Trichoscopy may enhance differential diagnosis of erythroderma.

Abstract

There is a paucity of data concerning the usability of trichoscopy in erythrodermic patients. The objective of the study was to compare trichoscopic features in erythroderma of various etiologies. Forty-nine patients with the determined cause of erythroderma (including atopic dermatitis, mycosis fungoides, allergic contact eczema, psoriasis, Sézary syndrome, drug reactions, pityriasis rubra pilaris, dermatomyositis, actinic reticuloid, crusted scabies and pemphigus foliaceus) were included in the study. Dotted vessels were present in patients with atopic dermatitis, pityriasis rubra pilaris, mycosis fungoides, Sézary syndrome and psoriasis and absent in dermatomyositis, crusted scabies, and pemphigus foliaceus (chi-square test, p=0.016). Spermatozoon-like vessels were observed only in mycosis fungoides and Sézary syndrome (p=0.001). Whitish-pinkish structureless areas were described in all patients with mycosis fungoides, pemphigus foliaceus, actinic reticuloid, and crusted scabies (p=0.028). The type of vessels and the presence of whitish-pinkish structureless areas under trichoscopy may indicate the cause of erythroderma.