Comparison of Dermoscopic Findings of Chronic Hand Eczema and Palmoplantar Psoriasis: A Cross-sectional Study

Introduction: Differentiation between Chronic Hand Eczema (CHE) and Palmoplantar Psoriasis (PP) is a diagnostic challenge. Dermoscopy can help to distinguish between the two conditions. Aim: To establish and compare the dermoscopic findings of the CHE and PP using DermLite DL4 dermoscope and to...

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Main Authors: Shilpitha Srinivas, Karjigi Siddalingappa, Kallappa C Herakal, Srinivasa K Murthy
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2022-10-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://www.jcdr.net/articles/PDF/17084/55493_CE(AD)_F(KR)_PF1(SC_SHU)_PFA(SS)_PB(SC_SS)_PN(SS).pdf
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author Shilpitha Srinivas
Karjigi Siddalingappa
Kallappa C Herakal
Srinivasa K Murthy
author_facet Shilpitha Srinivas
Karjigi Siddalingappa
Kallappa C Herakal
Srinivasa K Murthy
author_sort Shilpitha Srinivas
collection DOAJ
description Introduction: Differentiation between Chronic Hand Eczema (CHE) and Palmoplantar Psoriasis (PP) is a diagnostic challenge. Dermoscopy can help to distinguish between the two conditions. Aim: To establish and compare the dermoscopic findings of the CHE and PP using DermLite DL4 dermoscope and to confirm the accuracy of the dermoscopic findings with the histopathological findings. Materials and Methods: A cross-sectional study was conducted at Navodaya Medical College, Hospital and Research Centre, Raichur, Karnataka, India, from January 2017 to June 2018. Fifty patients each of CHE (26 male and 24 female subjects) and PP (25 male and 25 female subjects) were included in the study. A detailed clinical history, cutaneous clinical and dermoscopic findings of each case were noted. A 4 mm punch biopsy was taken from 30 patients for histopathological analysis. The data was tabulated, analysed and tested for significance using the Chi-square test. Results: The mean age of the patients was 46±4 years. On dermoscopic examination, diffuse white scales in 45 (90%) patients, over a red background in 49 (98%) patients with regularly arranged dots and globules in 45 (90%) patients was seen in PP. Patchy yellow scales 46 (90%), yellow dots, globules and yellow to brown crusts against a yellow background was seen in all patients (100%) of CHE (p-value <0.001). Histopathological findings are in agreement with dermoscopic findings in 9/16 and 10/14 cases of CHE and PP respectively. Conclusion: Dermoscope is a useful non invasive clinical aid to differentiate between CHE and PP. The presence of diffuse white scales over a red background and regularly arranged vessels indicates PP, whereas the presence of patchily distributed yellow scales, yellow dots and globules; and yellow to brown crusts against a yellow background is more suggestive of CHE.
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spelling doaj.art-96f36432b577494db95d17e26bd248bb2023-01-19T06:01:36ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-10-011610WC01WC0610.7860/JCDR/2022/55493.17084Comparison of Dermoscopic Findings of Chronic Hand Eczema and Palmoplantar Psoriasis: A Cross-sectional StudyShilpitha Srinivas0Karjigi Siddalingappa1 Kallappa C Herakal2Srinivasa K Murthy3Consultant Dermatologist, Department of Dermatology, Venereology and Leprosy, Skin and Cosmetology Centre, Bengaluru, Karnataka, India.Professor, Department of Dermatology, Venereology and Leprosy, Navodaya Medical College Hospital and Research Centre, Raichur, Karnataka, India.Professor and Head, Department of Dermatology, Venereology and Leprosy, Navodaya Medical College Hospital and Research Centre, Raichur, Karnataka, India. Consultant Dermatologist, Department of Dermatology, Venereology and Leprosy, Skin and Cosmetology Centre, Bengaluru, Karnataka, India.Introduction: Differentiation between Chronic Hand Eczema (CHE) and Palmoplantar Psoriasis (PP) is a diagnostic challenge. Dermoscopy can help to distinguish between the two conditions. Aim: To establish and compare the dermoscopic findings of the CHE and PP using DermLite DL4 dermoscope and to confirm the accuracy of the dermoscopic findings with the histopathological findings. Materials and Methods: A cross-sectional study was conducted at Navodaya Medical College, Hospital and Research Centre, Raichur, Karnataka, India, from January 2017 to June 2018. Fifty patients each of CHE (26 male and 24 female subjects) and PP (25 male and 25 female subjects) were included in the study. A detailed clinical history, cutaneous clinical and dermoscopic findings of each case were noted. A 4 mm punch biopsy was taken from 30 patients for histopathological analysis. The data was tabulated, analysed and tested for significance using the Chi-square test. Results: The mean age of the patients was 46±4 years. On dermoscopic examination, diffuse white scales in 45 (90%) patients, over a red background in 49 (98%) patients with regularly arranged dots and globules in 45 (90%) patients was seen in PP. Patchy yellow scales 46 (90%), yellow dots, globules and yellow to brown crusts against a yellow background was seen in all patients (100%) of CHE (p-value <0.001). Histopathological findings are in agreement with dermoscopic findings in 9/16 and 10/14 cases of CHE and PP respectively. Conclusion: Dermoscope is a useful non invasive clinical aid to differentiate between CHE and PP. The presence of diffuse white scales over a red background and regularly arranged vessels indicates PP, whereas the presence of patchily distributed yellow scales, yellow dots and globules; and yellow to brown crusts against a yellow background is more suggestive of CHE.https://www.jcdr.net/articles/PDF/17084/55493_CE(AD)_F(KR)_PF1(SC_SHU)_PFA(SS)_PB(SC_SS)_PN(SS).pdfbrown crustsdiffuse white scalesglobulespalmssoles
spellingShingle Shilpitha Srinivas
Karjigi Siddalingappa
Kallappa C Herakal
Srinivasa K Murthy
Comparison of Dermoscopic Findings of Chronic Hand Eczema and Palmoplantar Psoriasis: A Cross-sectional Study
Journal of Clinical and Diagnostic Research
brown crusts
diffuse white scales
globules
palms
soles
title Comparison of Dermoscopic Findings of Chronic Hand Eczema and Palmoplantar Psoriasis: A Cross-sectional Study
title_full Comparison of Dermoscopic Findings of Chronic Hand Eczema and Palmoplantar Psoriasis: A Cross-sectional Study
title_fullStr Comparison of Dermoscopic Findings of Chronic Hand Eczema and Palmoplantar Psoriasis: A Cross-sectional Study
title_full_unstemmed Comparison of Dermoscopic Findings of Chronic Hand Eczema and Palmoplantar Psoriasis: A Cross-sectional Study
title_short Comparison of Dermoscopic Findings of Chronic Hand Eczema and Palmoplantar Psoriasis: A Cross-sectional Study
title_sort comparison of dermoscopic findings of chronic hand eczema and palmoplantar psoriasis a cross sectional study
topic brown crusts
diffuse white scales
globules
palms
soles
url https://www.jcdr.net/articles/PDF/17084/55493_CE(AD)_F(KR)_PF1(SC_SHU)_PFA(SS)_PB(SC_SS)_PN(SS).pdf
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AT kallappacherakal comparisonofdermoscopicfindingsofchronichandeczemaandpalmoplantarpsoriasisacrosssectionalstudy
AT srinivasakmurthy comparisonofdermoscopicfindingsofchronichandeczemaandpalmoplantarpsoriasisacrosssectionalstudy