Dermatoscopic evaluation of leprosy: A multi-centre cross-sectional study.

Background Leprosy is known to be a great mimicker. Its dermatoscopic evaluation may be of value in establishing diagnosis. Objective To study the dermatoscopic findings encountered across the leprosy spectrum. Methods This was a multi-centre cross-sectional study of leprosy patients, where after a thorough cutaneous and neurological evaluation, representative skin lesions from the study patients were photographed in standard settings, and the most representative skin lesions were chosen for dermatoscopic evaluation. Data was entered in a structured proforma and a descriptive analysis of dermatoscopic patterns was carried out. Results A total of 53 cases of ages between 14 and 80 years, ranging from tuberculoid to the lepromatous spectrum of disease, with active skin lesions in the form of patches and plaques were included. The spectrum of leprosy as per Ridley-Jopling classification at diagnosis was indeterminate in 1 (1.9%), tuberculoid in 1 (1.9%), borderline tuberculoid in 25 (21.5%), borderline lepromatous in 9 (17%), lepromatous in 14 (26.4%) and histoid in 3 (5.7%). Dermatoscopic features included distorted pigment network in 48 (90.6%), focal white areas in 40 (75.5%), reduced eccrine and follicular openings in 43 (81.1%), widened skin lines in 28 (52.8%), circle hairs in 15 (28.3%) and white shiny streaks in 17 (32.1%). Conclusion Dermatoscopy is a practical, non-invasive device to assess skin lesions of leprosy and provide cues to its diagnosis, spectral classification and differentiating it from other granulomatous disorders. However, dermatoscopy alone cannot reliably differentiate between the various types of leprosy and future large-scale studies are required. Limitations of the study The numbers for each subtype were variable and few in some spectrum of leprosy patients. A dermatoscopic-histologic correlation was not done.

Dermoscopy of borderline tuberculoid leprosy.

INTRODUCTION: Leprosy is a chronic granulomatous condition caused by Mycobacterium leprae, and borderline tuberculoid (BT) leprosy is the most common type of leprosy and presents with large, well- to ill-defined hypopigmented patches. It is known for atypical presentations. Dermoscopy of granulomatous conditions is well documented. However, there is no description of dermoscopy of BT leprosy in the literature. Authors evaluated the dermoscopic patterns of BT leprosy. CASE REPORT: Patients with BT leprosy were studied for dermoscopic patterns. A total of 12 patients (8 male, 4 female) with a median age of 25 years were present. Mean duration of disease was 6 months. The most frequent pattern was white areas (100%) followed by decreased density of hairs. Yellow globules were observed in 8 (66.66%) patients. Decreased white dots (represent sweat duct openings) and branching vessels were noted in 6 (50%) and 4 (33.33%) patients, respectively. CONCLUSION: This is the first report of dermoscopy of BT leprosy in the literature, and new dermoscopic observations were made by the authors. Dermoscopy of BT leprosy shows characteristic patterns, thus it adds valuable information for the diagnosis of BT leprosy.