10.5826/dpc.1304S1a297S
Dermoscopic patterns of inflammatory dermatoses (inflammoscopy) have been extensively studied in the recent years, though data on patients with darker phototypes (IV-VI) are sparse. The aims of this systematic review were to summarize the current state of knowledge on inflammoscopy applied to skin of color and provide a standardized nomenclature of reported findings. Besides dermoscopic features, type of setting and magnification, number of cases, and histopathological correlation were analyzed. Eighty-five papers addressing 76 different dermatoses (25 papulosquamous dermatoses, 19 hyperpigmented dermatoses, seven hypopigmented dermatoses, four granulomatous dermatoses, two sclerotic dermatoses, five facial inflammatory dermatoses, and 14 miscellaneous conditions) for a total of 2073 instances were retrieved. Only one study showed a level of evidence of III (cross-sectional study), whereas 10 and 74 displayed a level of evidence of IV (case-control studies) and V (case-series and case-reports), respectively. Moreover, our analysis also highlighted that most of papers focalized on a limited number of dermatoses, with several conditions having only single dermoscopic descriptions. Additionally, few studies compared findings among phototypes belonging to the “skin of color” spectrum. Further studies designed according to a systematic approach and considering the above-mentioned issues are therefore needed.
text/xml
2160-9381
3540
en
Enzo Errichetti
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
systematic review
Dermoscopy of Inflammatory Dermatoses (Inflammoscopy) in Skin of Color—A Systematic Review by the International Dermoscopy Society “Imaging in Skin of Color” Task Force
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Review
2023-10-04
2023-05-13
2023-10-04
2023-11-27
e2023297S
Dermatol Pract Concept
Dermoscopic patterns of inflammatory dermatoses (inflammoscopy) have been extensively studied in the recent years, though data on patients with darker phototypes (IV-VI) are sparse. The aims of this systematic review were to summarize the current state of knowledge on inflammoscopy applied to skin of color and provide a standardized nomenclature of reported findings. Besides dermoscopic features, type of setting and magnification, number of cases, and histopathological correlation were analyzed. Eighty-five papers addressing 76 different dermatoses (25 papulosquamous dermatoses, 19 hyperpigmented dermatoses, seven hypopigmented dermatoses, four granulomatous dermatoses, two sclerotic dermatoses, five facial inflammatory dermatoses, and 14 miscellaneous conditions) for a total of 2073 instances were retrieved. Only one study showed a level of evidence of III (cross-sectional study), whereas 10 and 74 displayed a level of evidence of IV (case-control studies) and V (case-series and case-reports), respectively. Moreover, our analysis also highlighted that most of papers focalized on a limited number of dermatoses, with several conditions having only single dermoscopic descriptions. Additionally, few studies compared findings among phototypes belonging to the “skin of color” spectrum. Further studies designed according to a systematic approach and considering the above-mentioned issues are therefore needed.
Enzo Errichetti
2023/10/04
10.5826/dpc.1304S1a297S
e2023297S
University of Udine, Italy
2160-9381
systematic review
en
e2023297S
Soni, R., A.J. Lokhande, and P. D'Souza, Atypical Presentation of Sweat Dermatitis with Review of Literature. Indian Dermatol Online J, 2019. 10(6): p. 698-703.
Dermoscopy of Inflammatory Dermatoses (Inflammoscopy) in Skin of Color—A Systematic Review by the International Dermoscopy Society “Imaging in Skin of Color” Task Force
https://dpcj.org/index.php/dpc/article/download/3540/2349
        Dermoscopy of Inflammatory Dermatoses
    (Inflammoscopy) in Skin of Color – A Systematic
    Review by the International Dermoscopy Society
          “Imaging in Skin of Color” Task Force
       Martyna Sławińska1, Jakub Żółkiewicz1, Biswanath Behera2, Delaney D Ding3,
        Aimilios Lallas4, Payal Chauhan5, Soumil Khare6, Nkechi Anne Enechukwu7,
     Bengu Nisa Akay8, Balachandra S Ankad9, Yasmeen J Bhat10, Abhijeet Kumar Jha11,
  Feroze Kaliyadan12, Awatef Kelati13, Shekhar Neema14, Nisha V Parmar15, Jennifer Stein16,
      Richard P Usatine17, Keshavamurthy Vinay18, Michał Sobjanek1, Enzo Errichetti19


 1 Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Poland
 2 Department of Dermatology and Venereology, AIIMS, Bhubaneswar, India
 3 University of Florida College of Medicine, Gainesville, FL, USA
 4 First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
 5 Department of Dermatology, All India Institute of Medical Sciences (AIIMS), Bilaspur, Himachal Pradesh, India
 6 Department of Dermatology, Venereology and Leprosy, AIIMS, Raipur, India
 7 Nnamdi Azikiwe University/Nnamdi Azikiwe Teaching Hospital Nnewi, Anambra State, Nigeria
 8 Department of Dermatology, School of Medicine, Ankara University, Ankara, Turkey
 9 Department of Dermatology, Venereology and Leprosy, SN Medical College, Bagalkot, Karnataka, India
10 Department of Dermatology, Venereology and Leprology, Government Medical College, University of Kashmir, Srinagar, Jammu and
   Kashmir, India
11 Department of Dermatology & STD, Patna Medical College & Hospital, Patna, India
12 Department of Dermatology, Sree Narayana Institute of Medical Sciences, Ernakulum, India
13 Dermatology Department, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences (UM6SS),
   Casablanca, Morocco
14 Department of Dermatology, Venereology and Leprology, Armed Force Medical College, Pune, Maharashtra, India
15 Department of Dermatology, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
16 The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA
17 Department of Dermatology and Cutaneous Surgery, Department of Family and Community Medicine, University of Texas Health
   San Antonio, San Antonio, TX, USA
18 Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
19 Institute of Dermatology, “Santa Maria della Misericordia” University Hospital, Udine, Italy



Key words: dermoscopy, dermatoscopy, epiluminescence, inflammoscopy, pigmentaroscopy, skin of color, dark skin, black skin, ethnic skin,
dark phototype, african skin, systematic review
Citation: Sławińska M, Żółkiewicz J, Behera B, et al. Dermoscopy of Inflammatory Dermatoses (Inflammoscopy) in Skin of Color – a
systematic review by the International Dermoscopy Society “Imaging in Skin of Color” Task Force. Dermatol Pract Concept. 2023;13(4)
S1:e2023297S. DOI: https://doi.org/10.5826/dpc.1304S1a297S
Accepted: June 19, 2023; Published: October 2023
Copyright: ©2023 Sławińska et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.




Review | Dermatol Pract Concept. 2023;13(4)S1:e2023297S                                                                                1
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: Enzo Errichetti, MD, Institute of Dermatology, “Santa Maria della Misericordia” University Hospital, Piazzale
Santa Maria della Misericordia, 15. 33100-Udine, Italy. Email: enzoerri@yahoo.it




    ABSTRACT           Dermoscopic patterns of inflammatory dermatoses (inflammoscopy) have been extensively studied
                       in the recent years, though data on patients with darker phototypes (IV-VI) are sparse. The aims of
                       this systematic review were to summarize the current state of knowledge on inflammoscopy applied
                       to skin of color and provide a standardized nomenclature of reported findings. Besides dermoscopic
                       features, type of setting and magnification, number of cases, and histopathological correlation were
                       analyzed. Eighty-five papers addressing 78 different dermatoses (25 papulosquamous dermatoses, 19
                       hyperpigmented dermatoses, eight hypopigmented dermatoses, four granulomatous dermatoses, two
                       sclerotic dermatoses, five facial inflammatory dermatoses, and 15 miscellaneous conditions) for a t­ otal
                       of 2073 instances were retrieved. Only one study showed a level of evidence of III (cross-­sectional
                       study), whereas 10 and 74 displayed a level of evidence of IV (case-control studies) and V (case-series
                       and case-reports), respectively. Moreover, our analysis also highlighted that most of papers focalized
                       on a limited number of dermatoses, with several conditions having only single dermoscopic descrip-
                       tions. Additionally, few studies compared findings among phototypes belonging to the “skin of color”
                       spectrum. Further studies designed according to a systematic approach and considering the above-­
                       mentioned issues are therefore needed.




Introduction                                                             Materials and Methods
Dermoscopic patterns of inflammatory dermatoses have                     A comprehensive search of the literature through the
been widely studied in recent years, thereby providing the               PubMed electronic database using the following key words
clinician with clues facilitating the non-invasive diagnosis of          was performed from inception to 30th June 2022: “dermos-
several entities with a consequent reduction of number of                copy” OR “epiluminescence” OR “dermatoscopy” AND
cases requiring biopsy. However, most of structured evidence             “skin of color” OR “dark skin” OR “black skin” OR “ethnic
available from the literature concerns fair-skinned patients,            skin” OR “dark phototype” OR “african skin” OR “indian
with data on darker phototypes (Fitzpatrick’s phototypes                 skin”. After performing the initial search, two authors in-
IV-VI) being sparse. This is a relevant issue as inflammatory            dependently screened titles and abstracts for inclusion and
diseases in skin of color tend to differ under dermoscopy                exclusion criteria. Based on title and abstract analysis we
due to the darker background color, usually making vascu-                included articles concerning dermoscopic features of inflam-
lar findings less evident, as well as a higher prevalence of             matory, non-infectious dermatoses. Records not related to
pigmentary, follicular and fibrotic structures, that may cover           the topic, non-English manuscripts, review articles, personal
features considered to be peculiar in fair-skinned patients.             opinions/editorials and duplicates were not considered. Ad-
Hence, data on lighter phototypes may not be always appli-               ditionally, reports regarding inflammatory disorders of oral
cable to subjects with dark skin tones.                                  mucosa, nails and hair have been excluded as they were out
    Although previous attempts have been done to summa-                  of the aim of the present review. The remaining articles were
rize knowledge on dermoscopic patterns of inflammatory                   qualified as eligible for full-text reading.
dermatoses in skin of color, no systematic review on this                     After reading the full manuscript, some papers were ex-
topic does exist [1, 2]. Therefore, the International Der-               cluded (not relevant, not providing frequency of dermoscopic
moscopy Society (IDS) Task Force on “Imaging in Skin of                  structures according to specific dermatosis/number of patients
Color” promoted the present analysis in order to provide                 with particular dermoscopic structures). We included articles
a structured overview on the current state of knowledge                  concerning Fitzpatrick’s phototypes IV-VI. If the information
about dermoscopy of inflammatory diseases (inflam-                       on the skin phototype was not provided, decision on inclusion
moscopy) in dark phototypes and align dermoscopic ter-                   was made based on a title/abstract/full text showing that the
minology of described findings based on a standardized                   manuscript concerned “dark skin” or “skin of color” and for
methodology in order to identify possible gaps and show                  single cases also based on the attached figures; additionally,
directions of future studies.                                            we included papers concerning dermoscopy of inflammatory



