Dermaimaging

In a 43-year-old man, on the back (years of evolution)

What to see at dermoscopy:

-erythema
-giant comedo-like openings (circle)
-giant milia-like cysts
-scaly surface

Dermoscopy in favor of Darier´s disease and histopathology confirmed the diagnosis.

Comments:variable vascular structures (red dots, red lines or erythema) associated with giant comedo-like openings were previous demonstrated as dermoscopic pattern in patients with Darier´s disease.
For more information read: Vázquez-López F et al in “The handheld dermoscope improves the recognition of giant pseudocomedones in Darier´s disease. 2004. J Am Acad Dermatol 50(3): 454-455

In a 46-year-old woman, on the dorsa of hand

What to see at dermoscopy:

-raised and hyperqueratotic border (arrow)
-central light brown pigmentation                                                                                                                                                                                                                                  Dermoscopy in favor of porokeratosis

Comments: the dermoscopic findings are present even in early lesions; the hiperqueratotic border corresponds to the histological cornoid lamella

In a 53-year-old woman, multiple lesions on the sole. 

What to see at dermoscopy:

First picture corresponds to double hyperkeratotic papules with a central black dot (under the nail plate). At the second picture, the right lesion was gently shaved and white ovoid structures over the skin were observed which corresponds to eggs.
Dermoscopy in favor of tungiasis

Comments: There is upcoming evidence that dermoscopy facilitates the in vivo diagnosis of skin infections and infestations (viral warts, molluscum contagiosum, scabies,
 pediculosis, tinea nigra, tungiasis, cutaneous larva migrans). For more information read: Cabrera R. et al, Br J Dermatol, 2009. 160: 1136-1137

In a 35-year-old man, on the scalp

What to see at dermoscopy

-hair diameter diversity
-brown halo at the follicular ostium around the emergent hair shaft
-focal atrichia (empty follicles)
Dermoscopy in favor of androgenetic alopecia

Comments: androgenetic alopecia (AGA) is the most common form of hair loss (80 and 50% of men and women, respectively). Hair thinning is limited to the frontal, temporal, and vertex areas (androgen-dependent scalp regions) and dermoscopy is usefull to detect early AGA and for differential diagnosis with telogen effluvium.

In a 45-year-old woman, on the scalp

What to see at dermoscopy:

-loss of follicular openings
-follicular pluggings
-incontinentia pigmenti
-erythema
-arborizing vessels
-telangectasia
-peripilar casts
Biopsy was indicated
Histopathology correlation: discoid lupus erythematosus

Comments: the differential diagnosis of this lesion includes lichen planopilaris.
For more information: Ross et al.. Videodermoscopy in the evaluation of hair and scalp disorders. 2006. J Am Acad Dermatol 55: 799-806