|THROUGH THE DERMOSCOPE
|Ahead of print publication
Hidroscopy as an adjunctive tool in the assessment of borderline tuberculoid hansen's disease
Ishmeet Kaur1, Deepak Jakhar2, Rachita Misri2
1 Department of Dermatology, Consultant Dermatologist, Kaya Skin Clinic, New Delhi, India
2 Department of Dermatology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
|Date of Submission||20-Jun-2019|
|Date of Decision||15-Dec-2019|
|Date of Acceptance||08-Apr-2020|
|Date of Web Publication||19-Sep-2020|
H. No.-82, V.P.O Goyla Khurd, New Delhi - 110 071
Source of Support: None, Conflict of Interest: None
|How to cite this URL:|
Kaur I, Jakhar D, Misri R. Hidroscopy as an adjunctive tool in the assessment of borderline tuberculoid hansen's disease. Indian Dermatol Online J [Epub ahead of print] [cited 2020 Nov 1]. Available from: https://www.idoj.in/preprintarticle.asp?id=295446
A 50-year-old female presented with two erythematous, scaly, and hypoesthetic plaques over the face for last 1 year [Figure 1]. Nerve to patch was absent and right ulnar was thickened and tender. Rest of the mucocutaneous examination was noncontributory. Dermoscopy [Dinolite AM413ZT; polarizing video dermatoscope] of the plaque above the right eyebrow at polarizing mode showed yellow-orange background, yellow discrete areas, telangiectasia, and reduced hair follicles [Figure 2]a. Non-polarizing videodermoscopy was performed to assess the functioning of sweat glands and showed reduced sweat droplets [Figure 2]b as compared to normal skin (after 30 s) [Figure 2]c. Histopathology showed abundant tuberculoid granulomas with giant cells and lymphocytes, confirming the diagnosis of borderline tuberculoid Hansen's disease [Figure 2]d.
|Figure 1: A Borderline Tuberculoid Hansen's plaque over the forehead. Site A (lesional) and B (normal skin) are marked for videodermoscopy|
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|Figure 2: (a) Polarizing dermoscopy showing yellow-orange background with yellow areas (black arrow), telengiectasia (blue arrow), and reduced hair density. [Dinolite AM413ZT; 50×]. (b) Non-polarizing videodermoscopy of the BT Hansen's plaque showing scantly sweat production. [Dinolite AM413ZT; 50×]. (c) Non-polarizing videodermoscopy of the normal skin showing normal sweat production (black arrow). [Dinolite AM413ZT; 50×]. (d) Histopathology showing tuberculoid granuloma with giant cells, lymphocytes, and dermal edema. [H and E; 10×]|
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Hidroscopy, described by Jakhar and Kaur, is an in-vivo videodermoscopy of the sweat glands. Videodermoscopy of the sweat glands can be used as an adjunctive tool to assess in-vivo sweat production in a borderline tuberculoid (BT) Hansen's plaque. The sweat is better appreciable in non-polarizing light as compared to polarizing light., Using the non-polarizing mode active sweating can be appreciated. Due to the involvement of autonomic nervous system in leprosy, sweat gland functioning is reduced. The same can be documented through hidroscopy. Dermoscopy of BT Hansen's disease shows white areas, yellow globules, decreased hair density, decreased white dots, and telangiectasia. Our case showed similar features on polarizing dermoscopy. The yellow areas on histopathology represent granuloma.
To conclude, the utility of hidroscopy in the assessment of leprosy is highlighted in the present case study.
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
Conflicts of interest
There are no conflicts of interest.
| References|| |
Jakhar D, Kaur I. Hidroscopy: In vivo
videodermoscopy of the sweat glands. Skin Res Technol 2019;25:410-1.
Kaur I, Jakhar D. Starch-iodine test through the eyes of dermatoscope. J Am Acad Dermatol 2019. pii: S0190-9622(19)32555-1. doi: 10.1016/j.jaad.2019.08.008.
Ankad BS, Sakhare PS. Dermoscopy of borderline tuberculoid leprosy. Int J Dermatol 2018;57:74-6.
[Figure 1], [Figure 2]