Dermoscopy and reflection confocal microscope features of pigmented prurigo

Area of Science:

• Dermatology
• Pathology
• Medical Diagnostics

Background:

• Pigmented prurigo (PP) is a chronic, recurrent inflammatory skin disease.
• It is frequently misdiagnosed due to diverse clinical presentations across different stages.

Purpose of the Study:

• To analyze the clinical, histopathological, dermoscopic, and reflectance confocal microscopy (RCM) features of 20 patients diagnosed with PP.
• To identify key diagnostic markers for PP.

Main Methods:

• Retrospective analysis of 20 patients diagnosed with PP.
• Evaluation of clinical data, histopathology, dermoscopy, and RCM findings.

Main Results:

• Female predominance (1:4 ratio) observed; some patients had restrictive diets or diabetes history.
• Lesions varied from urticarial papules to erythematous papules with reticular distribution and hyperpigmentation.
• Dermoscopy and RCM revealed distinct features in early, developed, and late PP lesions, including epidermal spongiosis, inflammatory cell infiltration, and pigmentary changes.

Conclusions:

• PP is not exclusively seen in patients on restrictive diets and is prone to misdiagnosis.
• A combined approach using dermatoscopy and RCM is valuable for diagnosing PP.