2                                                                                 Review | Dermatol Pract Concept. 2023;13(4)S1:e2023297S
diseases from African, Indian subcontinent, and Caribbean                 Regarding the type of the study, we included 1 cross-­
countries as majority of inhabitants of these regions have            sectional study, 10 case-control studies, 33 case series, and
IV-VI skin phototype. Of note, papers concerning phototype            41 case reports, with a level of evidence being as follows:
IV-VI together with lighter skin phototypes were excluded             I – 0; II – 0; III – 1; IV – 10; V – 74. Seventy-eight differ-
unless fair-skinned patients represented less than 20% of the         ent dermatoses (also taking into account relevant disease
total. Additional relevant, eligible records identified through       variants typified by clinical/dermoscopic peculiarities)
references search were also included.                                 were assessed, including 25 papulosquamous dermatoses,
   All of the retrieved studies were classified based on stan-        19 hyperpigmented dermatoses, eight hypopigmented der-
dard definitions for diagnostic accuracy studies, and their level     matoses, four granulomatous dermatoses, two sclerotic
of evidence was assigned according to The Oxford 2011 Levels          dermatoses, five facial inflammatory dermatoses, and 15
of Evidence [3]. Dermoscopic findings, corresponding histo-           miscellaneous conditions; a total of 2073 instances were re-
pathological features (if specified), dermoscopic setting (polar-     trieved. Table 1 displays all the disorders analyzed with the
ized versus nonpolarized/magnification degree), and number of         number of s­ tudies and total number of included patients for
cases were assessed and summarized. Importantly, for studies          each condition.
assessing dermoscopic changes after therapies, we considered              Specific data on skin phototype was provided in 31/85
for the analysis only features before the treatment (if avail-        (36.5%) of records, while dermoscopic setting (polarized vs
able) to avoid therapies-induced variation. Finally, standard-        nonpolarized) was mentioned in 51/85 (60%) records (40/85
ized terminology according to the IDS dermoscopic criteria for        polarized; 4/85 non-polarized; and 7/85 both), magnifica-
non-neoplastic dermatoses validated for skin of color was spec-       tion degree in 56/85 (65.9%) records (46/85 x10 magnifi-
ified for each dermoscopic finding retrieved from the review [4].     cation; 7/85 x20 magnification; 4/85 > 20x magnification),
                                                                      and ­dermoscopic-pathological correlation in 33/85 (38.8%)

Results                                                               records. All the above-mentioned data are summarized in
                                                                      Supplemental Table, along with analytical description of each
The initial PubMed search and the additional extensive ref-           study evaluated in the review (number of patients, type of
erence search yielded 1287 and 53 publications, respectively,         study, and level of evidence), dermoscopic features, and cor-
with a total of 163 items being included for full-text reading        responding terminology according to the IDS dermoscopic
after title and abstract screening and excluding duplicates.          criteria for non-neoplastic dermatoses validated for skin of
Of these, 78 papers were ruled out according to exclusion             color. Table 1 also displays the general prevalence of tricho-
criteria, with 85 articles being eventually admitted to the re-       scopic findings for each condition calculated considering all
view procedure. Figure 1 shows the flow chart summarizing             the data available from the literature. Relevant findings for
the study selection process.                                          each dermatosis are reported as follows; for practical purpose,




         Figure 1. PRISMA flowchart displaying the selection process for study inclusion in the systematic review.



Review | Dermatol Pract Concept.2023;13(4)S1:e2023297S                                                                             3
Table 1. Total number of studies, instances and prevalence of standardized dermoscopic findings of
                     inflammatory/pigmentary dermatoses in skin of color
                                   Total number
                                    of instances
                         Total    [instances with
                        number      dermoscopy
                           of        prevalence
       Dermatosis       studies         data]               Dermoscopic findings* (total prevalence)**
Papulosquamous dermatoses
Acquired perforating
dermatosis
Non-specified subtype       1         19 [19]       Common findings: Central crust (100%); Peripheral pigmented
                                                    structureless area (94%) Three-zone concentric pattern (92%);
                                                    White structureless area (92%)
                                                    Less common findings: Pigmented dots (42%); Peripheral
                                                    pigmented reticular lines (40%); Follicular plugs (34%);
                                                    Dotted vessels (23%); Peripheral linear-curved vessels (21%);
                                                    Purple structureless areas (14%); Two-zone concentric
                                                    pattern (8%); Pigmented reticular lines (7%); Peripheral
                                                    dotted vessels (7%); Peripheral lines (4%); Linear vessels with
                                                    branches (1%)
Kyrle disease               2          2 [2]        Common findings: Central white/brown crust (50%);
                                                    Structureless whitish-grey area around the crust (50%);
                                                    Peripheral brown structureless area (50%); Central white
                                                    globules (50%); Peripheral grey structureless areas and reticular
                                                    brown lines (50%)
                                                    Less common findings: -
Acrokeratosis               1          1 [0]        Common findings: -
verruciformis of Hopf                               Less common findings: -
Darier’s disease            1          1 [1]        Common findings: Dark brown polygonal to round structures
                                                    surrounded by peripheral grey- white halo (100%); White scales
                                                    (100%)
                                                    Less common findings: -
Dermatitis (eczema)
Non-specified subtype       2         39 [39]       Common findings: -
                                                    Less common findings: Dotted vessels (46%); Patchy white
                                                    scales (39%); Patchy yellow scales/crusts (36%); Patchy scales
                                                    distribution (36%); Purple dots (36%); Brown dots (33%);
                                                    Patchy brown scales/crusts (31%); Fabric fibers (31%); Brown
                                                    focal structureless areas (28%); Yellow scales (26%); Erosions
                                                    (26%); Diffuse brown structureless areas (23%); White focal
                                                    structureless areas (23%); Purple focal structureless areas
                                                    (18%); Unspecific vessel distribution (18%); Clustered dotted
                                                    vessels (15%); White-yellow scales (8%); Perifollicular white
                                                    scales (8%); White scales (5%); White diffuse structureless areas
                                                    (5%); Grey focal structureless areas (5%); Unspecific vessel
                                                    distribution (5%); Diffuse white scales (3%); Central white
                                                    scales (3%); Peripheral scales distribution (3%)
Follicular eczema           1         11 [11]       Common findings: Follicular plugs with perifollicular white
                                                    color (100%)
                                                    Less common findings: -
Keratosis pilaris           1          1 [1]        Common findings: Twisted hairs forming loops and irregular
                                                    coils (100%); Perifollicular scales (100%); Scattered pigmented
                                                    globules (100%)
                                                    Less common findings: -
Lichen amyloidosis          3         48 [48]       Common findings; Brown, grey-brown, grey, blue-grey dots
                                                    (63%); Two-zone pattern (52%)




4                                                                Review | Dermatol Pract Concept. 2023;13(4)S1:e2023297S
                                          Total number
                                           of instances
                               Total     [instances with
                              number       dermoscopy
                                 of         prevalence
        Dermatosis            studies          data]               Dermoscopic findings* (total prevalence)**
                                                           Less common findings: Brown dots (29%); Central brown/
                                                           white dot/globule with peripheral pigmentation (23%); White
                                                           scales (23%); White structureless areas (17%); Dotted vessels
                                                           (15%); Blue-grey globules (11%); Central brown/white globule
                                                           with peripheral pigmentation (10%); Scattered brown dots
                                                           (8%); Perieccrine brown dots (6%); Scales distribution: central
                                                           (6%); Scales distribution: peripheral (6%); Brown structureless
                                                           areas (6%); Clustered brown dots (6%); Central globule (6%);
                                                           Follicular plugs (2%); White globules (2%); Brown globules
                                                           (2%); Clustered and scattered brown dots (2%)
 Lichen nitidus                   3           22 [22]      Common findings: White globules with sharp margins and lack
                                                           of skin creases (59%)
                                                           Less common findings: Lack of dermatoglyphics (36%); Ill-defined
                                                           white structureless areas (36%); Radial ridges (32%); Central
                                                           depression (27%); Linear vessels (23%); Peripheral scales (14%);
                                                           White globules (5%); Central brown structureless area (5%)
 Lichen planus (LP)
 Classic LP                      13          293[293]      Common findings: Wickham striae (60%)
                                                           Less common findings: Follicular plugs (39%); Blue globules
                                                           (37%); White structureless areas (29%); Diffuse grey-blue
                                                           structureless area (11%); Yellow structureless areas (11%);
                                                           Peripheral lines (10%); Dotted vessels (8%); Diffuse brown
                                                           structureless areas (8%); Brown dots (8%); Peripheral white
                                                           lines (8%); Brown globules (8%); Scales (7%); Grey-blue dots
                                                           (6%); White scales (6%); Patchy scales distribution (6%);
                                                           Vessels (5%); Brown and grey structureless areas (5%); Blue-
                                                           grey globules (4%); Peripheral dotted vessels (3%); Grey
                                                           dots (3%); Peripheral vessels distribution (3%); Grey-blue
                                                           structureless areas (3%); Yellow- brown dots (2%); Grey dots
                                                           and structureless areas (2%); Brown dots and structureless
                                                           areas (2%); Focal brown structureless areas (2%); Patchy white
                                                           scales (2%); Peripheral linear vessels (2%); Central white scales
                                                           (2%); Focal purple structureless areas (1%); Purple dots (1%);
                                                           Diffuse yellow structureless area (1%); Linear vessels (1%);
                                                           Unspecific vessels distribution (1%); Grey and brown areas
                                                           (1%); Brown structureless areas (1%); Brown reticular lines
                                                           (1%); Crusts (1%); Diffuse scales distribution (1%); Peripheral
                                                           scales distribution (1%); Yellow dots (0.3%); Linear and dotted
                                                           vessels (0.3%); Peripheral dotted and linear vessels (0.3%);
                                                           Peripheral pigmented dots (0.3%); White globules (0.3%);
                                                           Follicular openings obliteration (0.3%); Diffuse white scales
                                                           (0.3%); Perifollicular white scales (0.3%)
 Hypertrophic LP                  5           36 [36]      Common findings: Follicular plugs (64%)
                                                           Less common findings: Dotted vessels (central and peripheral)
                                                           (36%); Wickham striae (31%); White structureless areas (28%);
                                                           Yellow reticular lines (25%); Central white scales (19%); Focal
                                                           brown structureless areas (19%); Patchy white scales (17%);
                                                           Grey-blue globules (17%); Brown globules (8%); Peripheral
                                                           dotted vessels (8%); Dotted vessels (8%); Diffuse brown
                                                           structureless areas (8%); Dotted vessels of unspecific distribution
                                                           (3%); Diffuse white scales (3%); Focal white structureless areas
                                                           (3%); Grey-blue dots (3%); Brown dots (3%)

