Ankad Balachandra S, Gupta Akash, Nikam Balkrishna P, Smitha S V, Rangappa Manjula
Department of Dermatology, S. Nijalingappa Medical College, Bagalkot, Karnataka, India.
Department of Dermatology, Fellow of RGUHS, Cutis Academy of Cutaneous Sciences, Bengaluru, Karnataka, India.
Indian J Dermatol. 2022 Jan-Feb;67(1):5-11. doi: 10.4103/ijd.ijd_591_21.
Discoid lupus erythematosus (DLE) is chronic dermatosis manifests as scaly indurated plaques with erythema and peripheral hyperpigmentation. Few cases progress to systemic lupus erythematosus. Differentials include lichenoid photo dermatitis, Jessner's lymphocytic infilterate, and polymorphus light eruptions. It is difficult to assess the activity clinically. Histopathology is characteristic and evaluation of disease activity is possible. Dermoscopy is a useful diagnostic method in many dermatoses. Dermoscopy is reflection of histological changes. Hence, dermoscopic features may act as a tool for activity assessment. Here authors have pursued dermoscopic and histopathological correlation in DLE lesions to assess the activity of disease.
To study dermoscopic features in DLE and correlate the patterns with histopathological changes in skin of color.
This study was conducted in a tertiary hospital. Clinically suspected and histopathologically proven lesions of DLE were enrolled in this study. The target lesion was marked and sent for biopsy after performing dermoscopy. Activity of the lesion was assessed on the basis of histopathological features. SPSS statistics for windows v20.0 (SPSS Inc, Chicago, USA) was used to analyze data. Chi-square and Fisher's χ test was used to statistically signify association. Cohen's kappa coefficient was used to determine the agreement.
Study included 110 patients with Fitzpatrick skin type IV-V having 120 lesions. Follicular keratotic plug [73 (60.8%)] and peri-follicular whitish halo [65(54.1%)] were commonly found in dermoscopy. Blue-gray and brown dots, telangiectasia, follicular red dots, white rosettes and white areas include other features. Interface dermatitis, peri-appendageal infilterate, melanin incontinence, melanophages and fibrosis were noted in histopathology. Perfect agreement was observed in follicular plugs.
Dermoscopy patterns were well correlated with histopathological changes. Thus dermoscopy played an important role in assessing the activity of lesion.
盘状红斑狼疮（DLE）是一种慢性皮肤病，表现为带有红斑和周边色素沉着的鳞屑性硬结斑块。少数病例会进展为系统性红斑狼疮。鉴别诊断包括苔藓样光皮炎、杰斯纳淋巴细胞浸润症和多形性日光疹。临床评估疾病活动度较为困难。组织病理学具有特征性，且能够评估疾病活动度。皮肤镜检查是许多皮肤病有用的诊断方法。皮肤镜检查反映组织学变化。因此，皮肤镜特征可作为疾病活动度评估的工具。在此，作者对DLE皮损进行了皮肤镜和组织病理学相关性研究，以评估疾病活动度。
研究DLE的皮肤镜特征，并将其模式与有色人种皮肤的组织病理学变化相关联。
本研究在一家三级医院进行。临床上疑似且经组织病理学证实的DLE皮损纳入本研究。标记目标皮损，在进行皮肤镜检查后送检活检。根据组织病理学特征评估皮损的活动度。使用适用于Windows的SPSS统计软件v20.0（美国芝加哥SPSS公司）分析数据。采用卡方检验和费舍尔精确检验进行统计学关联分析。使用科恩kappa系数确定一致性。
研究纳入110例皮肤类型为IV - V型的患者，共120处皮损。皮肤镜检查常见毛囊角化性栓子[73处（60.8%）]和毛囊周围白色晕圈[65处（54.1%）]。蓝灰色和棕色小点、毛细血管扩张、毛囊红点、白色玫瑰花结和白色区域为其他特征。组织病理学可见界面性皮炎、附属器周围浸润、色素失禁、噬黑素细胞和纤维化。在毛囊栓子方面观察到完全一致。
皮肤镜模式与组织病理学变化具有良好的相关性。因此，皮肤镜在评估皮损活动度方面发挥了重要作用。
