Dermoscopic features of connective tissue disease

Dermoscopy in dermatological practice has a long history. It was carried out for the first time by Kolhause in 1663, for evaluating blood vessels of the nail bed. Nowadays there are two types of dermoscopy: polarized – for deeply located structures in the skin, and non-polarized – which visualizes the surface layers of the skin.
Initially, dermoscopic examination was used for diagnosing benign and malignant skin lesions, but now it is also used to detect other skin diseases. The positive aspects of dermoscopy include: non-invasiveness, easy to use, time-saving, less financial resources necessary and an improved system of saving documentation, which is convenient when using a stationary digital dermoscope.

Clinical and dermoscopic picture of connective tissue diseases

In addition to the use of dermoscopy in dermato-oncology, this method is also used in general dermatology [1]. Over time, such specific terms appeared as trichoscopy (dermoscopy of the scalp), onychoscopy (nail dermoscopy), entomodermoscopy (dermoscopy of infectious and parasitic skin diseases), inflammoscopy (dermatoscopy of inflammatory skin diseases). Dermoscopic characteristics of chronic inflammatory skin diseases, including the dermoscopic picture characteristic for connective tissue diseases, turned out to be especially informative [2, 3]. In cases of skin inflammatory diseases, dermoscopic examination helps to avoid the use of minimally invasive or invasive methods in order to establish a diagnosis [4]. Dermoscopic examination is informative not only for differential diagnosis, but also for prognostic assessment and monitoring of diseases [5]. Dermoscopic examination has been successfully used in diagnosing connective tissue diseases such as discoid lupus erythematosus, dermatomyositis and localized scleroderma.

Dermoscopy of discoid lupus erythematosus

Autoimmune and inflammatory diseases of the skin are characterized by generalized inflammation caused by the immune system activation, particularly acquired immune type activation. The main role is attributed to genetic factors. Discoid lupus erythematosus is a chronic type of cutaneous lupus erythematosus, mediated by autoimmune processes. Provoking factors include genetic predisposition, toxins and exposure to sunlight [6]. Clinically DLE is characterized by scaly, round-oval shaped well demarcated skin lesions. The rashes are mostly localized on the areas of exposure to sunlight (face, scalp,...


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