In a 50-year-old man, on the hip
What to see at dermoscopy:
-globular pattern
-terminal hairs with perifollicular hypopigmentation
-structureless areas
-erythema
-milia-like cysts
Dermoscopy in favor of dermal nevus. Regular control was suggested
Present complaint: a 64-year-old woman experienced muscle weekness of the shoulder girdle
Physical examination: Heliotrope erythema and edema of the lower lid
Laboratory: increased creatine kinase level
What to see at Capillaroscopy:
-disorganization of the normal capillary array
-ramified/bushy capillaries (white arrow)
-loss of capillaries with avascular areas (gray arrow)
Comments: capillaroscopy in favor of late scleroderma pattern. Additional studies (eletctromyography and muscle biopsy) were suggested to confirm the diagnosis of dermatomyositis
In a 23-year-old man, on the back
What to see at dermoscopy:
-blue-red to blue-black lacunae
-blue-white veil
-red halo of erythema
Dermoscopy in favor of vascular lesion. The confluent blue-black pigmentation sharply demarcated at the periphery suggests partially thrombosed lesion.Such lesions can sometimes be confused with nodular melanoma. Short follow-up was recommended
In a 57-year-old woman, on the back
What to see at dermoscopy:
-multicomponent pattern
-atypical pigment network
-negative pigment network
-regression areas (scar-like depigmentation)
-structureless areas
-hypopigmented areas
-vascular polymorphism
-erythema
Extirpation was indicated. Dermoscopy in favor of melanoma.
Present complaint: a 55-year-old woman presented 5 months earlier for arthromyalgias, fatigue, and muscle weekness which was more evident at the lower limb level.
Physical examination and laboratory: Gottron´s papules on both hands and Raynaud´s phenomenon. Elevated erythrocyte sedimentation rate and augmented levels of CPK and LDH; anti-jo-1 positivity. Electromyography examination impairment and muscle biopsy showed perivascular lymphomonuclear infiltrates with degenerative zones and necrosis.
What to see at Capillaroscopy:
-avascular areas (white arrow)
-megacapillaries (black arrow)
-frequent microhemorrhages (red arrow) and hyperkeratotic cuticle
-ramified vessels alternating with avascular areas (yellow arrow)
Comments: This case shows severe nailfold capillaroscopy (NC) abnormalities in a patient with dermatomyositis. The observation of dermatomyositis-specific NC changes in a “active” scleroderma pattern provides useful information that contributes to an early diagnosis, helps identify those with poor prognosis and assessment of response to treatment in dermatomyositis.