                                                                                                               Table1 continues


Review | Dermatol Pract Concept.2023;13(4)S1:e2023297S                                                                       5
Table 1. Total number of studies, instances and prevalence of standardized dermoscopic findings of
                inflammatory/pigmentary dermatoses in skin of color. (continued)
                                      Total number
                                       of instances
                            Total    [instances with
                           number      dermoscopy
                              of        prevalence
       Dermatosis          studies         data]               Dermoscopic findings* (total prevalence)**
Palmo-plantar LP             1            1 [1]        Common findings: Brown lines along the ridges of
                                                       dermatoglyphics (100%)
                                                       Less common findings: -
Lichen simplex chronicus     1            1 [1]        Common findings: Dotted vessels (100%); White structureless
                                                       areas (100%); Grey-blue structureless areas (100%)
                                                       Less common findings: -
Pityriasis lichenoides
PLEVA                        1           14 [14]       Common findings: Central crust with peripheral white
                                                       structureless area (86%); Blue-grey structureless areas (71%);
                                                       Yellow globules or structureless areas (71%); Dotted vessels
                                                       (71%); Scales (57%);
                                                       Less common findings: Purple structureless areas (29%); Brown
                                                       structureless areas (14%); White structureless areas (14%)
Pityriasis lichenoides       1           15 [15]       Common findings: Peripheral white scales (smooth inner free
chronica                                               edge) (80%)
                                                       Less common findings: Brown dots (40%); Focal brown
                                                       structureless areas (27%); Diffuse brown structureless areas
                                                       (27%); Central (mica-like) white scales (20%); Dotted vessels
                                                       of unspecific distribution (20%); Purple dots (13%); Diffuse
                                                       structureless areas (7%); Focal purple structureless areas (7%)
Pityriasis rosea             5           86 [86]       Common findings: -
                                                       Less common findings: White scale (30%); Scales (28%); Brown
                                                       dots (26%); Peripheral white scales (jagged inner free edge)
                                                       (23%); Peripheral scales (21%); Diffuse brown structureless areas
                                                       (19%); Patchy scales (15%); Brown scales (10%); Central scales
                                                       (8%); Unspecifically distributed dotted vessels (7%); Peripheral
                                                       brown scales/crusts (7%); Focal brown structureless areas (6%);
                                                       Uniform dotted vessels (6%); Focal grey structureless areas (5%);
                                                       Perifollicular white scales (5%); Peripheral white scales (jagged
                                                       mixed free edge) (2%); Diffuse scales (2%); Peripheral dotted
                                                       vessels (1%); Diffuse brown scales/crusts (1%); Diffuse white
                                                       structureless areas (1%); Diffuse yellow structureless area (1%)
Pityriasis rubra pilaris     1            4 [4]        Common findings: Follicular plugs (100%); Perifollicular
                                                       yellow halo (75%)
                                                       Less common findings: -
Porokeratosis
Non-specified subtype        1           10 [10]       Common findings: Brown/white peripheral keratotic tract with
                                                       a double free edge (100%)
                                                       Less common findings: Focal white structureless areas (30%);
                                                       Diffuse brown structureless areas (30%); Focal brown
                                                       structureless areas (20%); Brown dots (20%); Central white
                                                       scales (20%); Patchy white scales (20%); Uniform dotted vessels
                                                       (10%); Clustered dotted vessels (10%); Follicular plugs (10%)
Superficial pigmented        1            3 [0]        Common findings: -
disseminated                                           Less common findings: -
Superficial disseminated     1            1 [1]        Common findings: Peripheral brown dots and peripheral white
                                                       keratotic tract with double free edge (100%); Central dotted
                                                       vessels and brown structureless areas (100%)
                                                       Less common findings: -



6                                                                   Review | Dermatol Pract Concept. 2023;13(4)S1:e2023297S
                                          Total number
                                           of instances
                               Total     [instances with
                              number       dermoscopy
                                 of         prevalence
        Dermatosis            studies          data]                Dermoscopic findings* (total prevalence)**
 Porokeratosis of Mibelli         1            1 [1]       Common findings: Brown dots/globules/lines (100%); Brown/
                                                           white peripheral keratotic tract with a double free edge (100%)
                                                           Less common findings: -
 Prurigo nodularis                3           60 [60]      Common findings: Dotted vessels (62%)
                                                           Less common findings: Peripheral lines (42%); White
                                                           structureless areas (40%); Peripheral- radiating white lines
                                                           (28%); Diffuse white structureless areas (23%); Crusts
                                                           (20%); Scales (17%); Central white structureless areas with
                                                           peripheral-radiating white lines (17%); Follicular plugs (13%);
                                                           Brown globules (12%); Purple globules (12%); White globules
                                                           (10%); Central white scales (8%); Patchy white scales (8%);
                                                           Purple dots (8%); Dotted vessels (peripheral and central)
                                                           (8%); Dotted vessels of unspecific distribution (5%); Focal
                                                           purple structureless areas (5%); Peripheral linear vessels
                                                           (3%); Peripheral white scales (3%); Yellow structureless areas
                                                           (3%); Focal white structureless areas (3%); Diffuse brown
                                                           structureless areas (3%); Focal brown structureless areas (2%);
                                                           Uniform dotted vessels (2%); Brown dots (2%); Fabric fibers
                                                           (2%)
 Psoriasis
 Non-specified subtype            3           89 [89]      Common findings: -
                                                           Less common findings: Dotted vessels (48%); Scales (39%); Red
                                                           globules (30%); Diffuse white scales (29%); Uniform dotted
                                                           vessels (26%); Focal brown structureless areas (18%); Uniform
                                                           vessels distribution (17%); Scales (patchy distribution) (13%);
                                                           White scales (12%); Focal white structureless areas (12%);
                                                           Brown dots (12%); Diffuse brown structureless areas (12%);
                                                           Diffuse grey-blue structureless area (11%); Linear-curved
                                                           vessels (6%); White- yellow scales (5%); Perifollicular white
                                                           scales (5%); Purple dots (5%); Peripheral vessels distribution
                                                           (3%); Grey-blue dots (3%); Focal purple structureless areas
                                                           (3%); Clustered dotted vessels (2%); Peripheral white scales
                                                           (2%); Patchy white scales (2%); Focal grey structureless areas
                                                           (2%); Fabric fibers (2%); Central white scales (2%)
 Follicular Psoriasis             1            1 [1]       Common findings: Diffuse white-brown structureless area
                                                           (100); Perifollicular scaling (100); Dotted vessels (100); Linear-
                                                           curved vessels (100)
                                                           Less common findings: -
 Guttate psoriasis                2           85 [85]      Common findings: White scales (80%); Dotted vessels (69%)
                                                           Less common findings: Diffuse scales distribution (44%);
                                                           Patchy scales distribution (39%); Uniform vessels distribution
                                                           (31%); Brown-grey structureless areas (19%); Brown dots/
                                                           structureless areas (16%); Unspecific vessels distribution (15%);
                                                           Grey dots/structureless areas (13%); Perifollicular white color
                                                           (7%); Perifollicular pigmentation (5%); Follicular plugs (4%);
                                                           Peripheral scales distribution (2%)
 Hyperpigmented dermatoses
 Acanthosis nigricans             2           41 [40]      Common findings: Crista cutis (100%); Sulcus cutis (100%);
 (facial)                                                  Brown dots (100%)
                                                           Less common findings: -

