The Analysis Of Dermoscopic Features Of Psoriasis Vulgaris And Chronic Eczema

BackgroundPsoriasis vulgaris and chronic eczema are both chronic inflammatory diseases common in dermatology and can present as scaly red patches.Due to similar lesion morphology,the misdiagnosis rate of these two diseases is higher in clinical work.The pathology of skin tissue biopsy,which was previously used to confirm the diagnosis,has been invasive,time-consuming,and scarring has greatly reduced patient compliance.As an emerging non-invasive skin imaging technology,dermoscopy has been widely used in the diagnosis and differential diagnosis of various skin diseases,including skin tumors and pigmented skin diseases,by its real-time,non-invasive,fast and high repeatability.Dermoscopy can directly observe the morphology and distribution of blood vessels at the lesion,so its position in the identification of inflammatory diseases of the skin is also increasing.ObjectiveThe purpose of this study was to analyze the dermoscopic features of psoriasis vulgaris and chronic eczema in different anatomic locations,and evaluate the significance of dermoscopy in the differential diagnosis,to provide clinical assistance..MethodsFrom January 2020 to February 2022,patients diagnosed with psoriasis vulgaris or chronic eczema from the dermatology outpatient clinic of Qilu Hospital of Shandong University were evaluated.The dermoscopic features of all skin lesions(background color,vascular morphology,vascular distribution pattern,scale color,scale distribution,etc.)were statistically analyzed,and the chi-square test(Fisher’s exact probability test was used for those that did not meet the chi-square test conditions)was used to determine whether the dermoscopic features of psoriasis vulgaris and chronic eczema existed statistical differences,and the frequency of occurrence of various dermoscopic features and the sensitivity and specificity for the diagnosis of the two diseases were calculated.In this study,Microsoft Excel 2016 and XLSTAT 2022 software was used for statistical analysis,and P<0.05 was considered to be statistically significant.Results(1)The main manifestations of psoriasis vulgaris skin lesions under dermoscopy were:bright red background(56.72%),uniform distribution of blood vessels(88.06%),and punctate blood vessels(98.51%).The main manifestations of chronic eczema skin lesions under dermoscopy were bright red background(48.28%),uniform distribution of blood vessels(68.97%),and punctate blood vessels(96.55%).In the two skin lesions,there were significant statistical differences in the distribution pattern of blood vessels,linear and curved blood vessels,and the color of scales(P<0.05).The rate was significantly higher than that in chronic eczema,while vascular clusters and yellow or yellow+white scales were more common in chronic eczema.(2)There is no significant difference in the dermoscopic characteristics of psoriatic skin lesions in different parts.The dark red background is more likely to be found in eczema on the trunk,linear blood vessels are more likely to be found in eczema on the scalp and trunk,and linear curved blood vessels are more likely to be found in eczema on the scalp and limbs..The dark red background of chronic eczema skin lesions on the trunk was more common than that of psoriasis vulgaris(P<0.05).ConclusionPsoriasis vulgaris and chronic eczema have specific manifestations under dermoscopy,and the dermoscopic characteristics in different locations are partially different.Clinicians can use dermoscopy to assist in the differential diagnosis of these two diseases and reduce clinical misdiagnosis.