open access
Trichoscopy-guided biopsy for the evaluation of scarring alopecia due to discoid lupus erythematosus
, 3, 1, 1
Affiliations- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
- The Doctoral School, University of Rzeszow, Rzeszów, Poland
- Department of Pathology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
open access
Abstract
Discoid lupus erythematosus (DLE) is an autoimmune disease that represents one of the subtypes of chronic cutaneous lupus erythematosus(CCLE). When located on the scalp, DLE may lead to the development of scarring alopecia. The following study presents the case ofa 60-year-old female patient with slowly progressing cicatricial alopecia of a four-year duration. The clinical presentation did not allow fora definite diagnosis. The selection of the most representative site for biopsy was guided by trichoscopy and ultraviolet (UV)-enhanced dermo-scopy. The histopathological examination was consistent with the diagnosis of DLE. This paper also discusses the most commondermoscopic findings in active and end-stage DLE. It is postulated, that in all cases of alopecia, picking the spot for biopsy should beguided by trichoscopy.
Abstract
Discoid lupus erythematosus (DLE) is an autoimmune disease that represents one of the subtypes of chronic cutaneous lupus erythematosus(CCLE). When located on the scalp, DLE may lead to the development of scarring alopecia. The following study presents the case ofa 60-year-old female patient with slowly progressing cicatricial alopecia of a four-year duration. The clinical presentation did not allow fora definite diagnosis. The selection of the most representative site for biopsy was guided by trichoscopy and ultraviolet (UV)-enhanced dermo-scopy. The histopathological examination was consistent with the diagnosis of DLE. This paper also discusses the most commondermoscopic findings in active and end-stage DLE. It is postulated, that in all cases of alopecia, picking the spot for biopsy should beguided by trichoscopy.
Keywords
alopecia, scarring alopecia, discoid lupus erythematosus, dermoscopy, dermoscopy-guided biopsy
About this articleTitle
Trichoscopy-guided biopsy for the evaluation of scarring alopecia due to discoid lupus erythematosus
Journal
Issue
Article type
Case report
Pages
167-171
Published online
2023-12-13
Page views
373
Article views/downloads
164
DOI
Bibliographic record
Forum Dermatologicum 2023;9(4):167-171.
Keywords
alopecia
scarring alopecia
discoid lupus erythematosus
dermoscopy
dermoscopy-guided biopsy
Authors
Kinga Kołcz
Ewa Kaznowska
Adam Reich
Magdalena Żychowska
References (19)- Zhou W, Wu H, Zhao M, et al. New insights into the progression from cutaneous lupus to systemic lupus erythematosus. Expert Rev Clin Immunol. 2020; 16(8): 829–837.
- Concha JS, Werth VP. Alopecias in lupus erythematosus. Lupus Sci Med. 2018; 5(1): e000291.
- Fabbri P, Amato L, Chiarini C, et al. Scarring alopecia in discoid lupus erythematosus: a clinical, histopathologic and immunopathologic study. Lupus. 2004; 13(6): 455–462.
- Rongioletti F, Christana K. Cicatricial (scarring) alopecias: an overview of pathogenesis, classification, diagnosis, and treatment. Am J Clin Dermatol. 2012; 13(4): 247–260.
- Behera B, Kumari R, Mohan Thappa D, et al. Dermoscopy in the diagnosis of generalized acute cutaneous lupus erythematosus. Int J Dermatol. 2021; 60(8): e306–e308.
- Fathy H, Ghanim BM, Refat S, et al. Dermoscopic criteria of discoid lupus erythematosus: An observational cross-sectional study of 28 patients. Indian J Dermatol Venereol Leprol. 2022; 88(3): 360–366.
- Cummins DM, Chaudhry IH, Harries M. Scarring alopecias: pathology and an update on digital developments. Biomedicines. 2021; 9(12): 1755.
- Yavuz GO, Yavuz IH, Bayram I, et al. Clinic experience in discoid lupus erythematosus: a retrospective study of 132 cases. Postepy Dermatol Alergol. 2019; 36(6): 739–743.
- Miteva M, Tosti A. Dermoscopy guided scalp biopsy in cicatricial alopecia. J Eur Acad Dermatol Venereol. 2013; 27(10): 1299–1303.
- Lallas A, Apalla Z, Lefaki I, et al. Dermoscopy of discoid lupus erythematosus. Br J Dermatol. 2013; 168(2): 284–288.
- Żychowska M, Reich A. Chronic cutaneous lupus erythematosus in a white population: dermoscopic characteristics by clinical subtype, lesion location and disease duration. Dermatol Ther (Heidelb). 2022; 12(9): 2117–2133.
- Chiramel MJ, Sharma VK, Khandpur S, et al. Relevance of trichoscopy in the differential diagnosis of alopecia: a cross-sectional study from North India. Indian J Dermatol Venereol Leprol. 2016; 82(6): 651–658.
- Karadag Köse Ö, Güleç AT. Evaluation of a handheld dermatoscope in clinical diagnosis of primary cicatricial alopecias. Dermatol Ther (Heidelb). 2019; 9(3): 525–535.
- Dyer JM, Foy VM. Revealing the unseen: a review of wood's lamp in dermatology. J Clin Aesthet Dermatol. 2022; 15(6): 25–30.
- Rudnicka L, Olszewska M. Atlas of Trichoscopy: Dermoscopy in Hair and Scalp Disease. Springer, London 2012: 111–117.
- Żychowska M, Żychowska M. Dermoscopy of discoid lupus erythematosus - a systematic review of the literature. Int J Dermatol. 2021; 60(7): 818–828.
- Gómez-Quispe H, Elena de Las Heras-Alonso M, Lobato-Berezo A, et al. Trichoscopic findings of discoid lupus erythematosus alopecia: A cross-sectional study. J Am Acad Dermatol. 2021; 84(3): 804–806.
- Pietkiewicz P, Navarrete-Dechent C. Scabies mite is bright green under UV dermatoscopy. Dermatol Pract Concept. 2023 [Epub ahead of print]; 13(2): e2023135.
- Fernandez-Flores A, Pérez A, Cabo F. An atypical presentation of alopecia in discoid lupus erythematosus. J Cutan Pathol. 2021; 48(1): 194–197.
