DermatopathologyOral presentationsDP01 A single-centre cross-sectional observational study on dermoscopy of genital mucosal disorders and histopathological correlation in a tertiary care centre
Authors: K Shreya, Dinesh Asati
Journal: British Journal of Dermatology (2024)

Abstract Dermoscopy of mucosa is known as mucoscopy. Mucoscopy can aid in delineating minute aspects of mucosal lesions and will help to differentiate similar-looking lesions. The aim of this study is to describe mucoscopic features and correlate them with histopathology in various genital mucosal diseases. The study was conducted at a tertiary care centre between October 2020 to April 2022 after Institutional Human Ethics Committee approval. The sampling technique was based on the convenience purposive method. Any patients with mucosal disease receiving treatment or planning to receive treatment, and aged ≥ 18 years were included. Patients with clinically diagnosed sexually transmitted diseases, except for warts and molluscum, were excluded. All patients fulfilling the inclusion criteria were examined after informed consent was obtained, and clinical images were photographed using an iPhone 11. Dermoscopic images were taken using a DermLite DL4 dermatoscope (3Gen Inc., San Juan Capistrano, CA, USA) in both polarized and nonpolarized modes at 10 × magnification. In total, 200 patients were recruited and their mucoscopic features analysed. Mucoscopy of Fordyce spots showed a white–yellow discrete globule (100%) and central white dots (33%). The dermoscopic features of lichen planus were white structureless areas (41%), white radial lines (65%) and Wickham striae in the reticulate and annular variants (four cases). A tricolour pattern was seen in the erosive variant (two cases). Dermoscopy of molluscum showed a central white structureless area (100%) and crown vessels (50%), which correspond to cytoplasmic inclusions and ectatic vessels, respectively. Rosette was seen in all cases (100%). Genital verrucae on mucoscopy showed white perpendicular nontranslucent projections with pointed hyperkeratotic tips and a fused base. Mucoscopy of lichen sclerosus showed white structureless areas (100%), follicular plugs (35%) and dotted and linear vessels (80%). Circinate balanitis revealed regular red dotted vessels (100%), and coalescing pustules in an annular and polycyclic pattern (90%). Squamous cell carcinoma of the penis showed ulceration; serpentine, looped vessels; white structureless areas, a pink background; and yellow–brown crust. Hidradenoma papilliferum revealed central linear curved vessels with pink structureless areas and peripheral shiny white areas. Here, central linear curved vessels correspond to the fibrovascular core, and pink structureless areas correspond to the cystic space histopathologically. Limitations of our study include the small sample size, biopsies not being done in all cases, and the inability to assess variations in mucoscopic features in patients on therapy. Haziness while capturing pictures due to mist formation reduced the quality of the pictures. Various dermoscopic studies have been published, but mucoscopy is still a grey area. This study reveals the dermoscopic features of various genital disorders. However, biopsies were not done in all mucosal disorders, and thus conclusive correlation could not be performed.