RESUMEN
Dermatoscopy is a non-invasive and cost-efficient imaging technique augmenting clinical examination in neoplastic and non-neoplastic dermatoses. Recently, novel dermatoscopic techniques based on principles of reflectance/absorption and excited fluorescence have been developed. However, comprehensive data on their applications are sparse, and terminology is inconsistent. In this systematic review, we addressed the principles of ultraviolet (UV) imaging and proposed categorization based on spectral characteristics and signal acquisition, as well as discussed documented and potential clinical applications, safety measures during examination, and limitations associated with reflectance and fluorescence dermatoscopy. A literature search was conducted in the PubMed medical database until 2 December 2023 according to PRISMA guidelines, and 28 papers fit the scope of this review, whereas additional relevant articles were included to provide broader context regarding the chosen terminology, chromophores described, safety of sub-UV/UV, and regulations for light-emitting devices. UV and sub-UV dermatoscopy, categorized into different methods on the basis of the emitted wavelength and signal acquisition process (reflectance versus fluorescence), augment conventional dermatoscopy by optimizing safety margins in melanoma, facilitating early detection of tumor recurrence, and enhancing visualization in non-neoplastic conditions, including pigmentation disorders, intertrigo, papulo-desquamative dermatoses, and beyond. The review highlights the limitations of these techniques, including difficulty in differentiating melanin from hemoglobin, challenges in evaluating uneven surfaces, and artifacts. Although UV dermatoscopy complements conventional dermatoscopy, clinicians should be aware of their peculiarities, artifacts, limitations, and safety concerns to optimize their diagnostic accuracy and ensure patient's safety.
RESUMEN
BACKGROUND: Preliminary data support the possible use of ultraviolet-induced fluorescence (UVF) dermoscopy in general dermatology, yet no accuracy analysis has been performed so far. OBJECTIVE: To evaluate diagnostic accuracy of UVF dermoscopy in clinically similar non-neoplastic conditions as compared to polarized light-based dermoscopy. METHODS: Patients with dermatoses potentially showing UV-induced findings were considered; cases were grouped according to clinical patterns and controls were also included. Standardized evaluation of dermoscopic pictures of the target lesion along with comparative and accuracy analysis were performed for polarized and UVF dermoscopic findings. RESULTS: A total of 208 patients were included [31 foot intertrigo (7 due to Pseudomonas, 13 due to Corynebacterium and 11 due to dermatophytes); 57 intertrigo of major creases (18 inverse psoriasis, 13 erythrasma, 15 tinea infections and 11 candidiasis); 16 acne (papulopustular) and 13 Malassezia folliculitis; 46 papulosquamous dermatoses (14 guttate psoriasis, 11 lichen planus, 12 pityriasis rosea and 9 pityriasis lichenoide chronica); and 45 hypopigmented macular dermatoses of the trunk (9 progressive macular hypomelanosis, 9 idiopatic guttate hypomelanosis, 13 vitiligo and 14 achromic pityriasis versicolor)]. Significant (p < 0.01) UVF was seen in several conditions: green in Pseudomonas foot intertrigo; red in Corynebacterium foot intertrigo, inverse and guttate psoriasis (arranged around dermal papillae in the former), progressive macular hypomelanosis (folliculocentric distribution) and erythrasma (showing polygonal or structureless appearance); blue fluorescent concretions along hair shaft in erythrasma; light green in achromic pityriasis versicolor and tinea of major creases; and blue follicular in Malassezia folliculitis. Additionally, both acne and achromic pityriasis versicolor were also associated with interruption of uniform follicular red fluorescence. Notably, polarized and UVF dermoscopy were related to the most accurate feature in nine and eight analysed dermatoses, respectively. CONCLUSION: UVF dermoscopy improves recognition of non-neoplastic dermatoses, yet it should be considered complimentary to polarized light-based dermoscopy to increase diagnostic performance.
RESUMEN
INTRODUCTION: Vitiligo is an acquired chronic depigmenting disorder of the skin, predominantly asymptomatic. Although vitiligo does not cause direct physical impairment, it is commonly believed that it can produce an important psychosocial burden. AIM: To translate, cross-culturally adapt and validate the vitiligo-specific health-related quality of life instrument (VitiQoL) into Polish. MATERIAL AND METHODS: The study was conducted online on 97 patients with vitiligo from our private outpatient departments in Gdynia and Gdansk, Poland from May 2018 to December 2019. RESULTS: There was a significant correlation between VitiQoL and DLQI (r = 0.90, p < 0.001) and also between VitiQoL-PL and subjects' assessment of the severity of their disease (r = 0.94, p < 0.001). We also found a good correlation between the total DLQI and subjects' assessment of the severity of their disease (r = 0.87, p < 0.001). CONCLUSIONS: The physicians treating this disease still do not have a specific instrument for assessing patients' QoL in Poland. They have to administer other non-vitiligo specific questionnaires to do so. A Polish version of a specific index for estimating quality of life of patients with vitiligo was validated and implemented through an online survey.
RESUMEN
INTRODUCTION: There are many surgical methods for vitiligo treatment that have been used for over 30 years. Suction blister epidermal grafting (SBEG) is considered one of the simplest and most effective of them. AIM: To determine how effective suction blister grafts with concomitant phototherapy are in vitiligo treatment. MATERIAL AND METHODS: The study was conducted on 10 patients with vitiligo that was resistant to previous treatment including phototherapy in monotherapy. Involvement of affected sites was different for every patient. We used cryotherapy for blistering at the recipient site and an automatic suction device for blistering at the donor site. The blister was separated from the donor site and fixed with dressing to the recipient site. After removing the final dressing (about 7 days after SBEG) patients started phototherapy (6 patients had UVB 311 nm and 4 had PUVA). All patients treated with UVB 311 nm were qualified for treatment in our clinic and the method was chosen according to expert recommendations from the European Dermatology Forum (EDF) Guidelines for Vitiligo where narrowband (NB) UVB is the phototherapy of choice. Three patients who had PUVA therapy were treated with this method in other clinical centers and sent to us only to undergo SBEG. One patient had previously received UVB 311 nm for 3 months, which showed no effects. Repigmentation of lesions was evaluated at 3 and 6 months after the surgical procedure. RESULTS: Ten patients (9 females with a mean age of 36.88 years and 1 man aged 39 years) were enrolled in the study. Nine patients showed progressive repigmentation at 3 and 6 months follow-up with a rate varying from 13 to 76% (mean: 44.5%) and 35 to 100% (mean: 67.5%). One patient showed 5% depigmentation at a visit after 6 months in comparison to the follow-up visit 3 months after SBEG. CONCLUSIONS: With this technique, patients who did not respond to the usual treatments showed very good repigmentation over a 6-month follow-up. There were no side effects such as scarring.