                                                                                                               Table1 continues




Review | Dermatol Pract Concept.2023;13(4)S1:e2023297S                                                                          7
Table 1. Total number of studies, instances and prevalence of standardized dermoscopic findings of
                inflammatory/pigmentary dermatoses in skin of color. (continued)
                                     Total number
                                      of instances
                           Total    [instances with
                          number      dermoscopy
                             of        prevalence
         Dermatosis       studies         data]               Dermoscopic findings* (total prevalence)**
Acquired dermal macular     1           51 [51]       Common findings: Brown and blue-grey color: dots (82%),
hyperpigmentation                                     globules (67%), structureless areas (57%)
                                                      Less common findings: Vessels (82%); Color arrangement: lines
                                                      (41%), structureless (33%), reticular lines (33%)
Ashy dermatosis
Facial                      1           11 [11]       Common findings: Periostial blue dots (90%); Periostial grey
                                                      dots (73%)
                                                      Less common findings: Blue structureless areas (27%);
                                                      Blue globules (27%); Brown dots (18%);
                                                      Grey globules (9%)
Extra-facial                1           13 [13]       Common findings: Grey dots (92%); Blue dots (77%)
                                                      Less common findings: Blue globules (31%); Grey globules
                                                      (15%); White structureless areas (8%); Brown structureless
                                                      areas (8%); Grey structureless areas (8%); Blue structureless
                                                      areas (8%); Brown dots (8%)
Not specified               1            4 [4]        Common findings: Dotted vessels (75%), uniform (50%);
                                                      Brown dots (50%)
                                                      Less common findings: Grey-blue dots (25%); Structureless
                                                      pigmented areas (25%)
Dermatosis neglecta         1            1 [1]        Common findings: Polygonal plate-like brown scales arranged
                                                      in a mosaic-like pattern (100%); Smaller cornflakes-like scales
                                                      (peripherally) (100%); Background erythema (100%)
                                                      Less common findings: -
Exogenous ochronosis        5           22 [22]       Common findings: -
                                                      Less common findings: Grey semicircles/circles (interostial)
                                                      (41%); Focal white structureless areas (32%); Focal brown
                                                      (ostial sparing) structureless areas (32%); Focal brown
                                                      (ostial obliteration) structureless areas (32%); Interostial
                                                      brown globules (32%); Interostial grey globules (27%); Focal
                                                      grey (ostial obliteration) structureless areas (18%); Brown
                                                      semicircles (interostial) (18%); Blue-grey structureless areas
                                                      with focal ostial obliteration (18%); Brown structureless
                                                      areas (14%); White dots (9%); Interostial grey dots (5%);
                                                      Greyish structureless areas (5%); Semicircles (5%); ­
                                                      Blue-brown dots/globules (5%); Scales (5%); Brown-
                                                      grey dots/globules + semicircles/circles (interfollicular and
                                                      perifollicular) (5%)
Facial pigmentary           1           20 [20]       Common findings: Pigmented structureless areas (90%); Vessels
demarcation lines                                     (65%); Pigmented dots (60%)
                                                      Less common findings: -
Frictional melanosis        2           11 [11]       Common findings: Perifollicular white color (73%)
                                                      Less common findings: Focal white structureless areas
                                                      (45%); Reticular (network) brown lines (45%); Focal
                                                      brown structureless areas (27%); White globules (27%);
                                                      Brown dots and globules (18%); Hyperpigmented
                                                      globules (10%)
Gougerot-Carteaud           1            3 [3]        Common findings: Polygonal brown areas (cobblestone pattern)
syndrome                                              (67%)
                                                      Less common findings: Sulci and gyri (33%)



8                                                                  Review | Dermatol Pract Concept. 2023;13(4)S1:e2023297S
                                          Total number
                                           of instances
                               Total     [instances with
                              number       dermoscopy
                                 of         prevalence
        Dermatosis            studies          data]               Dermoscopic findings* (total prevalence)**
 Lichen planus                    3          104 [104]     Common findings: Dots/globules (54%)
 pigmentosus Facial                                        Less common findings: Brown pigmentation with ostial sparing
                                                           (pseudonetwork) (23%) Loss of vellus hair (23%); Vessels
                                                           (17%); Dots (16%); Dots/globules + brown pigmentation
                                                           with ostial sparing (pseudonetwork) (16%); Globules
                                                           (13%); Periostial brown dots (12%); Blue-grey dots (12%);
                                                           Perifollicular pigmentation (9%); Periostial brown-grey dots
                                                           (7%); Periostial grey dots (7%); Focal brown (ostial sparing)
                                                           structureless areas (4%); Follicular/eccrine ostia obliteration
                                                           (2%); Diffuse brown structureless area (1%)
        Extra-facial              2           15 [15]      Common findings: Diffuse brown structureless areas (93%);
                                                           Brown dots (87%)
                                                           Less common findings: Grey dots (40%); Brown globules
                                                           (40%); Grey globules (20%)
       Not specified              1            7 [7]       Common findings: White globules (57%)
                                                           Less common findings: Brown dots (43%); Brown structureless
                                                           areas (29%); Blue-black structureless areas (29%); Grey-blue
                                                           structureless areas (14%)
 Macular amyloidosis              3           65 [65]      Common findings: Brown dots (57%)
                                                           Less common findings: Clustered brown dots (38%); Central
                                                           brown/white globule with peripheral pigmentation (35%);
                                                           Scattered brown dots (32%); Pigmented (brown, grey-brown,
                                                           grey, or blue-grey) dots and globules (28%); Blue-grey globules
                                                           (20%); Clustered and scattered brown dots (15%); Perieccrine
                                                           brown dots (11%); Focal white structureless areas (11%);
                                                           Central globule (10%); Linear dots (8%); Brown globules (6%);
                                                           Brown structureless
                                                           areas (3%); Grey dots (2%)
 Maturational                     1            1 [1]       Common findings: Brown structureless area with ostial sparing
 hyperpigmentation                                         (100%); Brown globules (100%); Brown structureless areas
                                                           (100%); Perifollicular pigmentation (100%)
                                                           Less common findings: -
 Melasma                          7          150 [150]     Common findings: Ostial sparing (65%)
                                                           Less common findings: Brown reticular lines (focal) (42%);
                                                           Brown reticular lines (diffuse) (25%); Diffuse/focal brown
                                                           structureless areas (with ostial sparing) (13%); Focal brown
                                                           structureless areas (12%); Brown dots (9%); Interostial
                                                           brown dots (5%); Diffuse brown structureless areas with
                                                           ostial sparing (4%); Vessels (3%); Brown structureless areas
                                                           (3%) Perifollicular/perieccrine pigmentation (3%); Focal
                                                           grey (with ostial obliteration) structureless areas (1%); White
                                                           dots (1%); Blue-grey structureless areas (1%); Brown dots/
                                                           globules (1%)
 Photomelanosis                   1            1 [1]       Common findings: Hyperpigmented dots and globules (100%)
                                                           Less common findings: -
 Riehl melanosis                  1           17 [17]      Common findings: Intraostial brown dots (100%)
                                                           Less common findings: Interostial grey dots (35%); Periostial
                                                           grey dots (29%); Periostial brown dots (12%); Diffuse brown
                                                           structureless areas (6%); Blue dots (6%)

                                                                                                            Table1 continues




Review | Dermatol Pract Concept.2023;13(4)S1:e2023297S                                                                       9
Table 1. Total number of studies, instances and prevalence of standardized dermoscopic findings of
                inflammatory/pigmentary dermatoses in skin of color. (continued)
                                  Total number
                                   of instances
                        Total    [instances with
                       number      dermoscopy
                          of        prevalence
         Dermatosis    studies         data]               Dermoscopic findings* (total prevalence)**
Seborrheic melanosis       1         12 [12]       Common findings: White-yellow gelatinous protruding
                                                   follicular plugs (100%); Diffuse brown area with ostial sparing
                                                   (80%); Yellow scales (50%)
                                                   Less common findings: Linear vessels (30%)
Hypopigmented dermatoses
Idiopathic guttate         2         42 [42]       Common findings: White structureless areas with peripheral
hypomelanosis                                      projections (91%)
                                                   Less common findings: Perifollicular/perieccrine pigmentation
                                                   (26%); Peripheral white projections (24%); Well-defined diffuse
                                                   bright white structureless areas (21%); Reticular (intralesional)
                                                   brown lines (10%); Ill-defined diffuse bright white structureless
                                                   areas (7%); White structureless areas with ill-defined margins
                                                   (2%)
Pityriasis alba            1         12 [12]       Common findings: Diffuse dull white structureless areas with
                                                   blurred margins (100%)
                                                   Less common findings: Incomplete perieccrine brown
                                                   pigmentation (42%); Brown dots (42%); White scales
                                                   (42%): patchy (25%), in skin furrows (17%); Incomplete
                                                   perifollicular
                                                   brown pigmentation (8%)
Progressive macular        1          2 [2]        Common findings: (Smooth, ill-defined) diffuse white
hypomelanosis                                      structureless area (100%)
                                                   Less common findings: -
Vitiligo
Unstable                   3         75 [75]       Common findings: Perifollicular pigmentation (53%)
                                                   Less common findings: Perifollicular white color (10%); Brown
                                                   reticular lines (10%);
                                                   Marginal brown areas (5%); Peripheral white lines (4%);
                                                   Linear white structureless area
                                                   (4%); Perilesional multiple white globules (4%)

Stable                     3         37 [37]       Common findings: -
                                                   Less common findings: Perifollicular pigmentation (43%);
                                                   Marginal brown areas (43%); Perifollicular white color
                                                   (41%); Brown reticular lines (35%); White hair (32%); White
                                                   structureless areas (3%)
                                                   Common findings: Perifollicular pigmentation (66%);
Repigmenting               1         18 [18]       Perilesional brown structureless area (66%); Vessels (66%)
                                                   Less common findings: Perifollicular white color (22%)
Not specified              3       119 [119]       Common findings: Brown reticular lines (51%)
                                                   Less common findings: Perifollicular pigmentation (47%);
                                                   Marginal brown areas (20%); Diffuse bright white areas with
                                                   sharp margins (13%); Peripheral white lines (10%); White hairs
                                                   (7%); Reticular brown lines (intralesional) (3%); Perifollicular/
                                                   perieccrine pigmentation (3%); Perifollicular white color (2%);
                                                   Diffuse bright white areas with blurred margins (2%); Linear
                                                   white structureless area (2%); Brown dots (1%); Reticular
                                                   white lines/areas (1%)
Blue vitiligo              1          1 [1]        Scattered blue dots on the side of the white area (100%);
                                                   Pigmented hairs with perifollicular pigment (100%)


