A clinico-dermatoscopic study of acral dermatosis

Background: Dermatoscopy has been found to be a useful tool in enhancing clinical diagnosis beyond pigmented/neoplastic lesions. Aims: The present study was designed to identify the prevalence of skin lesions in the acral area and to study the clinical and dermatoscopic correlation of acral skin lesions. Methods: A cross sectional clinico dermatoscopic study of 334 patients presenting with acral lesions to the outpatient skin department was done. Veos hd 2 hand held dermatoscope in polarised mode (10x) and iphone 7 camera was used. Results: Out of 334 patients, maximum cases were of psoriasis 83 (24.85%) followed by its close differential chronic eczema 63 (18.86%), 44 (31.17%) scabies, 41 cases (12.28%) wart, 34 (10.18%) tinea. 12 cases of acute eczema, lichen planus 16 cases, 14 of pitted keratolysis, 10 of vitiligo, 4 of secondary syphilis, 4 of subacute eczema, 3 cases of dermatomyositis and 3 of lichen nitidus, 2 of porokeratosis and single case of eryhthema elevatum diutinum. Most of our patients (36.53%) were aged 31-40 years, and included 32.34% females and 67.66% males. In psoriasis, dermatoscopically regular dotted vessels (84.34%), red background (96.39%), and white scales (92.77%) were noted. In scabies, jet with contrail sign was seen in 97.73% cases. In palmoplantar warts, cluster of red/black dots (95.12%), yellowish structureless areas (87.80%) and interrupted skin markings (85.37%) were seen. Eczematous dermatitis showed yellow sero crusts and clusters of red dots with scaling. All patients of pitted keratolysis showed brown/yellow superficial pits with collarette of scaling. Wickham’s striae was seen in 86.67% cases of lichen planus. Vitiligo lesions showed trichrome pattern, starburst pattern and telangiectasia. Limitations: heterogenous group of disorders and histopathological co-relation was not done for all cases. Conclusion: To the best of our knowledge, this is the first study which investigated the dermatoscopic features and epidemiology of various acral lesions.