Pediatric Dermatology | 2019
Response to “Dermatoscopic features of lichen nitidus”
Abstract
To the Editor, We read with great interest the letter by Errichetti et al. Dermatoscopy has improved the noninvasive diagnostic potential of dermatologists. A 10‐fold magnification allows visualization of features not discernible to the naked eye; hence, expectedly, 50‐fold (and 200‐ fold) magnification can further enhance diagnostic features. We agree with the dermoscopic observations of lichen nitidus (LN) by Errichetti et al, but would like to report that at 50‐ to 200‐fold magnification with universal serial bus (USB) dermatoscopes used by us, the discernible features are improved. Errichetti et al observe that LN on the penis may retain skin markings (10X); however, in our observation, the lesional skin markings on the glans are lost or decreased similar to that of cutaneous lesions (50X) (Figure 1). In addition, polarizing dermoscopy shows hypopigmentation with underlying erythema. The typical “sun‐burst pattern” of cutaneous lesions is not observed. Studies involving a larger number of cases may help clarify these issues. Our study focused only on lichen nitidus cases; hence, we could not include dermatoscopic features of the most common differential diagnoses such as frictional lichenoid dermatitis, follicular eczema, lichen striatus, and other conditions. Examination with both polarized and nonpolarized modes show distinctive features when examined holistically. Additionally, the author s statement about handheld dermatoscopes (10‐fold magnification) being the most commonly used device has no support from the literature as the frequency of the use of handheld and USB devices remains unknown. It may be vary dependent on the geographical region or country. In our opinion, the versatility offered by USB dermatoscopes in examining many difficult areas is a major advantage, making it the preferred instrument in daily clinical practice.