Dermaimaging

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.

Presenting complaint: a 15-year-old woman was referred with the diagnosis of Raynaud´s disease for 1 year.

Physical examination and laboratory without remarks
 
What to see at capillaroscopy:

morphology and number of capillary loops were normal. Six months capillaroscopic follow-up was suggested

In a 15-year-old woman, on the abdomen

What to see at dermoscopy:

-regular globular pattern
-irregular blue-white veil distribution

Dermoscopy in favor of dermal nevus. Regular control was suggested

In a 63-year-old man, on the back

What to see at dermoscopy:

-multicomponent pattern
-atypical pigment network
-negative pigment network (circle)
-regression area (scar-like depigmentaton) [arrow]
-structureless areas
-hypopigmented areas

Dermoscopy in favor of melanoma and histopathology confirmed the diagnosis.

In a 55-year-old woman, on the shoulder

What to see at dermoscopy:

-lesion greater than 5 mm
-atypical reticular pattern (some areas with broadened pigment network)
-globules (rares)
-hypopigmented areas
-structureless area

Extirpation was indicated. Histopathology correlation was: lentiginous junctional nevus