10                                                              Review | Dermatol Pract Concept. 2023;13(4)S1:e2023297S
                                          Total number
                                           of instances
                               Total     [instances with
                              number       dermoscopy
                                 of         prevalence
        Dermatosis            studies          data]               Dermoscopic findings* (total prevalence)**
 Granulomatous dermatoses
 Granuloma annulare               1            4 [4]       Common findings: Diffuse white-yellow structureless area
                                                           (50%); White structureless areas (50%)
                                                           Less common findings: Diffuse white structureless area (25%);
                                                           Brown reticular lines (25%)
 Necrobiosis lipoidica            1            2 [2]       Common findings: Diffuse white-yellow structureless area
                                                           (100%); Linear vessels with branches (100%); Linear vessels
                                                           (100%); Brown reticular lines (100%)
                                                           Less common findings: -
 Sarcoidosis                      5           32 [32]      Common findings: -
                                                           Less common findings: Orange structureless areas (38%);
                                                           Linear vessels (31%); Diffuse orange structureless area
                                                           (28%); White scales (28%); Bright white structureless areas
                                                           (22%); Linear vessels with branches (19%); White globules
                                                           (16%); Orange globule (13%); Linear vessels with branches
                                                           of unspecific distribution (13%); Focal orange structureless
                                                           areas (9%) Focal bright white structureless areas (6%); Yellow
                                                           globules (6%); Brown reticular lines (3%); Focal brown
                                                           structureless areas (3%); Uniform linear vessels with branches
                                                           (3%); Patchy white scales (3%); Peripheral-radiating white lines
                                                           (3%); Linear vessels and linear vessels with branches (3%);
                                                           Yellow-orange globules (3%); White structureless areas (3%);
                                                           Orange-yellow structureless areas (3%); Pale orange globules
                                                           (3%); Bright white lines (3%); Dotted vessels (3%)
 Rheumatoid nodules               1            5 [5]       Common findings: -
                                                           Less common findings: White structureless areas (20%); Linear
                                                           vessels with branches (20%); Linear vessels (20%); Brown
                                                           reticular lines (20%)
 Sclerotic dermatoses
 Cutaneous lichen                 1           11 [11]      Common findings: Focal/diffuse bright white structureless areas
 sclerosus                                                 (100%); Follicular plugs (82%)
                                                           Less common findings: Perifollicular white color (bright) (27%);
                                                           Brown dots (27%); Patchy white scales (18%); Perpendicular
                                                           white lines (18%); Patchy brown scales/crusts (9%); Peripheral
                                                           linear vessels with branches (9%)
 Morphea                          3           16 [16]      Common findings: Focal dull white structureless areas (62%)
                                                           Less common findings: Perifollicular white color (dull) (31%);
                                                           Brown dots (25%); Focal and diffuse bright white structureless
                                                           areas (19%); Patchy brown scales (13%); Peripheral linear
                                                           vessels with branches (8%); Perpendicular white lines (6%);
                                                           Parallel white lines (6%); Unspecifically arranged white lines
                                                           (6%); Focal white structureless areas (6%); Linear vessels with
                                                           branches (6%); Yellow-white globules (6%)
 Facial inflammatory dermatoses
 Discoid lupus                    5          146 [146]     Common findings: Follicular plugs (81%)
 erythematosus                                             Less common findings: Perifollicular white color (44%); White
                                                           scales (37%); Structureless white areas (36%); Brown dots (31%);
                                                           Blue-grey dots (10%); Unspecifically distributed vessels (6%);
                                                           Diffuse brown structureless area (5%); Dotted vessels (5%);
                                                           Focal brown structureless areas with ostial obliteration (5%);

                                                                                                             Table1 continues




Review | Dermatol Pract Concept.2023;13(4)S1:e2023297S                                                                   11
Table 1. Total number of studies, instances and prevalence of standardized dermoscopic findings of
                inflammatory/pigmentary dermatoses in skin of color. (continued)
                                   Total number
                                    of instances
                         Total    [instances with
                        number      dermoscopy
                           of        prevalence
       Dermatosis       studies         data]               Dermoscopic findings* (total prevalence)**
                                                     Periostial brown pigmentation (3%); Focal bright white
                                                    structureless areas (3%); Patchy scale distribution (3%); Central
                                                    white scale (3%); Clustered dotted vessels (2%); Patchy white
                                                    scales (2%); Linear vessels of unspecific distribution (1%);
                                                    Brown structureless areas with ostial sparing (1%); Periostial
                                                    brown dots (1%); White lines (1%); Peripheral-radiating brown
                                                    lines (1%); Interostial brown dots (1%); Linear vessels with
                                                    branches of unspecific distribution (1%); Peripheral white scales
                                                    (1%); White-yellow scales (1%); Peripheral brown structureless
                                                    areas (1%); Blue-grey globules (1%); Central brown
                                                    structureless areas (1%); Peripheral white lines (1%); Peripheral-
                                                    radial red lines with white halo (“red starburst” pattern) (1%)
Lichen actinicus          2           12 [12]       Common findings: Focal/diffuse brown structureless areas with
                                                    ostial sparing (67%); Wickham striae (67%)
                                                    Less common findings: Periostial brown dots (33%); Follicular
                                                    plugs (25%); Interostial brown dots (17%); Greyish-blue (17%)
                                                    and brown structureless areas (17%); Peripheral white scale
                                                    (8%); Interostial brown globules (8%); White globules (8%)
Perioral dermatitis       1            1 [1]        Common findings: Brown reticular lines (100%)
                                                    Less common findings: -
Rosacea                   2           12 [12]       Common findings: Perifollicular/perieccrine pigmentation
                                                    (67%); Linear vessels in a reticular arrangement (67%)
                                                    Less common findings: Periostial brown globules (17%)
Seborrheic dermatitis     1           10 [10]       Common findings: Focal dull white structureless areas (70%);
                                                    Patchy white scales (70%); Patchy yellow scales/crusts (60%)
                                                    Less common findings: Patchy brown scales/crusts (40%);
                                                    Protruding follicular plugs (30%); Dotted clustered vessels
                                                    (10%); Linear clustered vessels (10%)
Miscellaneous
Capillaritis              1           13 [13]       Common findings: Brown reticular lines (100%); Purple
                                                    globules (67%)
                                                    Less common findings: Purple structureless areas (27%)
Cutaneous lupus
erythematosus (CLE)
Acute CLE Malar rash      1            9 [9]        Common findings: White structureless areas (78%); Follicular
                                                    plugs (67%)
                                                    Less common findings: Brown dots and globules (45%); Scales
                                                    (45%); Linear vessels (45%); Linear vessels with branches
                                                    (45%); Crusts (22%); Bright white structureless areas (22%);
                                                    Brown structureless areas (11%)
Generalized rash          2           21 [21]       Common findings: White structureless areas (76%); Brown dots
                                                    and globules (62%)
                                                    Less common findings: Follicular plugs (43%); Scales (43%);
                                                    Brown structureless areas (33%); Linear vessels (33%); Linear
                                                    vessels with branches (19%); Dotted vessels (19%); Blue-gray
                                                    dots (14%); Linear-curved vessels (14%); Crusts (14%); Bright
                                                    white structureless areas (14%); Two-zone targetoid pattern
                                                    (10%); Three zone targetoid pattern (10%); Brown dots (5%)




12                                                               Review | Dermatol Pract Concept. 2023;13(4)S1:e2023297S
                                          Total number
                                           of instances
                               Total     [instances with
                              number       dermoscopy
                                 of         prevalence
        Dermatosis            studies          data]                Dermoscopic findings* (total prevalence)**
 Subacute CLE                     2            2 [2]       Common findings: White structureless area (100%); Brown to
                                                           blue-gray dots (100%); Follicular plugs (50%); Linear, linear-curved
                                                           (comma), and dotted vessels (50%); Scales (50%); Patchy to diffuse
                                                           white scales (50%); Bright white structures (structureless area,
                                                           globules, and lines) (50%); Mixed vascular pattern comprised
                                                           of linear, linear-curved and dotted vessels (50%)
                                                           Less common findings: -
 Cutaneous mastocytosis
 Mastocytoma                      1            1 [1]       Common findings: Central white structureless area (100%);
                                                           Diffuse yellow structureless area (100%); Peripheral brown
                                                           reticular lines (100%)
                                                           Less common findings: -
 Telangiectasia macularis         1            1 [1]       Common findings: Linear vessels with branches arranged in a
 eruptiva perstans                                         reticular pattern (100%); White dots (100%); Diffuse brown
                                                           structureless area (100%)
                                                           Less common findings: -

 Urticaria pigmentosa             2            3 [3]       Common findings: Dark brown reticular lines (67%);
                                                           Light brown reticular lines (67%)
                                                           Less common findings: Brown reticular lines (33%)
 Dermatomyositis                  1            2 [2]       Common findings: Brown reticular lines (100%); Grey dots/
                                                           globules (100%); Linear vessels (unfocused) (100%);
                                                           White-pink structureless areas (100%); Brown/grey dots/
                                                           globules (100%); Linear vessels (100%)
                                                           Less common findings: -
 Fixed drug eruption              1            1 [1]       Common findings: Brown, grey and blue dots (100%);
                                                           Perifollicular white color (100%)
                                                           Less common findings: -
 Fox-Fordyce disease              1            1 [1]       Common findings: Loss of dermatoglyphics (100%); Follicular
                                                           plugs (100%); Perifollicular pigmentation (100%)
                                                           Less common findings: -
 Hailey-Hailey disease            1            1 [1]       Common findings: White areas + pink furrows (100%);
                                                           White structureless areas (100%); Dotted vessels (100%);
                                                           Brown/grey structureless areas (100%)
                                                           Less common findings: -
 Juvenile                         1           25 [25]      Common findings: Yellow-white or yellow-brown structureless
 xanthogranuloma                                           areas (92%); Yellow orange background with surrounding
                                                           erythema (56%); Scales (52%); Linear vessels (52%)
                                                           Less common findings: White structureless areas/lines (44%);
                                                           Purple structureless areas (36%); Linear-curved vessels (20%);
                                                           Perilesional structureless brown area (16%); Perifollicular
                                                           pigmentation (12%); Brown reticular lines (12%)




