Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
J Cosmet Dermatol. 2022 Nov;21(11):6434-6440. doi: 10.1111/jocd.15332. Epub 2022 Sep 20.
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.
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.
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.
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).
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.
原发性皮肤淀粉样变（PCA）和炎症后色素沉着过度（PIH）是常见的皮肤色素沉着原因，通常通过临床诊断。然而，它们的表现有时并不典型，而且难以区分。皮肤镜检查是一种用于色素性疾病的有价值的诊断工具，可能有助于诊断。
描述 PCA 和 PIH 的特征性皮肤镜特征，并结合组织病理学相关性，以非侵入性方式对这两种疾病进行区分。
纳入了 52 名 PCA（n=26）和 PIH（n=26）患者。进行了详细的病史、皮肤检查、使用手持和视频皮肤镜进行的皮肤镜检查以及组织病理学评估。
PCA 和 PIH 在疾病持续时间（p=0.027）、对称性（p=0.044）、波纹状（p<0.001）和背部受累（p=0.048）方面存在统计学显著差异。在皮肤镜检查中，中央结节在 PCA 组中更为常见（p<0.001），且具有不同的周边色素沉着模式。组织病理学上，PCA 组每高倍视野的黑素细胞数量明显更高（p=0.013）。
本研究结果表明，皮肤镜检查作为一种非侵入性诊断工具，在区分可疑的 PCA 和 PIH 病例方面具有潜力。
