Sub-Ultraviolet Reflectance and Ultraviolet-Induced Fluorescence Dermoscopy Versus Conventional Dermoscopy for Facial...

Sub-ultraviolet (sUVRD) and ultraviolet dermoscopy (UVFD) are emerging imaging modalities. The study aimed to compare the dermoscopic features of conventional dermoscopy (handheld polarized [hPD], camera-polarized, and camera non-polarized), sUVRD, and UVFD in facial pigmented macules.

This prospective multicenter study included pigmented facial macules imaged with handheld polarized dermoscopy (hPD), sUVRD, and UVFD. Two independent evaluators assessed predefined dermoscopic features and graded their visibility as low (G1), moderate (G2), or high (G3). Detection rates for sUVRD and UVFD were compared with hPD as the reference modality using paired statistical tests; p < 0.05 was considered significant.

One hundred and eighty-three macules were analyzed, including 12 (6.5%) malignant melanocytic lesions. Overall, features were best visualized with conventional dermoscopy, with some exceptions. Well-defined borders were better observed with sUVRD and UVFD compared with hPD (93.4% and 90.7% vs. 68.3%; p < 0.001). Although keratin and follicular pigmentation were also visualized with hPD, UVFD enabled a higher proportion of G2-G3 grades (58.0%) for keratin and sUVRD for follicular pigmentation (50.0%). Rhomboidal structures were infrequent but most often detected and showed the highest G2-G3 proportion with sUVRD (64.7%).

sUVRD and UVFD showed modality-dependent differences in the visualization of selected dermoscopic features, particularly lesion borders and follicular criteria. These exploratory findings require validation in dedicated diagnostic-performance studies.