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The Dermoscopic Auspitz Sign

Authors:
Feroze Kaliyadan at Sree Narayana Institute of Medical Sciences
Feroze Kaliyadan
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290 © 2018 Indian Dermatology Online Journal | Published by Wolters Kluwer - Medknow
A 20‑year‑old female patient presented to
us with erythematous, scaly plaques over
the extensor surfaces of the body. She
had signicant scaling over the scalp and
associated nail changes, including pitting
and onycholysis. A clinical diagnosis of
chronic plaque psoriasis was made.
Using dermoscopy we were able to visualize
regularly distributed dotted vessels on a
light erythematous background [Figure 1].
On repeating the dermoscopy after scraping
of the scales over part of the lesion, we
were able to visualize the dotted vessels
much more clearly, without inducing
actual bleeding or discomfort to the patient
[Figure 2].
Dermoscopic features of plaque psoriasis
include diffuse white scales with regularly
distributed dotted vessels on a light
erythematous background.[1] Auspitz’s
phenomenon/papillary tip bleeding denotes
the presence of pinpoint bleeding of
papillary vessels under easily detachable
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DOI: 10.4103/idoj.IDOJ_309_17
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The Dermoscopic Auspitz Sign
Feroze Kaliyadan
Department of Dermatology,
King Faisal University, Al Hasa,
Kingdom of Saudi Arabia
How to cite this article: Kaliyadan F. The
dermoscopic auspitz sign. Indian Dermatol Online
J 2018;9:290-1.
Received: November, 2017. Accepted: January, 2018.
scales of psoriatic plaques.[2] When the
presence of marked hyperkeratosis impedes
the view of underlying features, scale
removal may be useful to display the
above‑mentioned vascular pattern as well as
possible tiny red blood drops. This has been
referred to as the “dermoscopic Auspitz’s
sign.”[3]
We would like to suggest that the pattern of
regular dotted vessels becoming prominent
after removal of the scales itself strengthens
the diagnosis of psoriasis, without
actually having to induce bleeding. The
dermoscopic Auspitz’s sign is, thus, useful
in demonstrating the concept behind the
Auspitz’s sign without causing signicant
pain or discomfort to the patient.
Declaration of patient consent
The authors certify that they have obtained
all appropriate patient consent forms. In the
form the patient(s) has/have given his/her/
their consent for his/her/their images and
other clinical information to be reported
Through the Dermoscope
Address for correspondence:
Dr. Feroze Kaliyadan,
Faculty of Dermatology,
College of medicine,King
Faisal University, Al‑Hasa
campus, Al Hasa ,
Kingdom of Saudi Arabia.
E‑mail: ferozkal@hotmail.com
This is an open access journal, and arcles are distributed under
the terms of the Creave Commons Aribuon-NonCommercial-
ShareAlike 4.0 License, which allows others to remix, tweak, and
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Figure 1: Dermoscopy of psoriatic plaque showing
white scales with regularly distributed dotted vessels
on a light erythematous background (polarized
light ×10, Foto ii pro)
Figure 2: Same lesion in Figure 1 with scales gently
removed showing the vessels more prominently without
inducing actual bleeding (polarized light ×10, Foto ii pro)
[Downloaded free from http://www.idoj.in on Monday, July 2, 2018, IP: 176.23.224.53]
Kaliyadan: The dermoscopic Auspitz sign
291Indian Dermatology Online Journal | Volume 9 | Issue 4 | July-August 2018
in the journal. The patients understand that their names
and initials will not be published and due efforts will be
made to conceal their identity, but anonymity cannot be
guaranteed.
Financial support and sponsorship
Nil.
Conicts of interest
There are no conicts of interest.
References
1. Lallas A, Apalla Z, Argenziano G, Sotiriou E, Di Lernia V,
Moscarella E, et al. Dermoscopic pattern of psoriatic lesions on
specic body sites. Dermatology 2014;228:250‑4.
2. Holubar K. The man behind the eponym. Remembering Heinrich
Auspitz. Am J Dermatopathol 1986;8:83‑5.
3. Vázquez López F, González‑Lara L, Martin JS, Argenziano G.
Dr K. Holubar (1936–2013). Teaching with dermoscopy:
Revealing the subsurface morphology of Auspitz’s sign and
psoriasis. Int J Dermatol 2014;53:e322‑4.
[Downloaded free from http://www.idoj.in on Monday, July 2, 2018, IP: 176.23.224.53]
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"Citius emergat veritas ex errore quam ex confusione." (Truth springs out more readily from error than from disorder.) (C) Lippincott-Raven Publishers.
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Teaching with dermoscopy: Revealing the subsurface morphology of Auspitz's sign and psoriasis
  • F Vázquez López
  • L González-Lara
  • J S Martin
  • Argenziano G Dr
  • K Holubar
Vázquez López F, González-Lara L, Martin JS, Argenziano G. Dr K. Holubar (1936-2013). Teaching with dermoscopy: Revealing the subsurface morphology of Auspitz's sign and psoriasis. Int J Dermatol 2014;53:e322-4.