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THROUGH THE DERMOSCOPE
Year : 2020  |  Volume : 11  |  Issue : 4  |  Page : 678-679  

Dermoscopy of dermatitis neglecta in the periocular area in skin of color


1 Department of Dermatology, College of Medicine, King Faisal University, Saudi Arabia
2 Department of Opthalmology, College of Medicine, King Faisal University, Saudi Arabia

Date of Submission10-Dec-2018
Date of Decision11-Jan-2019
Date of Acceptance05-Feb-2019
Date of Web Publication26-Sep-2019

Correspondence Address:
Kaberi Feroze
Department of Dermatology, College of Medicine, King Faisal University
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/idoj.IDOJ_482_18

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How to cite this article:
Kaliyadan F, Feroze K, Kuruvilla J. Dermoscopy of dermatitis neglecta in the periocular area in skin of color. Indian Dermatol Online J 2020;11:678-9

How to cite this URL:
Kaliyadan F, Feroze K, Kuruvilla J. Dermoscopy of dermatitis neglecta in the periocular area in skin of color. Indian Dermatol Online J [serial online] 2020 [cited 2020 Aug 6];11:678-9. Available from: http://www.idoj.in/text.asp?2020/11/4/678/261231



A 24-year-old male patient presented to us with raised skin lesions around his eyes, more over the right eye, since three weeks. The lesions were asymptomatic. The patient had been using lubricating eye drops for complaints of burning and foreign body sensation of the eyes which was diagnosed as dry eye disease by the ophthalmologist. There were no skin lesions elsewhere and the patient was otherwise healthy, no present or previous history of skin or systemic illness.

On examination, the lesions appeared as hyperpigmented, slightly verrucous, polygonal papules grouped together [Figure 1]. The lesions were located on the periocular area, more on the lower side. A clinical possibility of dermatitis neglecta was considered and on taking a more detailed history, the patient admitted to not cleansing the area properly because of the eye symptoms. On gentle swabbing with saline itself the scales came off easily [Figure 2], thus confirming the diagnosis of dermatitis neglecta. Dermoscopy (polarized light ×10, Dermlite pro hr ii) – mainly showed polygonal plate like brown scales arranged in a mosaic-like pattern, with a few smaller cornflake-like scales mainly on the peripheral part of the affected areas. Some of the larger scales had a bluish color. The lesion also showed a background erythema [Figure 3].
Figure 1: Left periocular area showing hyperpigmented, polygonal papules

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Figure 2: After cleansing with saline swabs

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Figure 3: Dermoscopy (polarized ×10) showing brownish, polygonal scales arranged in a mosaic like pattern, with a few smaller cornflake like scales mainly on the peripheral part of the affected areas.Some of the larger scales had a bluish color. The lesion also showed a background erythema

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Errichetti and Stinco have reported that dermatitis neglecta (DN) and terra firmaformedermatosis (TFFD) tend to have distinctive dermoscopicpatterns, which can help to differentiate from each other and other conditions like pityriasis versicolor, macular amyloidosis, and frictional melanosis.[1] The larger polygonal scales are more suggestive of TFFD, while DN is characterized by more irregularly distributed corn-flake like scales. The difference is explained by the histopathology, where TFFD shows more prominent papillomatosis, acanthosis, and compactorthohyperkeratosis, while DN shows basket-weave hyperkeratosis and diminished rete pegs.[1]

The history of absence of cleansing and the easy removal by swabbing in our case suggested that DN was more likely than TFFD, but the dermoscopy features were a combination of those described in TFFD and DN. We would like to conclude that the dermoscopy features of TFFD and DN might also show some amount of overlap. This could be explained by the fact that both these conditions might show histological overlap too.[2] Larger case series would probably help clarifying dermoscopic similarities and differences between the two conditions.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Errichetti E, Stinco G. Dermoscopy in terra firma-forme dermatosis and dermatosis neglecta. Int J Dermatol 2017;56:1481-3.  Back to cited text no. 1
    
2.
Ashique KT, Kaliyadan F, Goyal T. Terra firma-forme dermatosis: Report of a series of 11 cases and a brief review of the literature. Int J Dermatol 2016;55:769-74.  Back to cited text no. 2
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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