Study of the Dermoscopic Findings and Their Correlation with Histopathological Findings in Various Lichenoid Dermatoses

Background: Lichenoid disorders are often difficult to diagnose clinically. Dermoscopy can act as an alternative technique to skin biopsy for diagnosis of various lichenoid dermatoses. Study aim: To study the correlation of dermoscopic with histopathological findings in various lichenoid dermatoses Methods: Fifty patients with clinical picture of lichenoid dermatoses were examined first under the dermoscope, followed by skin biopsy from the same site. The findings of both methods were recorded and correlated. Results: Nonvascular findings were the predominant features on dermoscopy out of which white structures were present in 93.33% of patients of classical lichen planus, 50% of actinic lichen planus, 90% of lichen planus hypertrophicus, 50% of lichen planopilaris and in only the case of lichen simplex chronicus. In classical lichen planus patients, a particular pattern of white structures with linear streaks arranged in a radial manner (starburst pattern) was observed. In lichen planus, it is suggested that the white structures on dermoscopy corresponded histologically to hyperkeratosis. Gray-blue dots or brown punctate areas represented melanophages in dermis. In lichen planus pigmentosus and ashy dermatosis patients, no specific patterns could be observed. In lichen planus hypertrophicus, white structures, corn pearls and comedolike openings appeared to represent hyperkeratosis and hypergranulosis, while pigmentation of variable colors could be due to presence of melanophages in the dermis. Conclusion: Dermoscopy can be a valuable tool for the dermatological diagnosis and may obviate need for skin biopsy.