                                                                                                                Table1 continues




Review | Dermatol Pract Concept.2023;13(4)S1:e2023297S                                                                      13
 Table 1. Total number of studies, instances and prevalence of standardized dermoscopic findings of
                 inflammatory/pigmentary dermatoses in skin of color. (continued)
                                             Total number
                                              of instances
                                 Total      [instances with
                                number        dermoscopy
                                   of          prevalence
        Dermatosis              studies           data]                    Dermoscopic findings* (total prevalence)**
 Langerhans cell                    3              5 [5]         Common findings: Brown structureless area (60%)
 histiocytosis                                                   Less common findings: White structureless area (40%);
                                                                 Central brown dots (20%); Crust (20%); Perifollicular white
                                                                 homogenous area (20%); Purple structureless areas (20%);
                                                                 Brown dots (20%); Irregular vascular blotches (20%); Pale
                                                                 pinkish background (20%)
 Perniosis (idiopathic)             1            36 [36]         Common findings: Orange structureless areas (64%)
                                                                 Less common findings: Linear-curved vessels (44%); White
                                                                 dots/globules (39%); Diffuse orange structureless area (28%);
                                                                 Brown dots/globules (22%); Diffuse brown-orange structureless
                                                                 area (19%); White lines (11%); Dotted vessels (11%); Diffuse
                                                                 purple structureless area (8%); Purple dots/globules (6%)
 Sweat dermatitis                   1              2 [2]         Common findings: Yellow-white structureless areas (50%);
                                                                 Increased cutaneous markings along (clue) + brown
                                                                 structureless areas + brown scales (50%)
                                                                 Less common findings: -
*Dermoscopic findings for which a standardized terminology was available; these are divided into common (prevalence ≥ 50%) and less
common (prevalence < 50%)
**Total prevalence is calculated only considering studies for which prevalence data of dermoscopic findings was available




14                                                                              Review | Dermatol Pract Concept. 2023;13(4)S1:e2023297S
    Figure 2. Examples of dermoscopic clues of papulosquamous dermatoses in dark-skinned patients: Three-zone concentric pattern (cen-
    tral white/brown crust surrounded by structureless whitish-grey area with a peripheral brown structureless area in acquired perforating
    dermatosis (Kyrle disease) (A); Central brown star-like areas with peripheral white halo in Darier’s disease (B); Diffuse white scales and
    patchy brown scales in dermatitis (eczema) (C); Follicular plugs surrounded by white color in follicular eczema (arrow) (D); Twisted
    hairs forming loops and irregular coils with perifollicular scales in keratosis pilaris (E); Pigmentary structures typified by central brown
    dots and peripheral pigmentation (arrow) in lichen amyloidosis (F); Well-defined white globule devoid of skin markings in lichen nitidus
    (G); Blue crossing lines (Wickham striae) over a diffuse brown structureless area in lichen planus (H); White and grey-brown structure-
    less area along with scales and follicular plugs (arrow) in hypertrophic lichen planus (I).




Figure 3. Examples of dermoscopic clues of papulosquamous dermatoses in dark-skinned patients: Multiple brown-black and white struc-
tureless areas along with uniform dotted vessels with white halo and purple dots in lichen simplex chronicus (A); Central crust with peripheral
white structureless area in PLEVA (B); Brown dots over an ill-defined white area in pityriasis lichenoides chronica (healing stage) (C); Peripheral
white scaling collarette with jagged inner free edge along with diffuse brown area in pityriasis rosea (D); Follicular orange-yellow areas with
perifollicular scaling (arrow) in pityriasis rubra pilaris (E); Brown peripheral keratotic tract with double free edge in porokeratosis (F); White
peripheral keratotic tract with double free edge in porokeratosis (G); White structureless areas with peripheral white projections surrounded by
a peripheral brown area (H); Uniform dotted vessels along with brown and white structureless areas and white scales in psoriasis (I).

we have grouped them according to the clinical presentation.               homogenous area, and outer-zone of hyperpigmentation) or
Figures 2-8 show dermoscopic clues of such conditions.                     “two-zone” pattern (white homogenous area around central
                                                                           keratotic plaque, also called by the authors “white collar
Papulosquamous Dermatoses                                                  sign”) being the main presentations.
Acquired Perforating Dermatoses
                                                                           Acrokeratosis Verruciformis of Hopf
Data on acquired perforating dermatoses mainly comes from
a case series by Behera et al. [5], with either “three-zone                A single dermoscopic description of acrokeratosis verru-

concentric” pattern (central keratotic plug, middle white                  ciformis of Hopf is available from the literature [6], with
                                                                           whitish cerebriform lesions along with network pattern

Review | Dermatol Pract Concept.2023;13(4)S1:e2023297S                                                                                         15
Figure 4. Examples of dermoscopic clues of hyperpigmented dermatoses in dark-skinned patients: “Crista and sulcus cutis” pattern along
with follicular plugs in facial acanthosis nigricans (A); Grey, brown and blue dots in ashy dermatosis (B); Irregular cornflakes-like scales in
dermatosis neglecta (C); Brown circles and semicircles in exogenous ochronosis (D); Perifollicular pigmentation and perifollicular white color
in frictional melanosis (E); “Sulci and gyri” pattern in Gougerot-Carteaud syndrome (F).




Figure 5. Examples of dermoscopic clues of hyperpigmented dermatoses in dark-skinned patients: Grey and brown dots in lichen pigmen-
tosus (A); Pigmentary structures typified by central brown dots and peripheral pigmentation (arrows) in macular amyloidosis (B); Diffuse
brown structureless areas with ostial sparing (pseudonetwork) in melasma (epidermal type) (C); Diffuse brown structureless areas with ostial
sparing (pseudonetwork) and focal blue-grey structureless areas (arrow) in melasma (mixed type) (D); Intraostial brown dots (arrow) in Riehl
melanosis (E); Brown diffuse brown structureless areas with ostial sparing (pseudonetwork) as well as protruding yellow follicular plugs
(arrow) in seborrheic melanosis (F).



composed of yellowish-white septa delimiting holes with                  Darier’s Disease
dotted vessels inside being described.                                   Only a single dermoscopic report on Darier’s disease has
                                                                         been published [7], with dark brown globule and periph-
                                                                         eral whitish halo described as the main clues; other findings



16                                                                                Review | Dermatol Pract Concept. 2023;13(4)S1:e2023297S
Figure 6. Examples of dermoscopic clues of hypopigmented dermatoses in dark-skinned patients: Well-defined white structureless area with
peripheral projections (arrow) along with perieccrine pigmentation (arrowhead) in idiopathic guttate hypomelanosis (A); Ill-defined white
structureless area with incomplete perieccrine pigmentation (arrowhead) in pityriasis alba (B); Ill-defined white structureless area with dif-
fuse white scales in pityriasis alba (C); Ill-defined white area in progressive macular hypomelanosis (D); Well-defined bright white area with
perifollicular pigmentation in vitiligo (E); Well-defined bright white area along with perifollicular pigmentation and white hairs (leukotrichia)
in vitiligo (F).




included central light-brown follicular opening, brown lines              observed in one-fifth of described cases, while other findings
(exaggerated pseudo-network) and white scale.                             were less common.

Dermatitis (eczema)/Follicular Eczema                                     Lichen Nitidus
Most of the evidence for dermatitis comes from two case-­                 The main study on lichen nitidus is by Errichetti et al.
control studies (Errichetti et al. [8] and Nayak et al. [9]).             (case-control analysis) [8], who found a constant pattern
Both found patchy scales, especially yellow but also brown                consisting of white globules with sharp margins and lack
and white, to be most characteristic feature. Additional                  of skin creases in 13 instances. This is consistent with other
common findings (prevalence ≥50%) found by Errichetti                     two studies, one of them also reporting a central brown area
et al. included purple dots and fabric fibers, while Nayak                [13, 14].
et al. also observed brown-black dots/background and
                                                                          Lichen Planus
erosions.
    When it comes to follicular eczema, it presented a repet-             Most data on classic lichen planus (LP) comes from a study
itive pattern consisting of follicular plugs with perifollicular          by Jose et al. on 108 patients [15] which showed blue glob-
white color [8].                                                          ules and Wickham striae (WS) as predominant features, being
                                                                          found in 100% and 92.6% of cases, respectively. Similarly,
Keratosis Pilaris                                                         Errichetti et al. [8] confirmed the high prevalence (>90%) of
A single report on keratosis pilaris showed twisted hairs                 WS in a case-control analysis involving 32 instances. This
forming loops and irregular coils, vellus hairs, peripilar focal          finding is in line with further studies including smaller sam-
casts, and brown structureless areas and dots [10].                       ples of patients. Of note, WS have been reported to show a
                                                                          white, yellow, or bluish hue. Unlike lighter phototypes, ves-
Lichen Amyloidosis                                                        sels displayed a relatively low prevalence.
Three studies have investigated dermoscopy of lichen amy-                     Moving to LP variants, data are available for hypertro-
loidosis, with a two-zone pattern (central brown/white dot/               phic LP, actinic LP, and palmoplantar LP. In detail, follicu-
globule and peripheral pigmentation) and pigmented dots/                  lar plugs (sometimes referred to as comedo-like openings)
globules (brown, grey, blue) being the typical features [8, 11,           are the main finding of the hypertrophic LP, whereas actinic
12]. Brown structureless areas and white dots/globules were               LP and palmoplantar LP have been reported to show focal/



