish halo (starburst pattern) (39.3%) was noticed for the first time in this study. Rosettes (57.1%) were also seen. There was significant agreement between many dermoscopic and pathological findings with high sensitivity and specificity of many dermoscopic variants in the diagnosis of DLE. Follicular plugging, perifollicular whitish halo, starburst pattern, follicular red dots and rosettes were detected in early stages of the disease but structureless whitish areas and telangiectasia need more time to develop.
We examined our patients at the time of presentation only without prospective monitoring and we had a relatively small sample size.
Dermoscopy helps in the diagnosis of DLE at different body sites.
盘状红斑狼疮（DLE）主要影响头颈部，病变愈合后会留下瘢痕。早期诊断 DLE 至关重要；皮肤镜检查可实现早期诊断，并有助于评估已确立病变的预后。
描述 DLE 的皮肤镜特征，并将其与组织病理学发现、DLE 的部位和病程相关联。
本研究纳入了 28 例基于临床和组织病理学检查诊断为 DLE 的患者。我们对病变进行了临床、皮肤镜和组织病理学检查。评估的皮肤镜变量基于现有文献中的数据和我们的观察结果。
最常见的皮肤镜表现为白色鳞屑（89.3%）、树枝状血管（85.7%）、毳毛栓塞（82.1%）和色素沉着（82.1%）。首次在本研究中观察到放射状排列的树枝状血管之间呈放射状排列的毳毛周围白色晕环（星爆模式）（39.3%）。也观察到玫瑰花结（57.1%）。许多皮肤镜和组织病理学发现之间存在显著一致性，许多皮肤镜特征在 DLE 的诊断中具有高敏感性和特异性。毳毛栓塞、毳毛周围白色晕环、星爆模式、毛囊红色斑点和玫瑰花结在疾病的早期阶段即可被发现，但无结构的白色区域和毛细血管扩张需要更长的时间才能发展。
我们仅在患者就诊时检查，没有进行前瞻性监测，且样本量相对较小。
皮肤镜有助于诊断不同部位的 DLE。
