Ultraviolet-induced fluorescence dermoscopy improves precision in non-neoplastic dermatoses

Preliminary evidence supports the possible use of UVF dermoscopy in general dermatology, yet no accurate analysis has been performed so far. Therefore, Paweł Pietkiewicz, Independent Researcher, Poznań, Poland, and colleagues aimed to evaluate the diagnostic accuracy of UVF dermoscopy in clinically similar non-neoplastic conditions as compared to polarized light-based dermoscopy.

For this purpose, the researchers considered patients with dermatoses potentially showing UV-induced findings. The cases were grouped according to clinical patterns and controls were also included. Standardized evaluation of dermoscopic pictures of the target lesion was performed for polarized and UVF dermoscopic findings along with comparative and accuracy analysis.

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 was performed along with comparative and accuracy analysis for polarized and UVF dermoscopic findings.

Two hundred and eight patients were included [31 foot intertrigo (7 due to Pseudomonas, 13 due to Corynebacterium and 11 due to dermatophytes); 16 acne (papulopustular); 57 intertrigo of major creases (18 inverse psoriasis, 13 erythrasma, 15 tinea infections and 11 candidiasis); and 13 Malassezia folliculitis; 46 papulosquamous dermatoses (14 guttate psoriasis, 11 lichen planus, 12 pityriasis rosea and 9 pityriasis lichenoid chronica); and 45 hypopigmented macular dermatoses of the trunk (9 idiopathic guttate hypomelanosis, 9 progressive macular hypomelanosis, 13 vitiligo and 14 achromic pityriasis versicolor)].

The researchers reported the following findings:

• Significant 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.
• Both acne and achromic pityriasis versicolor were also associated with the interruption of uniform follicular red fluorescence.
• Polarized and UVF dermoscopy were related to the most accurate feature in nine and eight analysed dermatoses.

"UVF dermoscopy has emerged as a valuable complement to polarized light-based dermoscopy for augmented accuracy in identifying various non-neoplastic dermatoses," the researchers wrote.

UVF revealed distinct patterns in conditions like foot intertrigo, acne, major crease intertrigo, papulosquamous dermatoses, and hypopigmented macular dermatoses.

"Importantly, UVF dermoscopy surpassed polarized light-based dermoscopy in nine dermatoses," the research team concluded.

Reference:

Errichetti E, Pietkiewicz P, Bhat YJ, Salwowska N, Szlązak P, Stinco G. Diagnostic accuracy of ultraviolet-induced fluorescence dermoscopy in non-neoplastic dermatoses (general dermatology): A multicentric retrospective comparative study. J Eur Acad Dermatol Venereol. 2024 Jan 30. doi: 10.1111/jdv.19795. Epub ahead of print. PMID: 38288676.