Review | Dermatol Pract Concept.2023;13(4)S1:e2023297S                                                                                       17
Figure 7. Examples of dermoscopic clues of granulomatous and facial inflammatory dermatoses in dark-skinned patients: Ill-defined white
structureless areas in granuloma annulare (interstitial variant) (A); Orange-yellow structureless areas along with sharp linear vessels with
branches (better seen in the inset) in necrobiosis lipoidica (adapted from Dermoscopy in General Dermatology for Skin of Color, Errichetti E,
Lallas A, eds. CRC Press 2021) (B); Yellow structureless area with peripheral brown reticular lines in sarcoidosis (Courtesy of Emilio Dognini,
MD – Brescia, Italy) (C); Brown follicular plugs over bright white areas in cutaneous lichen sclerosus (D); Ill-defined dull white areas in mor-
phea (E); Follicular plugs/rosettes along with bright white areas in discoid lupus erythematosus (scarring stage) (F); Follicular plugs/rosetted
as well as crossing white lines (Wickham striae) in lichen actinicus (G); Blurred purple linear vessels arranged in a reticular pattern along with
perieccrine/perifollicular pigmentation (arrow) in rosacea (H); Ill-defined dull white areas and patchy white scales in seborrheic dermatitis (I).




diffuse brown structureless areas with ostial sparing along                vessels, white rim of scaling and focal bluish-greyish areas/
with WS and a peculiar “hem-like” pattern of brown pig-                    centrifugal strands irregularly distributed at the periphery
ment distribution along the ridges of the dermatoglyphics,                 observed in late stages.
respectively.                                                                  With regard to pityriasis lichenoides chronica, the only
                                                                           available study is the case-control study by Errichetti et al.
Lichen Simplex Chronicus                                                   [8], who reported peripheral white scaling with a smooth
A single case analyzed in a case-control study showed dotted               inner free edge as the peculiar pattern. Pigmentary structures
vessels with unspecified distribution and grey/blue structure-             were also quite common (26.7%-40.0%), including brown
less areas [16].                                                           dots and focal or diffuse brown structureless areas.

Pityriasis Lichenoides                                                     Pityriasis Rosea
Dermoscopy of pityriasis lichenoides et varioliformis acuta                The main study on pityriasis rosea is a case-control analysis
was investigated only by a case series by Ankad et al. [17]                by Errichetti et al. [8], who found peripheral white scales
is available, with brown structureless area, central scaling               (jagged inner free edge) to be the typical pattern. This was in
rim and peripheral dotted vessels found in early lesions and               line with other studies, that also observed other common but
white structureless areas, central crust, peripheral dotted                less specific findings, especially dotted vessels.



18                                                                                  Review | Dermatol Pract Concept. 2023;13(4)S1:e2023297S
Figure 8. Examples of dermoscopic clues of miscellaneous inflammatory conditions in dark-skinned patients: Purple globules/spots along
with reticular brown lines in capillaritis (A); White structureless areas along with brown structureless areas, dots and globules in acute
cutaneous lupus erythematosus (generalized rash) (B); Brown dots and mixed vascular pattern (linear, linear-curved, and dotted vessels) in
subacute cutaneous lupus erythematosus (C); Reticular brown lines in urticaria pigmentosa (D); Brown reticular lines and dots/globules in
dermatomyositis (E); Pigmented dots of variable color (brown, grey and blue) and size in fixed drug eruption (F); Diffuse yellow structureless
area with perilesional brown area (halo) in juvenile xanthogranuloma (G); Brown and purple structureless areas in langerhans cell histiocy-
tosis (H); Increased cutaneous markings along with brown scales (I).




Pityriasis Rubra Pilaris                                                 Prurigo Nodularis
The only study on dermoscopy of pityriasis rubra pilaris                 Three studies are available (two case-control and a cross-­
is the analysis by Errichetti et al. [8] investigating four in-          sectional study) [8, 18, 19]. All of them reported peripheral-­
stances, that found follicular plugs being a constant finding,           radiating white lines to be the hallmark of prurigo nodularis;
followed by perifollicular yellow halo seen in three cases.              other common findings included erosions and dotted vessels
                                                                         with unspecific distribution.
Porokeratosis
Most data comes from the case-control analysis by Errichetti             Psoriasis
et al. [8] involving 10 patients, that showed a constant pat-            Psoriasis is one of the inflammatory dermatoses with the
tern consisting of brown/white peripheral keratotic tract                highest degree of evidence regarding the usefulness of der-
with a double free edge. Other studies confirmed this finding,           moscopy in its diagnosis, with four case-control and one case
regardless clinical subtype (superficial disseminated poroker-           series study [8, 9, 20-22] available from the literature be-
atosis and porokeratosis of Mibelli). Pigmentary structures              sides a single case report [23]. The main dermoscopic feature
(e.g., brown dots/areas) may also be observed.                           of psoriasis for all analyzed clinical variants (plaque-type,
                                                                         follicular, and guttate) was the presence of dotted vessels
                                                                         (60-100% of cases) with unspecific or uniform distribu-
                                                                         tion, that were often found along with white scales (around



Review | Dermatol Pract Concept.2023;13(4)S1:e2023297S                                                                                    19
three-fourths of cases) showing patchy or, most commonly,          Macular Amyloidosis
diffuse arrangement. Other relevant findings included pig-         Dermoscopy of macular amyloidosis has been assessed in
mented structures (brown, grey, blue structureless areas, dots     three studies (two case-control [8, 12] and case series [11]).
or globules).                                                      Two main presentations have been reported, i.e., (I) central
                                                                   brown/white dot/globule with peripheral pigmentation with/
Hyperpigmented Dermatoses                                          without focal white structureless areas and (II) pigmented
Ashy Dermatosis                                                    (black, brown, grey or blue-grey) dots arranged in a clus-
The main analysis on ashy dermatosis is the case-control           tered pattern, with/without rippled pigmentation (alternat-
study by Errichetti et al., [8] who found the presence of grey/    ing parallel hyperpigmentation and hypopigmentation), or
blue dots to be the most typical finding, with a characteristic    “jigsaw puzzle” pattern.
periostial arrangement in facial lesions. Brownish or grey-
blue dots were also reported by a smaller analysis on four         Melasma
patients [16].                                                     Melasma is one of the most investigated pigmentary dermato-
                                                                   ses from a dermoscopic point of view, with seven studies be-
Dermatosis Neglecta
                                                                   ing retrieved (one case-control study [8], four case series [25,
Only a single dermoscopic case report does exist [24]; the
                                                                   30-32], and two case reports [26, 33]). The most common
authors observed brown scale with unspecific distribution.
                                                                   feature was the presence of brown structureless areas with os-
Exogenous Ochronosis                                               tial sparing (pseudonetwork). Of note, diffuse distribution of

Most of data on dermoscopy of exogenous ochronosis (EO)            such areas turned out to be indicative of melasma over other

comes from the case-control study by Errichetti et al. [8],        facial pigmentary dermatoses according to the case-control

that found the following findings to be characteristic of EO       study by Errichetti et al. [8]. Other less common/less specific

over other facial pigmentary dermatoses: interostial brown/        findings are also possible (Supplemental Table), with grey

grey semicircles and circles, interostial brown/grey globules,     structureless areas with ostial sparing (pseudonetwork) and

focal brown structureless areas with ostial obliteration, and      interostial brown dots possible related to dermal variants.

focal white structureless areas. Other case series [25, 26]
                                                                   Riehl Melanosis
were in line with such observations, especially with regard to
                                                                   The only study on Riehl melanosis is the case-control analysis
semicircles/circles and ostial obliteration.
                                                                   by Errichetti et al. [8], who evaluated a total of 17 subjects and
Frictional Melanosis                                               observed brown dots showing either inter- or intra-ostial dis-

Two studies investigating dermoscopy of frictional melanosis       tribution, with only the last arrangement found to be specific.

(FM) have been retrieved, including a case-control study [8]
                                                                   Other Less Common Hyperpigmented Dermatoses
and a single case report [27]. Although several findings have
                                                                   Dermoscopic features of acanthosis nigricans, acquired der-
been described (i.e., focal white structureless areas, reticular
                                                                   mal macular hyperpigmentation, facial pigmentary demarca-
brown lines, focal brown structureless areas, white globules,
                                                                   tion lines, maturational hyperpigmentation, photomelanosis,
brown dots and globules), only the presence of perifollicular
                                                                   and seborrheic melanosis in skin of color patients have been
white color has been reported to be characteristic of FM.
                                                                   also described. Most of the evidence comes from case reports/
Gougerot-Carteaud Syndrome                                         series and data are shown in Table 1 and Supplemental table.

Three instances with dermoscopic descriptions have been
                                                                   Hypopigmented Dermatoses
reported by Errichetti et al. [8]. The most common finding
                                                                   Idiopathic Guttate Hypomelanosis
was the presence of polygonal brown areas (cobblestone pat-
tern), followed by “sulci and gyri” pattern.                       A total of 42 instances of idiopathic guttate hypomelanosis
                                                                   have been investigated by two studies, including a case se-
Lichen Planus Pigmentosus                                          ries [34] and a case-control analysis [8]. The most frequent
Current knowledge on dermoscopy of lichen planus pigmen-           finding was the presence of well-defined white structureless
tosus (LPP) beyond the face mainly comes from two case series      areas, perifollicular/perieccrine pigmentation, and periph-
by Sharma et al. [28] and Pirmez et al. [29], with brown dots/     eral white projections, with only the last two features being
globules being described as the most characteristic feature in     found significantly more common over other common hy-
both of them, consistently with other minor studies. Nota-         popigmented dermatoses.
bly, brown dots have been reported also in facial LPP, with a
periosteal distribution found to be specific compared to other
common facial pigmentary diseases by Errichetti et al. [8].



20                                                                         Review | Dermatol Pract Concept. 2023;13(4)S1:e2023297S
Pityriasis Alba                                                   consisting of yellow to orange structureless areas (mainly
Knowledge on pityriasis alba comes from the case-control          diffuse). Several additional findings have been reported, with
study by Errichetti et al. [8], that showed ill-defined white     white structureless areas, focused vessels (linear or linear
structureless areas and incomplete perieccrine brown pig-         vessels with branches of unspecific distribution) and white
mentation (semi-circles) as main findings.                        scale being the most common ones [8, 41-44].

