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05:39
Dermoscopy Aids in the Diagnosis of Discoid Lupus Erythematosus
Published on: May 16, 2025
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Papules in a blaschkoid distribution on the thigh
Avita Dhiman1, Payal Chauhan2, Manju Daroach3
1Dermatology, All India Institute of Medical Sciences Bilaspur, Bilaspur, HP, India.
BMJ Case Reports
|January 6, 2026
Summary
Dermatologists can differentiate inflammatory skin conditions along Blaschko's lines using dermoscopy and histopathology. This helps distinguish hypertrophic lichen planus from lichen striatus, improving diagnosis for these rare skin disorders.
Area of Science:
- Dermatology
- Pathology
- Dermoscopy
Background:
- Inflammatory dermatoses can manifest along Blaschko's lines, presenting diagnostic challenges.
- Two cases illustrate similar blaschkoid distribution in hypertrophic lichen planus and lichen striatus.
Purpose of the Study:
- To highlight the diagnostic utility of dermoscopy and histopathology in differentiating blaschkoid dermatoses.
- To compare the distinct clinico-dermoscopic and histopathological features of hypertrophic lichen planus and lichen striatus.
Main Methods:
- Clinical examination and patient history.
- Dermoscopic evaluation of skin lesions.
- Histopathological analysis of skin biopsies.
Main Results:
- Hypertrophic lichen planus showed follicular plugs, blue-grey globules on a purple background, follicular involvement, and melanophages.
- Lichen striatus presented with patchy dotted vessels, white areas, erosions, and deep peri-eccrine lymphocytic infiltrates.
- Both conditions exhibited similar blaschkoid distribution but distinct dermoscopic and histopathological findings.
Conclusions:
- Integrated clinico-dermoscopic-histopathological correlation is crucial for diagnosing blaschkoid dermatoses.
- Dermoscopy offers valuable insights for differentiating hypertrophic lichen planus and lichen striatus.
- Histopathology confirms diagnoses by revealing characteristic inflammatory patterns and cellular infiltrates.
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