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Clinical presentation of six facial papule dermatoses in children: (A) molluscum contagiosum (MC): multiple, flesh‐colored and translucent papules; (B) milia: elevated, and skin‐colored papules; (C) keratosis pilaris (KP): follicular, skin‐colored, or light brown papules; (D) verruca plana (VP): slightly elevated, flat‐topped, and skin‐colored papules; (E) seborrheic keratosis (SK): discrete, gray–brown, and flat papules; (F) juvenile xanthogranuloma (JXG): multiple, dome‐shaped, and yellow–red papules
Source publication
Background
Molluscum contagiosum (MC), milia, keratosis pilaris (KP), verruca plana (VP), seborrheic keratosis (SK), and juvenile xanthogranuloma (JXG) are common papule dermatoses on the face of children that have a similar appearance. In vivo evaluation of facial papule dermatoses with reflectance confocal microscopy (RCM) is helpful in the diagn...
Citations
... Reflectance confocal microscopy (RCM) is a noninvasive technique for "virtual" skin biopsies, offering real-time lesion evaluation, and corresponds to conventional histopathology results, reducing unnecessary biopsies. RCM been used to evaluate several inflammatory skin conditions [2,3,4], however, few RCM studies have been conducted on NLE to date. ...
Introduction:
Neonatal lupus erythematosus (NLE) is a rare autoimmune disease, which needs to be distinguished from eczema, congenital syphilis, and tinea corporis in newborns. Reflectance confocal microscopy (RCM) could be a helpful noninvasive diagnostic tool, which has been used to evaluate several inflammatory skin conditions. The aim of this study was to describe the RCM characteristics of NLE.
Methods:
Eleven NLE patients were included in the study, and all patients were evaluated clinically with RCM. We also evaluated RCM images from 11 eczema patients as controls.
Results:
Some major key diagnostic features of NLE can be observed by RCM: an enlarged honeycomb pattern (9/11, 81.8%), round-to-oval cyst-like structures were present (6/11, 54.5%), the normal ring-like structures were totally or partially obliterated (11/11, 100%) at the level of the dermo-epidermal junction, medium refractivity collagen fibers that were disorganized (10/11, 90.9%), numerous high refractivity round cells (11/11, 100%) in the dermis.
Conclusion:
RCM allows the visualization of major key diagnostic features of NLE and serves as a complementary diagnostic tool for NLE.
Background:
Owing to their similar appearance, mastocytosis, lichen planus pigmentosus (LPP), fixed drug eruption (FDE) and café-au-lait macules (CALM) often lead to misdiagnosis and missed diagnoses, especially in children. Reflectance confocal microscopy (RCM) is a noninvasive diagnostic tool similar to histopathological analysis that can help to diagnose these ambiguous lesions.
Methods:
We recruited 21 patients with mastocytosis, 18 with LPP, 11 with FDE and 12 with CALM and evaluated the characteristics and distinguishing features of the four grayish-brown dermatoses using RCM.
Results:
The four dermatoses all had unique RCM features at the dermo-epidermal junction (DEJ) and superficial dermis. In mastocytosis, the dermal papillary rings generally had a significantly increased bright refractive index and were significantly enlarged and thickened; the superficial dermis was filled with moderate refractive flocculent material, and many low-refractive circular structures were observed. In LPP, the dermal papillary rings were absent, showing nonedged dermal papillae. Numerous different-sized cellular structures were densely distributed in the superficial dermis. In FDE, the dermal papillary rings were intact and thickened, with a significantly increased bright refractive index. Some cellular structures were cluster aggregates distributed within the ring structures. In CALM, normal and regular dermal papillary rings were detected with a uniformly slightly increased refractive index and no obvious abnormality in the superficial dermis.
Conclusion:
RCM allows for real-time visualization of the major key diagnostic and distinguishing features of four grayish-brown dermatoses in children.
Vulvar lichen sclerosus (VLS) is a chronic inflammatory dermatosis of unknown pathogenesis, characterized by porcelain-white atrophic plaques around the vulvar and anal areas in girls. With this communication, we performed the study on 16 female girls with clinically and histologically confirmed VLS, described the main identifying characteristics of the lesions in reflectance confocal microscopy (RCM) and elucidated the corresponding relationship between RCM findings and histology. We recommend RCM, a noninvasive technique, as a complementary diagnostic tool for VLS.
Background
Owing to their similar appearance, lichen striatus (LS), lichen nitidus (LN), juvenile xanthogranuloma (JXG), and molluscum contagiosum (MC) on the penis often lead to misdiagnosis and missed diagnosis, especially in children. In vivo evaluation of penile dermatoses with reflectance confocal microscopy (RCM) is helpful in the diagnosis of these ambiguous lesions in children.
Methods
We recruited 12 patients with LS, nine with LN, seven with JXG, and nine with MC and evaluated the characteristics and distinguishing features of the four kinds of papule dermatoses on the penis using RCM.
Results
The four dermatoses all had unique RCM features. LS generally showed focally destroyed dermal papillary rings, with numerous mononuclear cell clusters aggregated inside the papillary rings, and highly refractive clumps were observed. For LN, the dermal papillary rings were completely destroyed and arranged in a solitary, enlarged, cavity‐like structure, in which round cells, particulate matter structures, and plump cellular structures were aggregated; the adjacent skin was completely normal. In JXG, the dermal papillary rings were significantly dilated, and the superficial dermis was filled with different‐sized large bright ring cells; smaller, refractive, roundish structures; and particulate matter. For MC, the normal structures completely disappeared; the lesions were arranged in a crater‐shaped structure; and a mass‐like substance formed by the aggregation of multiple, uniform, roundish structures was observed within the crater.
Conclusion
RCM allows for real‐time visualization of major key diagnostic and distinguishing features of four papule dermatoses, LS, LN, JXG, and MC, on the penis in children.