Progressive Macular Hypomelanosis                                 Rheumatoid Nodules
Only two instances of progressive macular hypomelanosis           Based on the case-control study by Ramadan et al. [41] in-
with dermoscopic description have been retrieved [8], with        cluding five subjects with rheumatoid nodules, white struc-
smooth, ill-defined, diffuse white structureless area being the   tureless areas, linear vessels or linear vessels with branches
only reported finding.                                            (of unspecific distribution), and brown lines (in reticular dis-
                                                                  tribution) were the most common features.
Vitiligo
Vitiligo is the pigmentary disorder with the highest number       Sclerotic Dermatoses
of published dermoscopic studies (2 case series [35, 36], 2       Cutaneous Lichen Sclerosus
case-control [8, 37], and 3 case-reports [38-40]). Bright white   Only the case-control study by Errichetti et al. [8] investi-
structureless areas (with sharp and convex margins), intrale-     gated dermoscopy of cutaneous lichen sclerosus (11 pa-
sional pigmentation (structureless or network-like), and per-     tients), with focal/diffuse bright white areas and follicular
ifollicular pigmentation were the commonest features; other       plugs being the main clues.
possible clues included white hairs (leukotrichia), perifollic-
ular depigmentation, marginal pigmentation, and reversed          Morphea
pigmentary network. In a single report, the so-called “blue       Most of evidence on morphea comes from the case-control
vitiligo” was found to show scattered blue dots on the side of    study by Errichetti et al. [8] involving 14 subjects, that found
the hypopigmented macule along with pigmented hairs with          focal dull white areas to be the main clue. Linear vessels with
perifollicular pigment [39].                                      branches (unspecific distribution) and white or yellow dots/
   Differences have been described based on disease ac-           globules have been described less commonly.
tivity: unstable lesions have been reported to show less de-
fined margins giving rise to specific patterns (i.e. trichrome,   Facial Inflammatory Dermatoses
“starburst” and “comet tail”), small white globules in perile-    Discoid Lupus Erythematosus
sional skin (described as satellites, confetti-like pattern and
                                                                  Most data on dermoscopy of discoid lupus erythematosus
“tapioca sago” appearance) and/or micro-Koebner’s phe-
­
                                                                  (DLE) comes from the case series by Ankad et al. on 110
nomenon (i.e. depigmented streaks along the line of trauma
                                                                  patients [45], with follicular plugs and perifollicular white
around the main vitiligo patch), while sharp borders and
                                                                  color being the most common features (>50% of cases). Such
perilesional pigmentation were considered signs of stability.
                                                                  findings have been reported regardless localization (facial vs
                                                                  extra-facial). The importance of follicular plugs as diagnos-
Granulomatous Dermatoses                                          tic clue of facial DLE has also been underlined by Errichetti
Granuloma Annulare                                                et al. [8]. Several other minor dermoscopic structures have
A dermoscopic case-control study by Ramadan et al. [41]           been described in these and other studies.
involving four patients with granuloma annulare showed
white and yellow structureless areas along with brown lines       Lichen Actinicus
in a reticular distribution as the main findings.                 See lichen planus section.

Necrobiosis Lipoidica                                             Perioral Dermatitis
According to the study by Ramadan et al. [41] on two sub-         A single dermoscopic report on perioral dermatitis has been
jects with necrobiosis lipoidica, the most indicative dermo-      found in the literature search [46], with dark-brown pigment
scopic features were short linear vessels/linear vessels with     network being the only described feature.
branches (unspecific distribution) along with white/yellow
structureless areas and brown reticular lines.
                                                                  Rosacea
                                                                  The main description about dermoscopy of rosacea results
Sarcoidosis                                                       from the analysis of 11 patients by Errichetti et al. [8],
Several studies have investigated dermoscopic findings of         with linear vessels in reticular distribution being found its
sarcoidosis, with most of them showing a repetitive pattern       hallmark, in line with a single report [47]. Additionally,



Review | Dermatol Pract Concept.2023;13(4)S1:e2023297S                                                                        21
perieccrine/perifollicular pigmentation was also commonly                      Medicine. Retrieved July from https://www. cebm. net/wp-content
observed (8/11).                                                               /uploads/2014/06/CEBM-Levels-of-Evidence-2.1. pdf, 2011.
                                                                          4.   Errichetti, E., et al., International Dermoscopy Society criteria
Seborrheic Dermatitis                                                          for non-neoplastic dermatoses (general dermatology): valida-
                                                                               tion for skin of color through a Delphi expert consensus. Int J
Based on the case-control study by Errichetti et al. includ-
                                                                               ­Dermatol, 2022. 61(4): p. 461-471.
ing 10 subjects [8], focal dull white structureless areas and             5.    Behera, B., et al., Dermoscopic features of acquired perforating
patchy yellow/brown scales/crusts are the main dermoscpic                       dermatosis: a retrospective analysis of 19 cases. Clin Exp Derma-
clues of seborrheic dermatitis.                                                 tol, 2021. 46(1): p. 184-187.
                                                                          6.    Llamas-Molina, J.M., et al., Acrokeratosis verruciformis of
                                                                                Hopf: dermoscopy approach in dark skin patients. J Eur Acad
Miscellaneous                                                                   Dermatol Venereol, 2022. 36(11): p. e944-e945.
Such a group encompasses other inflammatory dermatoses                    7.    Adya, K.A., A.C. Inamadar, and A. Palit, Dermoscopy of Local-
                                                                                ized Darier’s Disease in Fitzpatrick Type IV Skin. Indian Derma-
retrieved in the review analysis that are not classifiable in
                                                                                tol Online J, 2020. 11(2): p. 298-300.
the previous clinical patterns, including capillaritis, cutane-           8.    Errichetti, E., et al., Dermoscopy in general dermatology
ous lupus erythematosus (acute and subacute), cutaneous                         (non-neoplastic dermatoses) of skin of colour: a comparative ret-
mastocytosis, dermatomyositis, fixed drug eruption, Fox-                        rospective study by the International Dermoscopy Society. Eur
Fordyce disease, Hailey-Hailey disease, juvenile xanthogran-                    J Dermatol, 2020. 30(6): p. 688-698.
uloma, Langerhans cell histiocytosis, perniosis (idiopathic),             9.    Nayak, S., et al., Dermoscopy of general dermatological condi-
                                                                                tions in Indian population: A descriptive study. Clinical Derma-
and sweat dermatitis. Most of data about such entities comes
                                                                                tology Review, 2017. 1(2): p. 41-51.
from single case reports and described dermoscopic findings              10.    Sonthalia, S., J. Bhatia, and M. Thomas, Dermoscopy of Kerato-
are showed in Table 1/Supplemental Table.                                    sis Pilaris. Indian Dermatol Online J, 2019. 10(5): p. 613-614.
                                                                         11. Behera, B., et al., Dermoscopic features of primary cutane-
                                                                             ous amyloidosis in skin of colour: A retrospective analysis of
Conclusions                                                                  48 patients from South India. Australas J Dermatol, 2021. 62(3):
                                                                             p. 370-374.
Literature data on dermoscopic patterns of inflammatory                  12. Dincy Peter, C.V., et al., Dermoscopy in Cutaneous Amyloido-
dermatoses in skin of color is significantly growing, with                   sis. - A Prospective Study from India. Indian J Dermatol, 2022.
many articles being published in recent years. However, the                  67(1): p. 94.
                                                                         13. Jakhar, D., et al., Dermatoscopic features of lichen nitidus.
majority of the papers focalized on a limited number of der-
                                                                             ­Pediatr Dermatol, 2018. 35(6): p. 866-867.
matoses (e.g., psoriasis, lichen planus, pityriasis rosea, DLE,
                                                                         14. Malakar, S., S. Save, and P. Mehta, Brown Shadow in Lichen
sarcoidosis, and vitiligo), with several conditions having only               Nitidus: A Dermoscopic Marker! Indian Dermatol Online J,
                                                                              ­
single dermoscopic descriptions. Notably, apart from few                      2018. 9(6): p. 479-480.
studies, most of published data shows a low level of evidence,           15. Jose, S. and G. Kurien, Diagnostic dermoscopic features and the
thereby preventing an evaluation of diagnostic accuracy of                    correlation between dermoscopic and histopathologic features in
                                                                              lichen planus. International Journal of Research in Dermatology,
reported dermoscopic findings. Additionally, some studies
                                                                              2020. 6(5).
investigated the entire spectrum of “skin of color” without
                                                                         16. Garg, P. and T. Kaur, Study of the Dermoscopic Findings and
subanalyses comparing the different phototypes (IV-VI), with                  Their Correlation with Histopathological Findings in Various
consequent potential biases as possible differences between                   Lichenoid Dermatoses. Journal of Clinical & Experimental
dark (phototype IV) and very dark (V/VI) skin tones may ex-                   ­Dermatology Research, 2015. 06(06).
ist. Finally, our review highlighted a remarkable variability in         17. Ankad, B.S. and S.L. Beergouder, Pityriasis lichenoides et vario-
                                                                               liformis acuta in skin of color: new observations by dermoscopy.
the terminology used in published studies. Therefore, future
                                                                               Dermatol Pract Concept, 2017. 7(1): p. 27-34.
studies designed with a systematic approach are needed to in-
                                                                         18. Hanumaiah, B. and J.M. Joseph, Role of Dermoscopy in the
crease the value of inflammoscopy in dark-skinned patients.                    ­Diagnosis of Hypertrophic Lichen Planus and Prurigo N  ­ odularis.
                                                                                Indian J Dermatol, 2019. 64(5): p. 341-345.
                                                                         19. Ankad, B.S. and S.L. Beergouder, Hypertrophic lichen planus
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